Like other activities of daily living, bathing can be difficult for individuals with Alzheimer's disease. Your mother could be having difficulty with bathing due to several issues.  She may have forgotten how to undress, wash or dry.  She may be frightened about the bathtub surface or become disoriented to the people or place she is in. 

But there are ways to make the process easier for both caregivers and the person with the disease. Recognizing her abilities and preparing ahead of time can help simplify the process.  Try to follow the same bathing schedule you mom had prior to the onset of the disease. For example, if she used to take a shower, not a bath, head for the shower. If she used to bathe in the morning, follow that routine. This is the rule of thumb unless your mother has specific hygiene needs or behavioral changes arise.  For example, adjustments may be necessary if she is severely agitated, wakes up soiled in the morning, or experiences behavioral problems, or "sundowning" as evening approaches.

It is also important to “set up the scene” in advance to make bathing seem less intimidating. For example, if your mother thinks that another person might be in the room while seeing her 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 your mother 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 her dignity. It is a good idea to use a handheld shower head as this can also prevent water from splashing directly into her face (which can be very frightening to a person with this illness). Allow her to take part in the process by encouraging her to wash herself. You can use her favorite scents in the tub that could help spark memories from the past.

Also, try engaging her with activities and discussion throughout the process. Here is an example of a conversation you can have:

You: Mom, I want you to know that I bought this great bath soap for you. What do you think of the smell?

Mom: Smells like cake.

You: It sure does smell like cake! I know you love cake. It’s your favorite.

Mom: Yes.

You: (While washing her) Do you remember the time you baked that delicious cake for the bake sale? It was the one with the vanilla icing.

Mom: Oh yes, it won first prize!

You: (Pass the sponge to her) Yes it did, and it one of the best I ever tasted. I love this soap because it reminds me so much of your icing. I want to wash my hands with it now. Why don’t you join me?

Just remember to always be positive, patient and go at her pace. If you have exhausted all these options, and she continues to refuse to bathe, you may have to consider giving her 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

4-Provide her with reassurance

5-Always approach her from the front whenever possible

6-Make sure the room temperature is appropriate for disrobing

7-Keep your mother in a bathrobe until she is in the bathing area

8-Lay out clothing in advance to proceed quickly from drying to dressing