If you are caring for a loved one with Alzheimer’s or dementia, you may find it increasingly difficult to keep up with their personal hygiene. One of the biggest areas of concern that our clients’ loved ones have is the challenge of bathing.
Jumping in the shower may seem routine to you, but for someone with dementia, the experience can be quite the opposite. It’s very common for people with dementia to forget about, or even lose interest in bathing and changing their clothes. Understanding the cause may better help you determine your approach:
Lack Of Privacy
Many seniors were raised to think that washing and dressing should be intimate, private activities. Some have never dressed or undressed in front of others, which may lead to embarrassment or humiliation. They may refuse to change or bathe in front of others so they can hide incontinence issues.
- Pull down blinds, cover mirrors, and make sure the door is closed for added privacy.
- Approach the person with understanding and reassurance.
- Place a towel over the genitals and simply lift for washing if the person is uncomfortable with nudity.
- After washing, position towels over the person's lap and on the back of the wet shower chair for comfort and dignity.
- Keep them covered while you dress their top half first.
Remember that with dementia, your loved one’s depth perceptions may change, making them feel uncomfortable in small, dark places.
- Make sure that the bathroom is warm, well-lit, and inviting.
- Soft music may help make the environment more relaxing.
- Remove unnecessary clutter. Multiple bottles of shampoos and conditioners may be confusing.
- Keep water at a consistent, comfortable temperature.
- The sensation of water hitting your loved one in the shower may be perceived as painful. Try using a handheld shower wand.
- Spraying the head first can be frightening and cause an aggressive protective response. Start by showering the legs and move upwards to the chest and back.
- Try separating hair washing from bathing. Some people with dementia associate bathing with having their hair washed and become upset because water being poured over their head frightens them.
Remember that your loved one might not bathe as much as you do, nor do they need to. As people age, the body produces less oil, eliminating the need to shower every day. It is important that you do not impose your views about how often your loved one should bathe.
- Try to match your loved one’s bathing routine before the onset of dementia. If they always showered in the evening, set up an evening bathing schedule.
- Consider the time of day when your loved one is most relaxed and not exhausted.
Tasks are too complicated or confusing
Personal care (bathing, dressing, oral care) can be very confusing and complex with all of the steps involved.
- Break down each task into simple steps, while explaining each step. Use simple, respectful language.
- Try offering the person limited choices.
- Let your loved one feel the water before getting into the shower. Saying things like “The water feels nice” or “This feels so good”, can be reassuring and calming.
- Encourage your loved one to do as much as possible.
- Lay out the soap, washcloth, towel and clean clothes in a sequence so your loved one can use them as needed.
Always remember that patience is key. If your loved one shows signs of agitation, take some time to step back and regroup. Move onto another activity for a few minutes, then try again. If all else fails, sponge baths can be an option.
For help and information, contact the Alzheimer’s Association.
Home Helpers’ caregivers are trained and experience with Alzheimer’s and dementia. If you feel that you can no longer care for your loved one on your own, click HERE to learn how we can help.
We often have clients who have adult children living in different a state, making care difficult. Long distance caregivers are defined as caregivers who provide care for a loved one who lives more than an hour away. A growing number of adult children are discovering just how hard it is to try to ensure the welfare of aging parents who live hundreds, sometimes thousands, of miles away. We’re here to take some of the worry out of long distance caregiving. Here are some helpful tips for long distance caregivers:
Most people who live away from their aging parents are able to make a few visits each year. During your visits remember to:
Keep a journal and make a list of the following important information:
- Medical records.
- Notes on their condition.
- A list of medications they take.
- Names and phone numbers of all doctors.
- Name and phone number of their pharmacy.
- A list of insurance policies, the carriers and account numbers.
- Company names and phone numbers for all utilities, including electric, phone, cable and Internet.
- A list of all assets and debts (include dollar values).
- Yearly or monthly income.
- Yearly or monthly expenses.
- A statement of net worth.
- Information on bank accounts, other financial holdings and credit cards.
- Relevant legal documents your loved one has or wants to create (i.e. wills, advance directives, trusts, powers of attorney).
- Location of important documents (i.e. birth certificates, deed to home).
- Social Security numbers.
*It’s a good idea to make a copy of your list and give it to a trusted relative or friend who lives near your loved one.
Make sure that you discuss and understand your loved one’s wishes about legal and financial matters. Be sure to have a copy of all important documents. It’s a wise idea to give a copy to the physician and a friend or neighbor. Have a copy at your loved one’s house in an easily accessible place.
- Will - the elder decides how to disperse assets after death
- Power of attorney - gives a caregiver the authority to act on behalf of the older person
- Trust: estate-planning document allows the elder to transfer assets and avoid probate and other legal problems
- Joint ownership: makes it easier to gain access to the elder's finances
- Representative payee: A caregiver receives government checks for an older person unable to manage money
- Medigap insurance: pays portion of medical bills not covered by Medicare
You may live far away from your loved one, but hopefully you will have opportunities for visits throughout the year. During your visits, be sure to:
- Schedule appointments. If possible, attend appointments during your visit.
- Go through prescriptions to make sure nothing is expired and they are being taken properly.
- Refill prescriptions.
- Look in the refrigerator and pantry for expired food. Make sure your loved one is eating properly.
- Make a list of household items that need to be repaired or replaced. If possible, buy or fix the items during your visit.
- Look for safety hazards such as loose rugs, loose handrails, and poor lighting.
You may start to realize that more help is needed on a regular basis. Think about your parent’s daily needs and whether they are still being adequately met. Are they:
- Socializing with friends and other relatives?
- Attending religious services or other regular events?
- Keeping up with chores or housekeeping?
- Maintaining their personal appearance and hygiene?
- Eating well with a variety of foods in the house?
- Opening and responding to correspondence from insurers, banks or others?
- Paying bills and balancing the checkbook?
- Scheduling and getting to doctor appointments or other important visits?
- Getting out to the store or recreational activities?
- Maintaining the home?
- Taking medication as directed?
If you find that your loved one needs more help, look into bringing in outside help, such as a caregiving agency. You can find more information HERE .
While most of us have probably lost our keys or misplaced something that was under our nose the whole time, a question many people have is, “Is there a reason to be concerned, or might it just be a Senior Moment?”
A challenge for many families is often determining at what point a change in behavior merits consideration, and when to pursue medical attention.
People often make statements such as “Dad’s going nuts,” or “Mom’s lost her mind,” and don’t recognize that treatments may be available to help a loved one. Dementia, depression and delirium are conditions that cause behavior changes, yet are often undiagnosed and untreated.
The incidence of all three conditions increase as people age. If you sense a change in a loved one’s behavior, encourage your loved one to undergo an assessment by his or her physician. To help health care professionals diagnose and treat a medical condition, it can be helpful to keep a journal of unusual behaviors and report any and all symptoms.
Let’s take a look at each of the three conditions:
DEMENTIA is a term that describes disorders that affect the functioning of one’s brain, and it is characterized by mental decline and impairment. Dementia and Alzheimer’s, a degenerative disorder of the brain, is reported to be the most common cause of dementia in older adults. The Alzheimer’s Association reports that “As many as 10% of all people 65 years of age and older have Alzheimer’s. As many as 50% of all people 85 and older have the disease.”
People with Alzheimer’s have dementia; however people with dementia don’t necessarily have Alzheimer’s. For example, people with chronic conditions such as Parkinson’s can have dementia. A common form of dementia is a condition referred to as Multi-Infarct, where blood flow is cut off from a certain part of the brain, resulting in permanent damage and loss of mental capacity.
People with dementia often have trouble with their ability to recall information, solve problems and speak. They may also act strange or seem moody. People with dementia often lose the ability to perform everyday tasks necessary to live independently. Another characteristic is an inability to make decisions or respond to questions.
DEPRESSION refers to a mood disorder that can affect both a person’s mind and body. While many people never seek treatment for depression, those who do often experience improvement over time. While everyone occasionally feels depressed or sad, depression is characterized by intense sadness that lasts for a period of two weeks or longer, and impacts a person’s ability to lead a normal life.
DELIRIUM is a cognitive or mental disorder, not a disease. Delirium appears suddenly, often within hours or days, and may come and go throughout the day. A person who is delirious may appear disoriented, exhibit varying levels of consciousness, have disorganized speech, and an inability to comprehend what’s being sad. Delirium can be frightening as a loved one acts unpredictably, is uncooperative and sometimes acts violently. With delirium, there is typically an underlying cause such as infection (commonly UTI’s in older adults), dehydration, physical illness, head injury, trauma, substance abuse, or a reaction to medications (e.g., prescription, over-the-counter, supplements). Once the cause is identified and treatment begins (e.g., changing medications, increasing fluids or treating infections), there is often a quick turn-around.
SEEK MEDICAL ATTENTION
If you notice a change in a loved one’s behavior, regardless if the change is sudden or gradual over time, seek medical attention. Health care professionals are likely to complete an assessment to rule out possible causes, make a diagnosis and determine treatment options. People who receive treatment often enjoy a better quality of life.