- 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.
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