Whether the person with a memory loss is living at home or in a nursing facility, bathing often provokes agitation and distress. It is one of the most stressful tasks faced by Caregivers and recipients alike. One of my clients, who lives in a condominium, has a live-in caregiver because of her memory loss.
Mrs. Jones (not her real name) is very sweet and easy going, that is, until it comes time for her bath. But it was not always that way. When I first met Mrs. Jones, I was surprised to learn that her neighbors had called the police on two occasions. Why? Because her screams were so loud. The entire complex knew when Mrs. Jones was being given her bath.
Determine the Cause of Resistance
It is not uncommon for persons with dementia (memory loss) to be taken into a shower or tub verbally and physically resisting. Why do they resist? They resist for many reasons. In institutional settings, it is common for a resident to be undressed in their room by someone they perceive to be a stranger.
Remember that the resident suffers from dementia. The Caregiver may have cared for this resident for three years, but to the memory impaired resident, the Care-giver is a stranger. Wouldn’t you resist if a stranger were taking your clothes off?
Next, the Caregiver puts a flimsy gown on him, places the resident in a chair with wheels and whisks him down a corridor with strangers on either side, staring. As he enters the shower, he begins screaming because the tiles and faucets remind him of the gas chambers in Auschwitz. The memory impaired resident perceives that he is being taken to the gas chamber.
We unknowingly contribute to the agitation and distress experienced by our loved ones and residents with dementia. Our behaviors play a major role in whether or not the task of bathing the memory impaired will be successful (i.e. not stressful). Caregivers can reduce the physical aggression and other agitated behaviors when bathing persons with dementia.
Keep in Mind the Reasons we Bathe
Lets first lookout why we bathe. Oftentimes, when I am in a long term care facility, and I observe a resident who is not happy about being bathed, I ask the Caregiver, “Why are you taking Mr. Smith to the shower?” Usually, I am told, “Because it is Monday.” Or, “Everyone is bathed on Monday, Wednesday and Friday.”
Wrong. There are only two reasons to bathe Mr. Smith. Either Mr. Smith has soiled himself and needs to be cleaned, or he smells. But NOT because it is Monday.
Bathing is such a routine part of everyday life that it seems preposterous to ask why we do it. However, when residents and loved ones clearly become distressed by the experience of being bathed, it is worth inquiring whether, when, how, and how often this has to happen.