• Christine Christine
    April 15, 2010
    how do you get a patient with Alzheimers to take a shower
    Christine Christine
    April 15, 2010

    My Mom is in early to mid stages of Alzheimers' and does not want to take a shower anymore. I'm baffled as to why she refuses to get into the shower.  Here is a woman who was always so well groomed and maticular about her well-being and appearance, who now out right refuses to take a shower.  I am told that there may be a fear of the water, but I don't understand why, Can you tell me how I go about getting her to Take a Shower

     

     

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FROM OUR EXPERTS

  • AFA Social Services
    Health Guide
    September 24, 2010
    AFA Social Services
    Health Guide
    April 15, 2010

    Dear Christine,

     

    While you may never know the reason behind your mother's refusal to shower, it is important to understand that rationalizing with her may be ineffective, especially if her judgment is impaired. Even though Alzheimer's disease affects everyone differently, many individuals with this disease have difficulty expressing their thoughts clearly. As a  result they will often reply, "No!" to any requests that cause them to feel uncomfortable, anxious or unsafe. Therefore, instead of asking your mother "Would you like to shower?", you should try to direct and guide her into the shower.

     

    One recommendation to begin is to go with what you know about your mother's past routine. Did she take showers in the morning, afternoon or evening? Was it right after waking up, her morning coffee or watching the nightly news? Taking into consideration her shower routine prior to her illness can help set things in motion. Also of importance is to prepare the bathroom beforehand. Preparation can include running the water to make sure the temperature is to her liking, as well as bringing in items like her bathrobe, change of clothes, hairbrush, and any other things you need for her. Having such items handy is important to ensure you will not have to leave your mother alone to run out for something you may have forgotten.

     

    Once you have your mother in the bathroom, talking to her and walking her through the routine is also important as she will know what to expect. Doing so can prevent her from becoming afraid of something she is unprepared for. For example, if you are going to assist your mother with getting undressed, you may want to say, "Okay mom, I'm going to help you unbutton your shirt. Here's a towel for you to cover yourself so you won't feel cold." Take into account that the act of showering or bathing is when people are most vulnerable. Having to disrobe and exposing your body to a cool room are discomforting things. In addition, some people have to do it in front of someone else, which can be a very scary and frightening experience, even if it is a relative.

    • Cheryl
      December 26, 2012
      Cheryl
      December 26, 2012

      I wish people who tell me that taking care of somebody is a kick-back job could read all you just wrote here so that they could see how really hard and complicated it is. When the VA inspector came by last time he told me he thought the $4.00 hourly I got to take care of my 90 year old A.D. patient was "overpay". I wish I could email the above to him! Or have him try to get him to take a bath one of these days!

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FROM OUR COMMUNITY

  • Joseph April 18, 2010
    Joseph
    April 15, 2010

    Hi Christine,  There may be other explanations in addition to the one that Nina explained.  Surprisingly, the color of the shower floor may have something to do with the problem.  Depending upon the individual, where we may see an off white shower floor, the dementia patient may see what appears to be a hole or bottomless pit.  Perhaps the reverse is true for some patients.  A dark color may look like a deep hole.  Try this:  Find a shower mat that is a contrasting color from the shower floor.  A good mat will reduce the chance of slipping and falling in the shower, will be easier on the feet and will provide a closer color match to the trusted bathroom floor.  If there is more than one light in the bathroom, turn them all on.  The brightness will be helpful to overcome fears.

     

    The dementia affected brain doesn't always rationalize what the eyes see.  The water in the shower spraying on the shower floor and going down the drain, may be interpreted as spray falling into an empty void that disappears.  This is very scary for someone who can't figure out what they are looking at.  If it looks like an elevator shaft to them, they aren't going to step into it.  Not everyone with dementia may experience this delusion.  For those who are affected in this way, bathing will be a difficult task.  I hope this helps!  --  Joe  --

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  • NC
    NC
    April 16, 2010
    NC
    NC
    April 15, 2010

    Hi Christine,

     

    This is very common for middle stage AD patient for not wanting to take a shower because of water.

    Back in 2007, my father in-law who has late moderate  stage of Alzheimer's started asking why he had to wash his hands. Note that he was MD PhD and always told us to wash our hands once we come back to the house. Always. Until late 2006. We didn't realize that until the psychiatrist said he was drity and didn't take any shower and my FIL lied to him saying he took a shower at night. But he takes showers in the mornings.


    The reason is that the brain is damaged that he does not know how to adjust the temperature of water. Also he does not understand he needs to be clean. His bathroom counter was filthy in 2006. He  refused the caregiver's help at that time. The brain is like the animal's brain and it tells him not to worry about hygiene at all.

    The home care nurse had to come to the house to tell him why he needs to take a shower in 2007. The caregiver has to tell him the steps to take the shower. The other thing is they forgot the steps to do things. So there are "too many steps" for them to deal with by taking the shower. So the caregiver now gives him cues as to when to put on the soap and rinse. Now the caregiver adjusts the water first. They told him not to dress in the morning so he can take a shower. (Now he is sick temporarily so he has sponge bath.)

     

    You cannot insist on telling her to take a shower in the regular sense. You need to soothe her and distract her during the shower and reassure her that everything is fine and that she is clean. You need to guide her step by step. You need to adjust the water for her first. You can also apply some baby lotion on her after the shower or bath.

     

    Hope this helps,

    Nina

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  • daughter-in-law December 01, 2010
    daughter-in-law
    April 15, 2010

    Christine,

     

    All of the above advice is wonderful.  We have also stripped my father-in-laws bed and told him that we are putting on clean linnen so he has to be clean to go to bed (he alwys has showered at night).  He also loves his snacks so we tell him he can have a treat when he gets done.  I am the primary care giver for him but my husband helps him with the showering to lessen his embarrasement, unless I can catch him after he's had an accident.  In that case I just act like it's business as usual, tell him that it's my job to clean him up and that he has to wash the mess off in the shower.  At first we would blame everything on the doctor, 'the doctor said you have to.........' , worked some times.

     

    Good Luck!!!

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