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My father and I argue frequently with my mother when we are trying to get her to bathe. She always resists. She is in the moderate stage of Alzheimer's. Any thoughts or insights?
‘Bath’ or bathe’? Getting in and out of a bathtub is genuinely difficult – in fact I’ve just read a short story about an old widow who had a bath before visiting her husband’s grave and took over half an hour to get out of the tub, with real distress and fear. Slippery with the water, hard and dangerous without it. The story was called ‘The Tub’. Being ‘helped’ is embarrassing when you are naked.
A shower chair and a shower head on a flexible wand is easier, though once again embarrassing when naked. Even if your Dad is used to ‘naked’, it’s not the same, and you aren’t ‘normal’ or ‘proper’. When I helped my mother, I used to strip so that we both looked equally flabby (and equally wet).
I have a balance problem at present, and I’m using a toilet raiser which means I can wash from the bottom up through the smelly bits. Perhaps that might help your mother. Some people have found that it’s easier to hire a ‘nurse assistant’. Making it a stranger and a ‘medical’ procedure takes away some of the embarrassment. I can imagine that a piece of cloth that could cover bits in turn, might help as well.
PS Just remembering with my mother, she was upset to look at her naked reflection in the bathroom mirror, including her surgical scars, so I covered it with contact vinyl.
Make sure the bathroom is good and warm . Also many do not want the shower hitting over their head , or spraying on them constantly in general . The wand is better . Lather up and rinse with the wand. Don’t ask Mom . Tell Mom it’s time to get cleaned up . Sometimes you are better off having an aide come in to do it 2-3 times a week . In between you can use bath wipes daily for pits and privates .
Ditch the arguing. Remain calm. The more upset you get, the more upset she'll get. Keep father out of it (the male dominance thing). You be in charge.
Let the shower run for a while so the warmth from the water heats and humidifies the bathroom. Keep the bathroom door closed. Have extra handholds (the vacuum type, which you can attach and detach easily) so that mom can hold onto them. Keep your arms close around her as she steps in and out; that gives her a sense of security.
You can get a shower transfer seat, which she can sit on outside a tub. It then slides over and gets her into the tub itself. (A regular shower seat is fine too, if she's capable of getting onto it with your help.) She sits on the seat and you spray her with the shower wand, which is set to its gentlest spray. I like to start with the feet and legs and work up, which may be contrary to advice, but by doing that, I can keep the top part of the body covered with a light towel so the person won't feel cold. Use a long bath brush with soft bristles to soap her. That way you don't have to bend and twist so much as you reach to soap near and far. Soap and spray her in sections. Use a small complexion brush, also with very soft bristles, for her face and neck. Soap gently. Have washcloths handy so she can hold them over her eyes while you wash her face with the brush. Use a wet washcloth to rinse the soap from her face. Linger on soaping and rinsing the back. Most people like having their back rubbed, and she may enjoy the massage of the bristles. Dry her gently in the tub as much as possible while she's sitting. Let her help if she likes.
Instead of approaching the chore as if it's about the washing, approach as if it's a comforting time for her. Apply a fragrant body lotion before she dresses; that'll feel good to her. As you become more accustomed to showering her, you'll gain confidence and calmness. She'll feel that from you.
Thank you for taking the time to write such a good, descriptive reply. Your suggestions worked perfectly. My Mom responded well to each of your steps. Her favorite part is now choosing which fragrant lotion she wants after her shower. I bought two for her to choose from. I also really liked the bath brush idea so I don’t have to break my back washing her. Have a great day!
They start having a fear of the waterspraying on them.It is cold when they get out and they may fear falling.What once was a simple part of life turns into anxiety and fear.Sponge baths in bed or chair may help.Sometimes they may have a day when they will want a shower but you may have to wait for that mood change.
I don't believe that they don't like to bathe anymore, but in some cases they have forgotten how to or they fear slipping and falling in the shower, or like already said they don't like the water hitting them. So make sure that your mother has a sturdy shower bench, slip proof mat placed in the shower, grab bars, and a hand held shower head. Then you tell your mother(not ask)that it's time for a shower, and take her in and help her get in and if needed YOU wash her up real good and then help her out and dry her off. Most older folks only need a shower about twice a week, so for the in-between times you can use the extra large body wipes and waterless shampoo and conditioner caps that you can buy on Amazon or Walmart.com. And of course you can always hire a CNA to come to get your mother in the shower as well as often folks with dementia, listen better to strangers.
You write: "...they fear slipping and falling in the shower." Very true, but I think they also fear slipping and falling in the bathroom itself. I think stats indicate that the bathroom is the no. 1 place in a home where seniors fall. I have purchased two (now on the 2nd one) rugs that go right next to the bathtub. My bathroom is tiny, so the rug takes up most of the bathroom area. It's a very warm, comfortable, absorbent kind of rug. I used to get them at Bed, Bath and Beyond (now closed) but recently found another store carrying them online -- beige is the color and don't put them in the washing machine as I think they fall apart. Just buy a new one every once in a while. Good luck!
When my dad was diagnosed and came to live with me I was finally able to make sure he showered at least one a week. But I had to get a shower chair and help him with it. First of all I took a space heater in and got the air extra warm in the bathroom. He was pretty frail and being cold was unpleasant, so making it really warm helped. I have a hand held shower which is also necessary. The chair slid out of the tub on a rail so we could make the transition without having to stand up or down when wet. Then he could use his walker to help with standing after he was out. I could get him partially dressed while still sitting and then get everything in place once he stood up. He had vascular dementia which caused him to have poor balance. Hope these suggestions make showering more pleasant for your mom. You sort of just have to say, “today is shower day” and then just do it.
Try giving her a bed bath, if you haven't already. She may be resistant to that as well, but its a little easier on her. Be sure to place water barrier pads and/or towels underneath her. then using a large bowl or basin of warm water, gently wipe her down with a soft washcloth, starting with the face and head, and work your way down. You can use a towel or sheet to keep her body covered so she is more comfortable. Not completely exposed, naked and wet. My 62 yr old husband is partially paralyzed and suffers brain damage as a result of a stroke. He is still quite strong and resistant to any personal cares. It's a challenge, but I find it easiest to do only his upper half or lower half of his body at a time. While he is sitting up in a wheelchair, I wash his head, neck, chest and underarms as best I can. It's always a fight. Then, when performing a diaper change, I thoroughly clean his lower half with disposable wipes and warm soapy water. Just remember, it doesn't have to be perfect. Just do the best you can to care for her skin, while keeping her comfort in mind. Dementia can cause the person to feel vulnerable and "attacked" by too much close personal care.
I can only speak from my experience but with my mother in her mind she had taken a shower already. It is the same with changing her clothes. When I tell her we need to get a new outfit on since she is wearing the same clothes as the day before she gets upset telling me she changed that morning. Her short term memory is pretty much gone. I do want to add thank you for this page with tips and issues we have taken care of our elderly parents and spouses. Two and a half years ago when I moved to take care of my mother I had no idea what I was in for. I remember the day when I knew I had to read up and get support from people who understood what was happening was the day she told me to get out of the house that I was an imposter.
I am COMPLETELY in this situation. Our mother is not following the "stages" very accurately. It's often hard to find fitting help as her intellectual/spiritual/literary/poetic self still has such brilliance... but so much is crumbling all around her and she's fighting like a stevedore to stay "right-minded." I suppose that there is no way to explain things any more- we avoid even the slightest hint of condescension... I wish I knew how to best act... but there is so much kindness and open words and gestures of affection between my father and mother and between her and us... My God, it is such wrenching work...
Dementia impacts more than just memory. The senses change: depth perception and vision change, and certain physical sensations become unpleasant. She doesn’t want to bathe not because she is trying to be bull-headed, but because she can’t tell you that it feels bad. Remember, every “behavior” is a response, and it’s up to the caregivers to play detective. Rather than strong arming her into something she dislikes, try to approach it differently. Did she enjoy getting a manicure? Use some aromatherapy and tell her she gets to have a spa day. I know that this creates more work for you as the caregiver, but if you can turn something ugly into something to look forward to, it may be worth the effort.
There are tiny needles going into my skin!! Make them stop!!
I was assisting another staff member to shower a woman with dementia.
We explained she was in the shower. She didn't understand our words.
I showed her the showerhead dropping water onto my hand. She couldn't see see the water.
She couldn't understand what was causing the sensation on her skin.
As she was so distressed, we moved her out of the direct water stream & used wash cloths instead. Quickly dried up & kept warm under the towel until redressed.
I guess this would be later stage, not moderate stage.
I find in my long experience as a caregiver that the senior with dementia refusing to bathe, shower, wash-up, or change into clean clothes is very similar to a child that refuses to.
The same as with a child, sometimes you have to make them do it. The way to get this done is to allow absolutely nothing else until they are washed up. No tv, no snacks, no going out, no conversation (other than communicating about getting cleaned up), no phone calls, computer, or visitors until they're cleaned up.
You can promise treats and rewards if they are compliant and sometimes they work. When they don't you have to just wear the person down.
I suppose our mother is not as far advanced in her dementia, as she very clearly and eloquently explains how she's fine and doesn't need bathing. She also refuses any change of clothing- none. We have bought her dozens of things that she simply leaves folded- unused. She maintains a dignified autonomy over herself. Yesterday, she had a bowel episode which meant we had to bathe her and I made all the mistakes possible in the situation- uncomfortably chilly, too hot, etc. but she is very adamant about how she'll have herself showered and so we assume she's not as advanced in her condition as some... I was just happy to get her into the tub shower. She gets furious when we use any kind of care-giver tone with her- she finds it belittling.
* 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. If people regard bathing as scary, embarrassing, unpleasant or uncomfortable, they may communicate their discomfort by verbally and/or physically resisting attempts to bathe. * In some cases, this can escalate and become be unsafe and upsetting for all who are involved.
There are ways to make bathing easier and more comfortable — however, each situation is unique, and finding what works is often the result of trial and error.
Gena's comment: Try to understand the resistance from their point of view: confused, fearing something (new / unusual). Be patient. If too stressful, do sponge bathing. Always use soft voice, smile, be gentle.
How is this comment helpful? Everyone already knows that bathing can be a challenge with people who have dementia.
Let me tell you something. The 'soft' voice, the smiling, and gentle approach are not always the way. In fact, it rarely is. I have worked for many seniors with dementia who would have eaten me alive if I came in with the soft voice and the smiling. That doesn't get an stubborn person who's filthy and smells into the shower or to a sponge bath.
Are you expecting het to bathe or shower on her own or are you helping bathe her?
Either way, take extra steps to warm up the bathroom and keep her physically comfortable. The prospect of being cold and wet is enough to discourage a lot of peopoe, with or without dementia.
I made it very cozy for my mom, sometimes bribed her with a treat afterwards. Took the tower heater in there & got it toasty, she complained of the cold. I got 2 big towels and a smaller one. Had her clothes in there so as not to interrupt the rhythm. I took my shoes off & whatever else I thought might get wet. I warmed the water then assisted her to the shower chair. Wet her leg up first then progressively got her wet. Washed her quickly and rinsed so she wouldn’t get cold. Then washed her hair. Put big towel in her lap & other one around her shoulders. Put her hair up in small towel. Then patted her dry & towel dried her hair. Then I applied powder, lotion, & antiperspirant, if fussy this can be done later. Then quickly got her dressed. Of course I would give her a treat whether it was a hug, ice cream, lunch, cup of coffee, music, whatever she perceived as a treat. Did this about every 5-7days with cleaning as needed in between.
Wow, Toni, what a great daughter you are! And I bet she loved the hugs and ice cream. I'd like to share a "tip" that a nurse gave me a couple of years ago, when she washed my hair. I had been in a bad accident and hadn't been able to wash it myself for something like 6 weeks: yuk! I said this to her, just in passing, and she was so sweet -- I still remember her name (Misty). She said "Come on!" and took me into the bathroom and had me sit on the toilet (right next to the bathtub luckily) lean over the tub, while she knelt down by my side and washed my hair with the handheld shower tool. Many women (myself included) like to use both shampoo and a conditioner, using the latter after rinsing out the shampoo & then leaving the conditioner in for a little bit before also rinsing it out too. When she had me leaning over the bathtub, she just took her hand and poured into it dabs of BOTH shampoo and conditioner at the same time -- worked this mix into my hair and then rinsed my fine. It worked just fine.
My husband likes taking a bath in the walk-in tub, but I have to watch him like a hawk. More than once, he has opened the door before the water has drained. Fortunately, I managed to slam shut the door before the floor was completely flooded. Now I just sit on the toilet seat -- next to the tub -- read -- and keep one eye on that handle.
tbevan25: A patient with Alzheimer's cannot remember the steps necessary to bathe, perhaps they cannot recall the last time that they did get clean or it is just far too burdensome to perform the task.
My mum doesn't like to be bothered; she just wants to be left alone. She feels discomfort when she is handled, however gently. Her main complaint about being showered, recently, was that she was too cold and that the carers pulled her about. She copes better with strip washes, in the bedroom where she is warm. I don't see the point of distressing her, providing that she is clean enough. Perfection shouldn't be the goal - it's unobtainable.
I'll add that at a certain point it is tough for their brain to identify white things. Mom would not put her hand under running water. I don't think her brain could "see" or identify the clearness of water.
We put red lobster non slip stickons on the bathtub. The red of the lobster helped her to "see" the bath tub. This really helped.
We also put red mats on the floor in front of the tub on top of the white tile. White tile is problematic as their brain can interpret it as clear like glass and they are scared to go in the bathroom.
There is a lot of steps to "simply taking a shower" the undressing, turning on the water, getting it to the right temperature, getting wet (more on that in a minute), getting a washcloth, lathering and on and on. We don't think anything of all the steps because it is "routine". Next time you take a shower think about EACH thing you do from gathering everything you need to drying off then getting dressed after the shower. There is a LOT to do. Now to the getting wet. When my Husband was in Rehab I was told by the PT that the trunk and face are "Vulnerable" areas. that people with dementia do not like being hit in those areas. I never had a problem with my Husband in the shower. When he was using the walk in shower I had removed the sliding glass door and replaced it with a shower curtain so that he would not use the towel bar as a grab bar. I had a walker that I got at a resale shop and put that in the shower so that he would have something to hold onto while he was in the shower. I also placed it so that he was facing away from the shower head. Getting him to turn to rinse was easy enough. When he was at the point where I was showering him in the roll in shower I would start at his back and then the legs and feet. He would sit in the shower chair and once his back and feet were wet I would hand him the shower wand and let him go at his pace and get his torso wet. I would take the shower wand and guide his hand if he was not getting himself wet. I will say he really did enjoy his showers so I was lucky in that respect.
One thing that I did which helped me in showering my wife who had Alzheimer’s was ….. warmth. I preheated the entire room, water, even its floor (fortunately I knew about this disease quirk and had floor heating installed when I updated the bathroom for a boundary free shower area). The other area which created anxiety in her was slipping, always a concern in showers. I installed strong highly visible grab-bars both within the shower and leading to the shower. Lastly, I installed a strong dropdown bench within the shower so she could sit (pre-warmed) through most of her showering …. helped by a handheld shower hose.
Forgetfulness. She may think she already bathed. She may also consider it "wrong" for you and her hubby to bathe her. Help her to reframe bathing - maybe consider it "spa time:" scented candles, music, bubble bath, luxurious shampoo, warmed lotion, and warm towels. It will probably take longer to have a "spa bath" than a quick shower, but she (and you) may enjoy this more.
Being covered with a shower of water isn't necessary for someone who just sits all day. My husband kept saying, "I'm not dirty" even though he hadn't showered in weeks! I finally bought him some XL disposable cloths. He will use them after toileting to wipe his privates. When I see any bare skin while he's dressing, I'll bring a warm, soaped washcloth to wash that area. He likes being "pampered" like that. He will apply a little of his favorite cologne if I ask him, and praise him for "smelling nice." My attitude towards cleanliness has really been challenged!
Some excellent suggestions here. Just a few comments for those who may be further interested. African American between the ages of 70- 90+ depending on where they grew up may not have access to showers (I know my mother didn't and I didn't really have access to a shower until I was in my 40s) and beaches were restricted so many never learned to swim or got the glorious feeling of moving water on the face: therefore for many it seems like they are being drowned. At my suggestion at the SNF and LTCs where I worked, they used only wash cloths for washing the face and when washing the hair, made sure the bath chair was firmly secured with a backward tilt (that was ok because it reminded folks of all races and cultures of going to the hairdresser even if It was at home!). We actually started using that process on all our residents and saw an amazing decline in fights about bathing. When we added music and talked about taking folks for their "spa" time, we actually had people lining up in their wheelchairs for "spa" time. Of course, that was prior to covid when we had a lot more staff and could take time.
For folks that really like baths and not showers, I'm still researching the bath lift suggested by one of the respondents here a few days ago. Sounds like a great idea.
My late husband had frontotemporal degeneration, not Alzheimer's. But he seemed not to care about showering or bathing that much, even though he sweated profusely and used to take two showers a day before he became ill. I would have to get him into the larger bathroom (shower and tub, not just shower) and walk him through each body area he needed to wash from the top down. Eventually, I just did the washing for him. I flat out told him that we weren't going out to eat, to a movie, to church, to the doctor/dentist/optometrist until he showered or bathed. Once he entered long-term care, he received a shower every other day. He didn't fight the nursing assistants who helped him shower. Maybe it was because they were mostly younger women! I also had to remind him to clean the appropriate body parts after using the bathroom and to wash his hands afterward.
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We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
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APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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A shower chair and a shower head on a flexible wand is easier, though once again embarrassing when naked. Even if your Dad is used to ‘naked’, it’s not the same, and you aren’t ‘normal’ or ‘proper’. When I helped my mother, I used to strip so that we both looked equally flabby (and equally wet).
I have a balance problem at present, and I’m using a toilet raiser which means I can wash from the bottom up through the smelly bits. Perhaps that might help your mother. Some people have found that it’s easier to hire a ‘nurse assistant’. Making it a stranger and a ‘medical’ procedure takes away some of the embarrassment. I can imagine that a piece of cloth that could cover bits in turn, might help as well.
Don’t ask Mom . Tell Mom it’s time to get cleaned up .
Sometimes you are better off having an aide come in to do it 2-3 times a week . In between you can use bath wipes daily for pits and privates .
Let the shower run for a while so the warmth from the water heats and humidifies the bathroom. Keep the bathroom door closed. Have extra handholds (the vacuum type, which you can attach and detach easily) so that mom can hold onto them. Keep your arms close around her as she steps in and out; that gives her a sense of security.
You can get a shower transfer seat, which she can sit on outside a tub. It then slides over and gets her into the tub itself. (A regular shower seat is fine too, if she's capable of getting onto it with your help.) She sits on the seat and you spray her with the shower wand, which is set to its gentlest spray. I like to start with the feet and legs and work up, which may be contrary to advice, but by doing that, I can keep the top part of the body covered with a light towel so the person won't feel cold. Use a long bath brush with soft bristles to soap her. That way you don't have to bend and twist so much as you reach to soap near and far. Soap and spray her in sections. Use a small complexion brush, also with very soft bristles, for her face and neck. Soap gently. Have washcloths handy so she can hold them over her eyes while you wash her face with the brush. Use a wet washcloth to rinse the soap from her face. Linger on soaping and rinsing the back. Most people like having their back rubbed, and she may enjoy the massage of the bristles. Dry her gently in the tub as much as possible while she's sitting. Let her help if she likes.
Instead of approaching the chore as if it's about the washing, approach as if it's a comforting time for her. Apply a fragrant body lotion before she dresses; that'll feel good to her. As you become more accustomed to showering her, you'll gain confidence and calmness. She'll feel that from you.
So make sure that your mother has a sturdy shower bench, slip proof mat placed in the shower, grab bars, and a hand held shower head.
Then you tell your mother(not ask)that it's time for a shower, and take her in and help her get in and if needed YOU wash her up real good and then help her out and dry her off.
Most older folks only need a shower about twice a week, so for the in-between times you can use the extra large body wipes and waterless shampoo and conditioner caps that you can buy on Amazon or Walmart.com.
And of course you can always hire a CNA to come to get your mother in the shower as well as often folks with dementia, listen better to strangers.
Be sure to place water barrier pads and/or towels underneath her. then using a large bowl or basin of warm water, gently wipe her down with a soft washcloth, starting with the face and head, and work your way down. You can use a towel or sheet to keep her body covered so she is more comfortable. Not completely exposed, naked and wet.
My 62 yr old husband is partially paralyzed and suffers brain damage as a result of a stroke. He is still quite strong and resistant to any personal cares. It's a challenge, but I find it easiest to do only his upper half or lower half of his body at a time. While he is sitting up in a wheelchair, I wash his head, neck, chest and underarms as best I can. It's always a fight.
Then, when performing a diaper change, I thoroughly clean his lower half with disposable wipes and warm soapy water.
Just remember, it doesn't have to be perfect. Just do the best you can to care for her skin, while keeping her comfort in mind.
Dementia can cause the person to feel vulnerable and "attacked" by too much close personal care.
I know that this creates more work for you as the caregiver, but if you can turn something ugly into something to look forward to, it may be worth the effort.
Wishing you so much patience!
I was assisting another staff member to shower a woman with dementia.
We explained she was in the shower. She didn't understand our words.
I showed her the showerhead dropping water onto my hand. She couldn't see see the water.
She couldn't understand what was causing the sensation on her skin.
As she was so distressed, we moved her out of the direct water stream & used wash cloths instead. Quickly dried up & kept warm under the towel until redressed.
I guess this would be later stage, not moderate stage.
The same as with a child, sometimes you have to make them do it.
The way to get this done is to allow absolutely nothing else until they are washed up.
No tv, no snacks, no going out, no conversation (other than communicating about getting cleaned up), no phone calls, computer, or visitors until they're cleaned up.
You can promise treats and rewards if they are compliant and sometimes they work. When they don't you have to just wear the person down.
https://www.alz.org/help-support/caregiving/daily-care/bathing
In part, it says:
* 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. If people regard bathing as scary, embarrassing, unpleasant or uncomfortable, they may communicate their discomfort by verbally and/or physically resisting attempts to bathe.
* In some cases, this can escalate and become be unsafe and upsetting for all who are involved.
There are ways to make bathing easier and more comfortable — however, each situation is unique, and finding what works is often the result of trial and error.
Gena's comment: Try to understand the resistance from their point of view: confused, fearing something (new / unusual). Be patient. If too stressful, do sponge bathing. Always use soft voice, smile, be gentle.
Gena / Touch Matters
How is this comment helpful? Everyone already knows that bathing can be a challenge with people who have dementia.
Let me tell you something. The 'soft' voice, the smiling, and gentle approach are not always the way. In fact, it rarely is. I have worked for many seniors with dementia who would have eaten me alive if I came in with the soft voice and the smiling. That doesn't get an stubborn person who's filthy and smells into the shower or to a sponge bath.
Either way, take extra steps to warm up the bathroom and keep her physically comfortable. The prospect of being cold and wet is enough to discourage a lot of peopoe, with or without dementia.
Her main complaint about being showered, recently, was that she was too cold and that the carers pulled her about. She copes better with strip washes, in the bedroom where she is warm. I don't see the point of distressing her, providing that she is clean enough. Perfection shouldn't be the goal - it's unobtainable.
We put red lobster non slip stickons on the bathtub. The red of the lobster helped her to "see" the bath tub. This really helped.
We also put red mats on the floor in front of the tub on top of the white tile. White tile is problematic as their brain can interpret it as clear like glass and they are scared to go in the bathroom.
The red mats really helped.
the undressing, turning on the water, getting it to the right temperature, getting wet (more on that in a minute), getting a washcloth, lathering and on and on. We don't think anything of all the steps because it is "routine".
Next time you take a shower think about EACH thing you do from gathering everything you need to drying off then getting dressed after the shower. There is a LOT to do.
Now to the getting wet.
When my Husband was in Rehab I was told by the PT that the trunk and face are "Vulnerable" areas. that people with dementia do not like being hit in those areas.
I never had a problem with my Husband in the shower.
When he was using the walk in shower I had removed the sliding glass door and replaced it with a shower curtain so that he would not use the towel bar as a grab bar. I had a walker that I got at a resale shop and put that in the shower so that he would have something to hold onto while he was in the shower. I also placed it so that he was facing away from the shower head. Getting him to turn to rinse was easy enough.
When he was at the point where I was showering him in the roll in shower I would start at his back and then the legs and feet. He would sit in the shower chair and once his back and feet were wet I would hand him the shower wand and let him go at his pace and get his torso wet. I would take the shower wand and guide his hand if he was not getting himself wet.
I will say he really did enjoy his showers so I was lucky in that respect.
African American between the ages of 70- 90+ depending on where they grew up may not have access to showers (I know my mother didn't and I didn't really have access to a shower until I was in my 40s) and beaches were restricted so many never learned to swim or got the glorious feeling of moving water on the face: therefore for many it seems like they are being drowned. At my suggestion at the SNF and LTCs where I worked, they used only wash cloths for washing the face and when washing the hair, made sure the bath chair was firmly secured with a backward tilt (that was ok because it reminded folks of all races and cultures of going to the hairdresser even if It was at home!). We actually started using that process on all our residents and saw an amazing decline in fights about bathing. When we added music and talked about taking folks for their "spa" time, we actually had people lining up in their wheelchairs for "spa" time. Of course, that was prior to covid when we had a lot more staff and could take time.
For folks that really like baths and not showers, I'm still researching the bath lift suggested by one of the respondents here a few days ago. Sounds like a great idea.