My mom has dementia and is in the nursing home after living with me and my husband in our home for 7 years. We always had to argue with her to get her to bathe and were only successful with getting her in the tub twice a week after a lot of arguing with her. In her mind, each time she changed clothes, she thought she had already bathed (or so she argued). Now in the nursing home, they have her scheduled to bathe 3 times a week and the staff tries really hard to get her to comply and shower. They have no other problem with her--just the bath. I don't know what to do. I've gone up a few times and insisted that she shower and have taken her clothes off and put her in the shower by lifting her in myself and showering her. What can we do to change this battle and get her to shower?
I was surprised that in Illinois the regulation is 2 times a week. So if they are trying 3 times a week but succeeding 2 times that is great.
A Bed Bath can be just as effective as a full shower or bath.
As long as she is cleaned properly after toileting I see no need to worry or insist about showering 3 times a week.
Showering or bath can make the skin drier. It removes oils that are necessary. This can make skin itchy and if she begins to scratch that can be a never ending cycle itself.
I am surprised though that they have a problem. Typically the CNA's or CNA assists are real good at getting people that are non compliant to shower. That said they can not "force" and to do so could be more traumatic and make showering again later more of a problem.
My suggestion...
Let the staff do their job, let them handle the situation.
Sorry to hear you're facing this problem.
I agree with Greton777, I would have expected the nursing home to have experience with such matters.
Maybe they've tried various things and nothing has worked?
Some video's talk about pretending the experience to be a spa treatment and encouragement by suggesting a nice lunch or dinner afterwards or a hair styling.
They also suggest to be flexible in the time, i.e. if loved one say no in the morning, suggest bathing in the afternoon.
Maybe a sponge bath and then slowly progress to the shower. I don't know if this will work, but it might be small steps for encouragement.
Solace, I really do hope your issue with your mom showering/bathing is resolved soon, with the help of the nursing home.
Love & Peace.
First thing...ask them if they ask her if she wants a shower and the answer is no. If so ask that they don't ask, they tell her "Mrs Jones, time to get a shower" maybe not even that, just walk her to the shower and guide her in.
Second...my daughter, RN, worked in NHs for 20 yrs. She says you allow them to think they made the decision. "Mrs Jones would you feel so much better all clean and fresh clothes on?" She says they may agree and allow u to shower them.
In NHs by law they cannot force a resident to do anything they don't want to. With the shortage of CNAs, I would say when they get no for an answer, they move onto the next resident.
Does she really need to have a bath? The poor soul doesn't like to bathed. Why not give her a good overall wash if this is more acceptable to her?
My husband has dementia and he won't go near water but he has a really good wash every day.
Remember that dementia is a disease with loss of reasoning abilities. Place yourself in someone's shoes about forced activities you don't want.
So like others have said.... when a resident says no they can not force them to do anything and it all depends on how various options are presented to them. Perhaps request a "bed bath" or other type of bathing at least once a week when she refuses a shower.
That's terrible a nursing home that wakes its residents up in the middle of the night to give them a shower. That's not care. That sounds like something the Geneva Convention would have a rule about for POW's detained by the enemy.
If someone woke me up in the middle of the night for a shower they would have a hard time on their hands. Your poor father. I'm glad you were able to get the showering schedule changed.
My mom was given a bath in a whirlpool when she was in SNF she loved it. She got two baths a week, and if she asked for a bath and they would accommodate her if schedule allowed it.
Every morning, I gave her a warm soapy wash cloth so she could wash her face and arms. Every other day, I helped her change her bra, and washed her back, neck and assisted in washing her breasts. She was incontinent, so at least three times a day, I cleaned her rear end, put Calmoseptine cream on to prevent pressure ulcers, and made sure she had new pull ups. Once a week I soaked her feet and powdered them, cleaned her legs, and put lotion on. Clean pads and sheets on her bed daily. Once a month we went to her hairdresser for some special pampering. Our routine worked and she was clean. She died in January 2022 at age 93.
Drop the shower mandate and discuss with staff a different approach to keeping her clean. If you can, make unannounced visits to monitor the situation. Believe me, staff will pay attention if they know you are on top of things. My mom got a pressure ulcer when she was in nursing home rehab for hip surgery, and boy, did I explode. I vowed she would never get one under my watch. She never did. I wish you all the best.
I've worked for care clients who were bedbound or whose homes were not equipped for them to be able to use the shower or take a bath. So we did daily bed baths. Maybe your mother would be more responsive to getting 'washed-up' in the bathroom instead of showering.
She is currently in hospital and has showered there 3 times already (twice with me assisting) and she’s only been in 4 days. Technically one wasn’t necessary as she’d had a shower before bed and the morning staff gave her a shower again not knowing.
I get her into a positive mood beforehand. There is absolutely no point arguing.
At home I basically put on an entertainer front, I put her favourite music on and basically made it a fun experience. Yeah she still would at times say a few nasty words as the water first sprayed her but then she’d calm down. To wash her hair I’d usually have to make it a “spa” type thing where I then also blow dried her hair after. After shower I’d use positive re-enforcement of how good she looks/must feel. Oh and I’d serve her something yummy afterwards.
For the last few months she has suggested a shower out of her own merit as she knows it helps soothe with the incontinence (she has sensitive skin that quickly irritates with the urine) and she basically repeats my re-enforcements. She’s also learnt to associate her favourite songs with the shower.
tonight I gave her a wash at the hospital with one of the nurses, again I put her favourite music on first, she was humming along and then I took her hand and we went into the shower and got to it quickly. I was so proud of her. They are only quick showers and then she gets lathered in moisturiser :) Mum prefers before bed time showers but if washing hair, we do earlier. However, I don’t worry too much about the hair as it’s not necessary that often.
Check out Teepa Snow. She’s a dementia person whisperer, and has many videos on communicating with these folks. There may be one on the clothing issue.
* Realize that staff has limited time. You might want to hire someone who is patient and has more time to manage the process. Your mom may relate differently to a professional than she does with you - from her point of view, which might help her respond more positively.
What do you do when someone with dementia refuses to shower?
Try a sponge bath at least twice a week, if they refuse a bath or shower. You can wash them with a wet sponge or cloth, but without them getting into a bath or under a running shower.
_________________________
* 2x / week is enough: As people get older, they have less energy to get things done each day. Usually, personal hygiene (specifically bathing) is one of those things that gets neglected. So how often should an elderly bathe? To avoid any skin conditions or infections, a senior should bathe at least once or twice a week.
_______________________
IMPORTANT: Fear of drowning; depth Perception off / scary. She may not be able to verbalize these fears / concerns.
What are the potential risks of showering someone with dementia?
Feeling out of control and powerless may add to a person's lack of cooperation with bathing. The person with dementia may fear drowning, particularly if water is being passed over their head. Prepare the bath ahead of time. Check the water level.
_____________________________
Why do dementia patients dislike showering?
Use non-rinse soap products to make the process easier. Fear of bathing may be related to a number of factors such as fear of falling, fear of the water, fear of being cold, loss of dignity in being naked in front of you, or feeling vulnerable in the coldness of a bathroom.
_______________________________
Bathing can be a challenge because people living with Alzheimer's may be uncomfortable receiving assistance with such an intimate activity. They may also have depth perception problems that make it scary to step into water. They may not perceive a need to bathe or may find it a cold, uncomfortable experience.
What to do if a dementia patient refuses to shower?
Establish a daily routine. ...
Use positive reinforcement and don't argue. ...
Say “we” not “you” ...
Make the bathroom warm and comfortable. ...
Reduce effort and help them feel safe and relaxed. ...
Use a hand-held shower head to reduce fear. ...
Use extra towels for comfort and warmth.
_____________________
Before Bathing
Before starting a bath or shower:
Get the soap, washcloth, towels, and shampoo ready.
Make sure the bathroom is warm and well lighted.
Play soft music if it helps to relax the person.
Be matter-of-fact about bathing. Say, “It’s time for a bath now.” Don’t argue about the need for a bath or shower.
Be gentle and respectful. Tell the person what you are going to do, step by step.
Make sure the water temperature is comfortable.
Don’t use bath oil. It can make the tub slippery and may cause urinary tract infections.
_________________________________
During a Bath or Shower
Allow the person with Alzheimer’s to do as much as possible. This protects his or her dignity and helps the person feel more in control. Here are other tips:
Put a towel over the person’s shoulders or lap. This helps him or her feel less exposed. Then use a sponge or washcloth to clean under the towel.
Distract the person by talking about something else if he or she becomes upset.
Give the person a washcloth to hold. This makes it less likely that he or she will try to hit you.
_______________________________
After Bathing
Prevent rashes or infections by patting the person’s skin with a towel. Make sure the person is completely dry. Be sure to dry between folds of skin.
If the person is incontinent, use a protective ointment, such as petroleum jelly, around the rectum, vagina, or penis.
If the person has trouble getting in and out of the
Perhaps a compromise could be reached 2 showers / baths a week and then sponge/ bed baths. Or even one shower a week and maybe two bed baths.
Check with her PCP for recommendations.
Guess I would suggest a weekly shower with a notification the night before and the morning of, to remind your mother what's happening the next day.
The aides in the nursing home don't have time for all that. What you can do is hire a private-paid bath/shower aide or go yourself.
What I find that works with a bath/shower resistant elder is that nothing else is happening until the bath or shower is finished.
This means no tv, no meal or snacks, no games or entertainments, no going out, no socializing, nothing.
Either the shower or bath gets done or nothing else does. You have to wear them down sometimes. I find in my experience when nothing else is allowed until the bath/shower happens it won't take as long as you think. In the case of your mother, it may have to come down to she isn't allowed to leave her room until she showers/bathes.