How do I get someone to take a shower when they are violently combative, especially if they are soiled and must be bathed right away?
Dear Getting Hit,
In my training presentations, I often refer to this situation as a “lactose moment”. As they age, some people become lactose intolerant and will have very explosive bouts of diarrhea. This is a particularly tricky situation for someone with dementia, as they may not have time to process what is happening and find their way to the bathroom. While your loved one may not have all the capabilities she once had, be assured she will still find this occurrence very embarrassing.
Absolute #3 of the Ten Absolutes says, Never Shame, Instead Distract. In this case, the distraction you will use will be the “befriending or rescuing” technique that can include a little bribery, if necessary. When you see someone in this situation it is best to find something large like a sheet or towel, and approach them and say very quietly, “you must be uncomfortable, let me help.” Wrap the sheet around them so the cold, embarrassing area is completely covered. Then, with an arm on one shoulder, have them walk with you towards an area where they can be assisted with bathing.
If they already hate bathing and are reluctant to go into the bathroom, it is perfectly alright to offer them a cup of coffee and a comfortable chair just outside or maybe even inside the bathroom. Once you get them to relax a bit, you can usually get them to move to a chair inside the shower area. If they don’t yet trust you to remove the sheet and clothing, then make certain the water is warm and comfortable. Show them the warm water with the shower wand. Then, while talking in a comforting tone, remove their shoes and socks and start running the water on the lower part of the body, even while their clothing is still on. It helps clean the clothing, and as it gets wetter it will become more uncomfortable and then you can assist them with removing the wet things. Make certain you offer them a towel or two to cover up with as the clothing is being removed to maintain their modesty and dignity. This works almost every time. Lastly, you can assist them with wrapping in a towel or another sheet and possibly even helping them get dressed before leaving the shower room.