THE SITUATION

When you think about it, showers can be pretty overwhelming for a person with Alzheimer’s disease. None of it makes sense. This might be what he or she is thinking: “Why would a person try to take my clothes off and put me under running water? In fact, I feel like I just got cleaned up and don’t even need to get wet.” Take a moment and put yourself in the same position. Confusion, visual difficulties, echoes, misinterpretation of the situation—and all with a caregiver the person might not recognize or even really know. As an aside, you will never convince a person with Alzheimer’s disease to take a shower. Given symptoms that typically include lack of judgment and reasoning ability, you will simply be reasoning with yourself. The real truth is that you are on your own to create an environment that is nonthreatening and soothing for the person with dementia.

THE SOLUTION

  • Set the mood. Be excited about the shower. Your nonverbal cues will be most easily read by the person. This is going to be the best experience ever!
  • Prepare the environment. Have the towel, washcloth, soap and shampoo ready. Prepare the clean clothes as well. Be sure the bathroom is as warm as possible. With Alzheimer’s disease comes an inability to adapt to temperature so you need to be sure the person is warm. Before taking the person into the bathroom, run the water until it is already warm so you do not waste time with the person sitting there while the water heats up.
  • Provide assistance. Help the person into the bathroom. Talk about something else. For example, if possible, engage the person in a discussion about favorite vacations. If not, talk about your vacations. If nothing else, hum; if you can’t hum (you know who you are), put on some music from the person’s era.
  • Avoid distractions. Turn off your cell phone or any other things that could make startling noises.
  • Engage the person in the activity. Ask for the person’s help. For example, ask, “Would you help me with these buttons?” Also give some choices, such as, “Do you want me to start on this side or this side? Do you want to hold this washcloth or this one?” Likewise, at the end of the shower, let the individual be involved, if possible, in putting on lotion, closing buttons, etc.
  • Be respectful. If the person starts to shy away or gets agitated, put a towel around the person’s shoulders and relax a little–then go for it again, very calmly. Or, put a towel on the person throughout the process and use it to wash the body. When washing hair, place a washcloth over the individual’s eyes or ask the person to hold the washcloth there.
  • End on a high note. When you turn off the water, have several towels at the ready to put around the person and give the person a warm squeeze as the drying off process begins. Tell the individual what fun you had and that you look forward to the next time. Be positive and upbeat! Reinforce yourself for a job well-done!
    — WRITTEN BY P.K. BEVILLE

PREPARE IN ADVANCE Consider the “Behavior Equation” in order to develop a plan to assist with showers. What is the individual’s functional level? What are the person’s past habits, such as time of day for taking a shower? Is the room as familiar as possible? Try to answer each part of the equation as much as possible and prepare accordingly.

P.K. BEVILLE of Marietta, GA, is a geriatric specialist and founder of Second Wind Dreams, based in Marietta.