Like other activities of daily living, bathing can be difficult for individuals with Alzheimer's disease. Your father-in-law could be having difficulty with bathing due to several issues. He may have forgotten how to undress, wash or dry. He may be frightened about the bathtub surface or become disoriented to the people or place he is in.
But there are ways to make the process easier for both caregivers and the person with the disease. My suggestions apply to bathing, but can be used to assist with other activities of daily living. Recognizing your loved one’s abilities and preparing ahead of time can help simplify the process. Try to follow the same bathing schedule you father-in-law had prior to the onset of the disease. For example, if he used to take a shower, not a bath, head for the shower. If he used to bathe in the morning, follow that routine. This is the rule of thumb unless he has specific hygiene needs or behavioral changes arise. For example, adjustments may be necessary if he is severely agitated, wakes up soiled in the morning, or experiences behavioral problems, or "sundowning" as evening approaches. Also, you can try to utilizing a male caregiver to provide assistance, as he might feel more comfortable with the same gender.
It is also important to “set up the scene” in advance to make bathing seem less intimidating. For example, if your father-in-law thinks that another person might be in the room while seeing his own reflection, you should consider covering up the mirror. You can also dim the lights, play soft music, and turn on the hot water in advance to warm up the room. You also must consider privacy issues, as it is possible he feels uncomfortable being exposed. When in the shower, it can be helpful to wash one body part at a time, while keeping the rest covered to preserve his dignity. It is a good idea to use a handheld shower head as this can also prevent water from splashing directly into his face (which can be very frightening to a person with this illness). Allow him to take part in the process by encouraging him to wash himself. You can use his favorite scents in the tub that could help spark memories from the past. , try engaging her with activities and discussion throughout the process. Here is an example of a conversation you can have
Just remember to always be positive, patient and go at his pace. If you have exhausted all these options, and he continues to refuse to bathe, you may have to consider giving him sponge baths as an alternative.
Here are a few other helpful tips:
1-Give one-step instructions in short, simple terms, and go slowly
2-Make sure to communicate with non-verbal cues to help the individual understand
3-Remember to provide privacy, and ensure dignity for your mother throughout the whole process
5-Always approach from the front whenever possible
6-Make sure the room temperature is appropriate for disrobing
7-Keep your father-in-law in a bathrobe until in the bathing area
8-Lay out clothing in advance to proceed quickly from drying to dressing
Another concern you are having is his over-eating. Since your father-in-law is eating too much, it is imperative to consult his primary care physician to discuss this matter. It is important that he receives adequate nutrition and is maintaining a healthy, sufficient diet. The physician can run tests to determine if there are underlying medical reasons for his increased appetite, and possibly prescribe a treatment that can decrease his appetite. When he goes to his physician for an evaluation, ask his doctor if the medications he is on causes an increase in appetite. The doctor also might refer him to be seen by a dietician, to evaluate his caloric intake.
Your father-in-law has Alzheimer’s disease which has impaired his cognition. Your father-in-law might have forgotten when he ate last. He can also be eating out of boredom. He might not realize how much he is eating, and perhaps requires supervision to maintain a diet appropriate to his plan of care. Here are some helpful tips:
1-Control access to sweets by placing theme where he cannot reach or find them.
2-Give him healthy snacks in small portions throughout the day
3-Make sure he is hydrated, by giving him water
4-Plan activities to help to prevent boredom-related overeating.
For other ways to cope with activities of daily living, please check out http://carecrossroads.org/cms/index.php?option=com_content&view=article&id=8&Itemid=12