As a caregiver, one of the many issues of caring for dementia patients is practicing personal hygiene. You may wonder, “Why don’t dementia patients like to shower?”
The issue may stem from aquaphobia or a fear of water. People living with dementia often feel wary of water since they can’t see it. Bathing resistance can also come from feeling ashamed of the lack of independence or embarrassment of having someone helping you with this very personal activity of daily living.
Fortunately, there are several methods you can apply to ease the bathing process for you and your patient or loved one. A few methods to make the bathing process easier for both of you include creating a safe and relaxing environment, incorporating their favorite personal care products, and relaxing music.
Whether you are a family caregiver or a CNA working in a long-term care setting, knowing how to help the person you care for when it comes to bathing and grooming can be one of the toughest parts of caregiving.
Dementia and Aversions to Showers
As people with cognitive deficits progress further into more severe stages of dementia, they’ll likely need assistance with bathing, dressing, and toileting.
People may refuse to bathe or receive help with other personal care for various reasons:
It’s a Personal Activity
Bathing is an intimate and personal activity. Dementia patients may feel that your assistance poses an invasion of their privacy.
Getting undressed tends to make us all feel cold. It can evoke vulnerability and a sense of embarrassment when removing clothes in front of someone else. People with dementia may feel shame from their helplessness.
They May Be Scared
Dementia patients tend to experience disorienting bouts or confusion, making bathing a scary prospect. During the process, they may be worried about falling or slipping on a wet surface.
When bathing or showering, dementia patients may feel off-balance due to reduced depth perception. Perhaps they’ll argue and resist the ordeal altogether.
Dementia can progress to a point where cognitive function deteriorates and triggers overstimulation.
Consequently, patients feel overwhelmed by bright lights, loud noises, and cold water. While bathing or showering is usually relaxing, dementia patients may experience pain and anxiety.
Feelings of Confusion
For people with dementia, bathing involves multiple steps. It can muddle and overwhelm them. For this reason, breaking down and simplifying the steps while verbally instructing them can alleviate this issue.
You can give people choices to integrate independence, starting with asking whether they want to have a bath or a shower. When people have choices and feel like they are part of the decision, they may be less resistant to care.
What Can I Do to Help a Dementia Patient Shower?
Convincing a dementia patient to shower or bathe may be challenging due to fear, embarrassment, or uncomfortableness.
Understanding the cause of their fear is the first step to easing the showering process. That way, you can better cater to their personal hygiene needs.
For instance, some dementia patients may perceive the odorous essential oil scents in personal care products as toxic and evoke paranoia. In this case, you’ll want to avoid using strong aromatherapy or scented candles.
You don’t need to bathe older adults daily. Bathing two to three times weekly will usually suffice and make the process much easier. Here are some tips to help when it is time for a shower or bath.
Use Positive Reinforcement – 10 Phrases to Use
Approaching your patient or loved one by saying, “You need to shower,” will likely trigger negative emotions and result in resistance. Instead, you’ll want to phrase your request in a more inviting tone using simple and reassuring language.
10 Tips: Phrases to use when asking someone with dementia to bathe or shower
Remember to maintain a calm and positive tone, and be prepared to adjust your approach depending on the person’s reaction. It may take some trial and error to find the most effective phrases and techniques to entice someone with dementia to bathe or shower. Always prioritize the person’s safety, dignity, and comfort during the process.
Create a Relaxing Environment
A calm and soothing environment will likely reassure a person with dementia. You can incorporate flameless candles, add light and calming scents, or create a bubble bath.
Use their favorite shampoo or other bathing products to create a positive association with grooming. Relaxing music can also create an inviting atmosphere for you and the person you are caring for.
A cold environment may make bathing or showering challenging. If needed, add a space heater and offer a thick, cozy bathrobe with slippers before reaching the tub. Monitor the water temperature to ensure it’s warm. Adjust the water pressure accordingly.
Be sure to observe the person throughout this process. If you notice any discomfort, communicate to understand any underlying issues.
Ensure Safety Precautions
People living with dementia may have weak depth perception. Keep them safe with non-skid mats and a secure shower or bath bench. Add grab bars in the shower and bathroom where needed.
Allowing the patient as much control as possible over the bathing process to ensure a smoother experience for you both. For example, offer them a handheld showerhead so they can shower independently.
If they are concerned about being unclothed during a bath or shower, a caregiver bathing wrap or a shower cover-up can help maintain privacy while you are still at hand to assist with hygiene.
While helping the patient, observe at which point they’re most resistant. There may be days when a shower is not worth the angst and frustration. A quick cleanup with a sponge bath or disposable wipes will do for the day.
Why don’t dementia patients like to shower? The refusal to shower or bathe can originate from a fear of the water or feeling uncomfortable and vulnerable being naked in front of someone else.
A person might also experience paranoia and delusions about their surroundings. People living with dementia may have hallucinations about water or they could be worried about falling or losing their balance on a cold hard surface.
You can resolve bathing and showering issues through positive reinforcement, reassurance, and the addition of products for caregivers in the bathroom.
Why Don’t Dementia Patients Like to Shower? Frequently Asked Questions
People living with dementia may forget to shower during the early stages of cognitive decline. Refusing to shower tends to come in the later stages of dementia. The later stages of dementia can last anywhere between two to four years.
Dementia is often associated with aquaphobia. People may feel sensory overstimulation from water. They may also fear water because they can’t see the transparent liquid. During showers, they may stand aside the shower head to avoid getting the water on them. The dislike can also stem from cold temperatures. One of the many symptoms of dementia in the mid or late stages is feeling chilly.
Dementia patients may neglect their hygiene causing body odor, skin infections, and urinary tract infections (UTIs). They may tend to avoid bathing and changing their clothes or undergarments.
People living with dementia may lose interest or forget about their hygiene. This can encompass toileting, dental, ear, hair, fingernails, and toenails hygiene.
Dementia can affect an individual’s ability to shower or perform personal hygiene tasks in various ways. As dementia progresses, cognitive, physical, and emotional challenges may arise, making showering and other daily activities increasingly difficult. To help individuals with dementia maintain good hygiene, caregivers should be patient, empathetic, and willing to adapt their approach to the person’s specific needs. This may include using visual cues, verbal prompts, offering choices, providing a safe and comfortable environment, and breaking down the task into smaller, manageable steps.
Amie Clark, BSW
Aging Advocate and Senior Care Expert
Amie has worked with older adults and their families for the past twenty-plus years of her career. Her senior care knowledge is based on her experience as a social worker, family caregiver, and senior care consultant. Learn more about Amie here.