MAMACITAT Asked May 2011

How do you encourage and actually get your Alzheimer’s patient who is being extremely defiant about bathing?

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How do you encourage and actually get your alzheimer's patient who is being extremely defiant about bathing? How effective is sponge bathing? What can we do to help move this situation in the right direction?

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RayLinStephens Jul 21, 2017
I don't fight him. We have to bathe together and sometimes that is enough incentive. But I also have Aloe Vesta Cleansing Foam - Perineal Wash - it is foaming and no rinse. Does a great job.

If your patient is a Veteran, the VA will supply 1 bottle per month. This is the same No-Rinse Cleansing Foam given at the hospitals. I also get Betasept (Hibiclens generic) which is pre-surgical scrub and I mix them 50/50 for my hand-washing as it kills pretty much all germs. The VA will provide 2 bottles per month if needed. I put a few drops into the bucket with his washcloths to kill the germs.

Depending on the age of your patient - mine grew up in the depression - some of them grew up using "sink baths" and that is pretty much what you are calling sponge bathing. This is what my DH prefers to do most of the time. He does a good job of it so I don't fight with him. He keeps his nether regions clean. (hence the washrags)  The soap I leave out for him is the 50/50 mixture of Aloe Vesta Cleansing Foam and Betasept.  It gets him clean.
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monteros Jul 21, 2017
My dad also responded well to having his clothes on (most of them) to start. Once he is wet, he will let me take them off. We also wrap a velcro towel around his waist for privacy which helps a lot. He likes to hold the shower head himself; I put his hand under it first. Also, he is at a stage where he shouts a lot; when I turn on his music from the '40s, hold his hand and hum or sing, he stops shouting. On hair, when he doesn't want the shower, we use a warm, wet washcloth to wet and wash his hair. Not enough to cause drips but enough to get his hair clean and good smelling.  Also used warming the bathroom A LOT beforehand and the towels warmed in the dryer.  All great tips that worked well for us.  
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Can I just say that hand sanitiser is not always quite as wonderful as we all think it is. After 4 consecutive uses (and by that I mean without washing properly) the sanitiser acts like a culture t bacteria rather than sanitising the area. There is nothing better than washing according to the medics but I do sympathise. Mum likes to soak her feet so I use that time to give her a strip wash if she is having one of those days.

That said don't get into a fight over it, you'll only lose and be more frustrated than ever. Try making sure the room is warm - that is a must - mine feels like a sauna when we are finished and I feel drained buyout hey she is clean!

Warm towels (I warm mine in the tumble drier - quicker , smells nice and get really warm too. I also have a towelling robe that I put round her while I sponge her down. I use hot water so that by the time we finish it is still warm and I wash and dry bits at a time. She is OK with hands and face usually so that isn't a problem, if it is might I suggest you use aqueous cream. Rather than tell her she is having a wash tell her the doc has recommended that you use cream to stop her skin from getting dry. OK it is a lie but I have found it useful when all else fails..... Then I lather Mum in cream and say oops i think I have put too much on mum let me sponge some of it off for you. Always soft low voice always with some soft music in the background and I usually spray lavender room spray in the room before I do anything if she is a bit grumpy - either that or coconut spray they both seem to be calming to her.

One thing I have learned is that if she is having a moment then she doesn't want me to see her more 'personal areas - shoulder to groin so I have been known to use a towel wrap - they fasten with velcro and sponge under that - she stays warm retains her dignity and everything runs a little smoother. As for her undercarriage I make sure when she has a poop that I am there with wet wipes, sponge (actually I use a disposable flannel - they are paper and look like wet wipes so I get away with it) and I wash her thoroughly as I wipe her. If she is angsty about it I say Im sorry mum I don't do this as well as you but I just need to make sure you're clean down there(as I wash it again rinse it again and cream it) Adding for good measure Im going to put some cream on so you don't get sore hun OK? and I get right on with it before she has chance to say NO.

OK I wouldn't pass the carers tests but I am a caregiver not a carer AND IT WORKS FOR ME. Remember that people you may have to lie now and again to get the end result but IMHO? A little lie now and again is worth it for a clean person.

I always rip Mums depends off and I also rip a little at the side of them for a snugger fit - that way to is easy to say oops I ripped a little too far there. It might help if you use a pad inside the depends and just remove and replace that - saves a heap of money and if you want you can apply a swathe of cream to the pad so you know it reaches the right area (I would only do this once a day though usually straight after a wash)

Hope some of those ideas help. In hospital they never fight bathing they do however use the wipes and I have known them use them for certainly 2 weeks.

Just light on the sanitisers especially for you. And remember if you wash your hands with soap and water wash them for at least 25 seconds - sanitisers and soaps both need that type of time to work so it isn't any quicker to use one over the other.
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Jinx4740 Mar 2016
There is a cool feature here that I noticed. It is the "Search Site" bar in the upper right corner of the page. I typed Bathing, and go a ton of results.

Also, Look for videos online by Teepa Snow. She is sort of a dementia whisperer. She uses kindness and getting inside the person's head to avoid resistance in the first place.
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mmonteros: Many thanks for your suggestions. I will certainly try some of them. I really do appreciate your taking the time to address my issues.

Georgia
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mmonteros Mar 2016
We have had similar experiences with my father who doesn't see the point of his shower and doesn't smell it when he poops! The solutions have been calm conversation, encouraging him to help us, ordering the pants that zip down the sides (making undressing less shocking), wrapping his waist in a towel (he is very modest), covering him with a pancho we fashioned from an oversized towel, sometimes letting him enter the shower clothed (then he wants to take the wet clothes off), also a long bench to make entering the shower/bath easier, letting him hold the shower head, warming up the bathroom before we even start....Hope some of this helps.
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Many thanks for the tips. I certainly will use some of them. I am grateful for this site. My brother is 90. He will not get in the shower. He sponge bathes to his waist everyday. When I ask if he wants a shower or bath. He vehemently says "No." He is very strong physically. Thanks much. Georgia
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OBrien487 Aug 2015
Thank you pam, we do have a script for a sedative, will fill it. Tomorrow is my first day of full time care.Mom is a real fighter so good suggestion . Habd sanitizer is now on my list and dry shampoo...imposible to was her hair. I was thinking of music also .thought i read an article somewhere for alzh.patients. mom doesnt know me anymore so thats a tuff one to swallow.
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pamstegma Aug 2015
You start by giving them an anti-anxiety med one hour before bath time. You sit them in a shower chair, robe and panties still on and wash the feet, then the arms, talking softly to distract them, giving them a washcloth or hand towel. As the clothing gets wet, they will want to take it off. Have another warm robe ready.
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OBrien487 Aug 2015
I will be taking care of my 95 yr.old mother starting Friday due to incompetent care..who says im competent or qualified lol but this is my mom and I will do my best. I will be checking in on this site for any and all advice I can get. I also have a 93 yr. old father in the home . My moms alizhiemers is quite advanced and we lack the funds for placement.She is afraid of water so bathing is an issue. More advice on that would be appreciated.
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