Bathing and Alzheimer's Disease

By Chris Woolston, M.S.

Alzheimer's disease steals a person's privacy as surely as it steals memory. At a certain stage, your loved one may recall a time when she could bathe herself, but that time has passed. As a caregiver, it's your job to keep her clean while maintaining her comfort and dignity.

The job description will change constantly with the disease. At first, the person in your care may feel embarrassed about undressing in front of you. You can ease his mind by giving him a towel or shower blanket to drape over himself. If he is still able to do so, he'll also feel better if he can do most of the scrubbing. Just give him clear, step-by-step instructions as he goes along.

Maintaining comfort and safety

Modesty wears off with time, but new problems will set in. The person with Alzheimer's may become frightened or confused by a shower or the sound of running water, or she may fear drowning in a bathtub. If she seems alarmed, try changing your approach. For instance, it might help to put water in the tub before she enters the room, or to allow her to watch you run the water. She may prefer a sponge bath to a shower if, for example, the sound of the water hitting the tiles or tub is unsettling her (this is common among Alzheimer's patients).

If bath time is still distressing, consider buying a bath chair and a hand-held shower hose. The chair can be a way to help her relax, and you will worry less about slips and falls.

When bathing a person with Alzheimer's, safety is a very real concern. Check the temperature of the water, keep the bathwater no more than six inches deep, install a nonskid bath mat, and don't use any slippery bath oils or soaps. If you have a tub, you may want to have your loved one sit on a chair beside the tub, then move her legs over the side from a seated position. Most important, don't turn away for even a moment.

Here are some other tips for making bath time go smoothly:

• If balance and muscle weakness are concerns, have grab bars and handrails installed near the shower, toilet and wash basin. Have the toilet seat raised, too, if possible.
• Set up a routine for bathing and tooth-brushing. If it continues to be a struggle, it's okay to wait a few days between baths. Do spot-washing with sponges instead.
• Warm up the bathroom before helping someone undress older people are more sensitive to changes in temperature.
• Check the water temperature is just right. Installing a simple sensor on the bathtub that changes color if its too hot or too cold.
• Change out any door locks that lock from the inside. Your loved one might lock himself in by accident and panic.
• If he claims he doesn't need a bath, don't argue. Just keep giving him clear, simple instructions in a calm and loving tone to help him get ready.
• Don't ignore a person's genital or anal area for the sake of dignity. There's nothing dignified about a nasty rash. If your loved one can't wash these areas daily, gently do it for her.
• Make sure the person is completely dry, and put body powder or cornstarch in rolls of skin or under a woman's breasts.
• If a person refuses to bathe, use regular sponge baths as a last resort. Keep an eye out for red spots or rashes, so you can treat them before they become severe; consult your health provider right away if they are long lasting or can't be identified.

References

Bevery Bigtree Murphy, M.S. Alzheimer's and Bathing. http://www.ec-online.net/Knowledge/articles/reflections.html

Sloane, Philip. Advances in the Treatment of Alzheimer's Disease. American Family Physician. Vol. 58, No. 6, 1577-1586.

Dr. William Molloy and Dr. Paul Caldwell. Alzheimer's Disease: Everything you Need to Know. Firefly Books.

Last Updated: March 11, 2013

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