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Bathing the Alzheimer's Patient

Bathing a patient with Alzheimer's or dementia is often a difficult task for the caregiver. Here are some suggestions.

For most adults, washing is a personal and private activity. When you are helping someone with Alzheimer's to wash, it's important to be sensitive and tactful, and to respect their dignity. A few simple considerations can help to ensure that washing and bathing remains a relaxing experience for both of you.

Personal care, including washing and bathing, is a common source of anxiety for people with Alzheimer's and their caregivers. It's not hard to understand why - most of us have been carrying out these activities on our own since we were small children.

There are some particularly common reasons for anxiety among people with Alzheimer's, including:

  • Deep bath water
    Deep water can make some people feel worried. You can reassure them by making sure the bath water is shallow, or by setting up a bath seat for them to use.
  • Overhead showers
    Some people find the rush of water from an overhead shower frightening or disorienting. A hand-held shower may work better.
  • Incontinence
    This may be a sensitive issue for both of you. If the person has an accident, they may feel ashamed. They may refuse to admit that it has happened, or to wash afterwards. Try to be reassuring. A matter-of-fact approach, or humor, may work well. Adopt an approach that fits with the nature of your relationship with the person.
  • Self-consciousness
    The person with Alzheimer's may find it embarrassing to be undressed in your presence. One way to overcome this is to uncover only the part of their body that you are washing at the time, leaving the rest covered.
  • Isolation
    Some people may become anxious if they are left on their own and may want you to stay with them while they are washing

Talk to the person about how you feel about bathing them. Ask how they feel and how they would prefer you to do things. Try to find ways to help them remain independent in as many ways as possible, and offer support as unobtrusively as you can. Here are some practical tips.


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Encouraging independence

We all have our own routines for personal care - particularly when we get up in the morning. Try to encourage the person with Alzheimer's to continue with these routines for as long as possible. Take the time to think about which routines work best, as well as the person's preferences, so that you can help them carry on with their normal routine. Where do they like to get undressed? Do they prefer a bath or a shower? What toiletries are they used to? What dental care do they need?

If the person seems confused, it can help if you break the process down into small stages. When someone's nerve pathways are damaged, it becomes harder for them to process a lot of information at once.

  • Offer tactful reminders about which step comes next in their process of personal hygiene.
  • Offer practical help - for example, by handing the person the soap at the point when they would normally wash, or holding out a towel when it's time for them to dry themselves.

Safety precautions

There are some very practical considerations when someone with Alzheimer's is using the bathroom:

  • Check that the floor is not slippery.
  • Make sure that the room is warm before the person undresses. Older people are more sensitive to heat and cold than younger people.
  • Check that the water temperature is not too hot or too cold. You can buy a heat sensor that sticks to the side of the bath and changes color if the bath water is too hot, to prevent scalding.
  • You may need to remove locks from the bathroom door, or replace them with locks that can be opened from outside. Someone with Alzheimer's may lock themselves in and panic, or they may go into the bathroom and then forget why they went in.
  • Don't forget your own safety. If you have to help the person get into the bath, make sure you don't strain your back. If this is becoming a problem, talk to an occupational therapist about equipment to help you (see Aids and equipment, below).

Last Updated: 23 July 2014
Reviewed by Harry Croft, MD

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