Bathing and Grooming

  • Understand/assess/respect psychological factors such as fear, privacy, and vulnerability issues.  Fear of water is common.
  • Assure dignity by assuring privacy.  Use privacy screens.  Close doors.  Make sure the individual is covered as much as possible.
  • Determine the best time of day for your loved one (when they're most relaxed, least interruptions)  and develop a routine around that time.  Be prepared to try again, if necessary.
  • Try to observe personal preferences (before disease) as best as possible (e.g., bath vs. shower, morning vs. evening)
  • If the individual is still able to read and follow notes, write reminders for them, e.g., "Mary needs to bathe on Monday, Wednesday, and Friday."
  • Avoid unnecessary explanations, reminders, and discussion about the need to bathe.  Be matter-of-fact.  Don't ask if they want to bathe in a "yes" or "no" form.  Say simply, "It's time for your bath now."
  • Break each step into smaller steps; involve the person in each step, as possible, to give them control.
  • Use appropriate products and adaptive safety equipment (e.g., bath benches, hand-held shower heads, bath bars, non-slip devices)
  • Observe safety factors like water temperature.
  • Prepare bathroom in advance with all supplies.  Cover mirrors and windows if necessary.
  • Make sure room temperature is comfortable and the bathroom is warmed up in advance.  Persons with AD tend to be very cold most of the time.  Use warm towels, robe, by putting in dryer first.
  • LEt the person feel the water before they get into it.  Gently pouring water on their hands may reassure them.
  • Coach and cue the person to participate and use distractions, like music or snacks, if necessary.
  • Focus on pleasantness of interaction, not just cleanliness, e.g., pleasant room fragrance.  Try candles and softer lights.  Use scented soaps, bath oils, or bubble bath.
  • Modify your approach as impairment increases (encourage, cue, supervise, assist and do) - evaluate each of the changes carefully.  Never leave later-stage patient in bathroom alone.
  • Consider a sponge bath while person is on commode or "waterless" soap, if all else fails.
  • Dont get upset or confront the person if they refuse a bath.  Try again later when they are less agitated.
  • Keep hairstyles simple and quick to style, or take the person to hairdresser for hair care.  This is usually enjoyable for them and one less task for the caregiver.
  • Try applying after shave or cologne to entice.
  • Provide mouth care after each meal.  Yawning in front of someone can help trigger opening mouth.
  • Use child-sized item to reduce anxiety (e.g., hairbrush, toothbrush, combs, etc.)
  • Try oral swabs soaked in mouthwash.
  • Use soft bristle hairbrushes, large tooth combs, spray detanglers.