As a dementia diagnosis progresses, difficulties with personal care such as bathing, grooming and changing clothes might start to occur. If your loved one is experiencing these issues it is important to understand why refusals are happening. Gaining a deeper understanding of the why behind the behavior will increase your empathy for your loved one, and can help caregivers manage this difficult situation.

It can be a common occurrence for a person with dementia to resist bathing. As people age, they lose more control over their lives. One thing that generally remains in their control is personal care. Often, the more a person is told what to do, the more resistance they show.

Consider the following common obstacles and possible solutions:

These common issues may be the cause of resistance.

Pain or Discomfort:

Consider changing the time pain medication is given to fit with the personal care routine

For bathing, make sure your loved one is positioned comfortably, keep the bathroom warm, and have towels and a bathrobe ready for before and after bathing

Provide a gentle touch taking extra care of areas that might be painful

Try shortening a shower by using no-rinse shampoo or soap

Fear:

Consider that people with dementia may be unable to communicate feeling of fear and a person may feel unsteady or fearful of falling

Improve the environmental safety: Adding grab bars, bath mats, a hand held shower hose, and a shower seat can reduce fears

Make sure when sitting that your loved one has his or her feet are the floor and not dangling

Embarrassment:

Take into consideration preferences regarding modesty

Have caregivers build a relationship with your loved one before taking the bathing task, and try to keep changes in caregivers to a minimum

Make certain the person feels safe and comfortable with the caregiver, consider if a caregiver of the opposite sex may be upsetting

Loss of independence:

Try to maintain independence and sense of control during dressing and bathing

Always ask for permission instead of saying “it is time to take a shower.”

Provide choices throughout the experience

Honor your loved ones preferences and history of routine; do they usually shower at night or in the morning, what products do they use?

Poor communication:

Learn how best to communicate with your loved one: a person with dementia might find it hard to process a lot of information at once. Try explaining the process and breaking down a task into smaller steps

Caregivers should speak slowly and move slowly; don’t rush your loved one through the process. Communicate what is going to happen throughout each step of the activity

If verbal communication is challenging, try using sensory bridging techniques such as providing a favorite/familiar soap or shampoo to smell before starting the activity, using relaxing music, singing or letting them feel a soft scarf or sweater before donning it

There are many strategies to try when helping your loved one through a personal care task. Remember that every individual is different, and it may take trial and error to find a solution that best helps to create a positive experience for everyone involved.