How do I get someone to take a shower when they are combative?
Rose L. in Madison
Dear Rose,
Bathing is a very difficult challenge, not only for the Alzheimer’s sufferer, but also for the caregiver. It is important for the caregiver to think first about the issue and put themselves in the position of the person with Alzheimer’s. That can best be done with a question: Is there anyone in your life that you would allow to give you a shower, because they think you need one? Would it be your parent, your child, your sibling, your spouse, your best friend, or your neighbor?
Think of it this way: having your clothing removed is a very personal and private act, and if another person were to remove your clothes without your consent, it would make you (or anyone) very combative. With that in mind, we need to then focus on the outcome – not necessarily the task. The outcome should be to maintain ones skin in good health by keeping it clean. One tool I have learned is that bathing can be done little by little, in a soothing, spa fashion, rather than giving a full shower. In addition, one must also take the time to create a rapport during bath time and develop trust regarding this private issue.
Start with several washcloths handy, and begin with a foot soak. You can roll up your loved one’s pant legs, sit on the floor and just let her soak her feet while you wash up to the knees. If that is going well, you can then start with a new warm cloth for the face. Next, move to the neck and remove the shirt or blouse “so it doesn’t get wet.” Remember, only do this if you are in a private place. You can then wash the arms, and after you dry them, apply either powder or lotion. This is not only soothing but helps the Alzheimer’s patient stay fresh and feel pampered. You may find that as you continue with this practice, “bath” time becomes less confrontational and more relaxing, and you can move closer to a full bath one step at a time.
If bath time has been difficult for some time, it may require a bit of conditioning for your loved one to feel safe again. Remember that he or she communicates primarily through emotions, and may not remember the events of the last bath time but will remember the feeling, whether fearful or comforting. Forcing someone into the shower, even if you feel you must because you have an unsanitary or “smelly” situation, creates negativity in relation to bath time. This makes it increasingly difficult for you in the future – she will remember the experience and fight it every time. When a peaceful bathing routine is established, you can avoid the fight or flight reaction.