Avoid battles over bathtime
Bathing is a constant struggle for many caregivers of seniors with Alzheimer’s disease, dementia, or other cognitive impairments.
It’s important to keep your older adult’s body clean to prevent skin infections, reduce the risk of urinary tract infections, and avoid unpleasant body odor.
But trying to get them to take a bath or shower often results in arguments, hostility, crying, or screaming. That ruins everyone’s day and skyrockets your stress level.
So what can you do when someone with dementia refuses to shower?
We’ve got 8 tips to help you overcome their resistance to bathing. Experiment to find out which of these works best for your older adult.
8 tips to get someone with dementia to shower or bathe
1. Establish a daily routine
Even if older adults don’t need to bathe every day, it’s often easier to establish a regular daily routine that includes bathing at the same time every day.
That way there’s no question about when or why it’s happening – it’s just part of the normal flow of their day, like eating or sleeping.
A predictable daily routine reduces their overall stress and anxiety and makes it more likely that they’ll bathe without resistance.
2. Use positive reinforcement and don’t argue
Don’t try to argue with your older adult about how many days it’s been since their last shower, how stinky they are, or why good hygiene is important.
Logic and reason don’t work. Instead, keep sentences short and simple and focus on the positive, fun activities that come after the bath.
For example, when the bathroom is warm enough, go over to your older adult, make eye contact, and smile. Extend your hand so they’ll take it, get up, and let you escort them as they walk (toward the bathroom).
After they’ve started walking, say something like “Let’s go shower now and then we’ll have a yummy snack (cookies, juice, etc.) and do something fun.”
As you walk, keep the conversation focused on the snack or fun activity to avoid discussing or arguing about the shower. “Those chocolate chip cookies are your favorite, aren’t they? And we can put together that puzzle with the beautiful birds.”
If you consistently take this type of approach, taking a shower becomes associated with positive things like their favorite snack or activity.
If they refuse to bathe and start to argue, drop the subject and move on to something pleasant. This avoids a fight that will create negative feelings that often linger. Wait and try again in a little while.
3. Say “we” not “you”
During the entire bathing experience, it’s helpful to use a calm, soothing tone and say “we” instead of “you.”
This gives the feeling that you’re doing this relaxing activity together, they’re not going through it alone, and scary things won’t be done to them.
4. Make the bathroom warm and comfortable
Older adults feel cold much more easily than someone younger. Seniors often don’t like to bathe because all they remember is being cold and shivering.
Making the bathing experience pleasant and comfortable will reduce objections before and during the shower.
5-10 minutes before they enter the bathroom, turn on a space heater to make the bathroom nice and warm. If you get hot and sweaty, that’s probably a good temperature.
Lay a towel on the chair or toilet seat where they sit to take off their clothes so it won’t feel cold and hard.
You might even want to play soft, soothing music to create a serene, spa-like atmosphere.
5. Reduce effort and help them feel safe and relaxed
Using a shower bench or chair significantly reduces the effort needed to take a shower since they won’t need to stand and balance while soaping and rinsing.
A shower transfer bench allows them to slide into the tub or shower area while staying safely seated the whole time. Some benches (like this one) even have rails that allow you to slide the seat from outside to inside, eliminating the need to scoot.
A shower chair would require them to step into the shower or bath before they can sit down.
6. Use a hand-held shower head to reduce fear
The overhead spray of a shower can be terrifying to a person with dementia.
Some experts think this happens because they can’t see the water that’s hitting them and it feels like something invisible is attacking their head.
To solve this problem, install a hand-held shower head instead of a regular one so you can control when and where the water touches them.
Before turning on the water, get them seated in the shower chair. Then, with the shower head at feet-level and pointing away from them, turn on the water and adjust the temperature.
When the water is warm, say “Let’s put our hands (or feet) in the water now” and slowly start spraying water on those body parts to give them time to adjust to the feeling and let you know if the temperature is right for them.
If the loud sound of the water bothers them, don’t turn the taps on all the way so the spray won’t be as strong.
Or, minimize the time the water is on by using a simple shut-off valve so you can easily turn the water on and off while soaping up.
Bathing takes so many steps, it’s no wonder that it’s overwhelming for a person with Alzheimer’s or dementia.
But even if your older adult doesn’t know what to do next, they’ll likely still remember how to do it.
At every step, let them know what’s going to happen and coach them through it so they can do as much as possible on their own.
Give them some time to do things on their own, but be ready to provide gentle assistance when needed.
This gives them control and improves self-confidence. Plus, if they know what’s going to happen at every step, they won’t be as scared or anxious.
For example, you could say “Let’s rub the soap on your arm now. That’s great. Now we’ll rinse the soap away with the water.”
8. Use extra towels for comfort and warmth
While showering, some people might like to use a towel to cover body parts that aren’t currently being washed. (The towel will get wet and that’s ok.)
Help them stay comfortable by keeping the wet towel warm with occasional sprays of water.
After bathing, immediately wrap them in two large, dry towels (front and back) to keep them from getting chilled.
This can be done while they’re still sitting on the shower chair. Getting them mostly dry before moving them out of the tub also helps to keep them warm.
Recommended for you:
- How Often Should Seniors Bathe? 3 Essential Health Tips
- Therapeutic Fibbing: Why Experts Recommend Lying to Someone with Dementia
- 3 Stages of Dementia: What to Expect as the Disease Progresses
By DailyCaring Editorial Team
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Thank you very much for sharing this information. It’s perfectly timed for us! My 90 year old mother reluctantly showers but isn’t able to/doesn’t always thoroughly clean her genital area.
This also happens after bowel movements. (She is able to still use the toilet.) When I clean her bathroom after her shower, I often notice stains on her towels.
I don’t know how to best address this issue or how to make her cleansing more effective.
I am not sure her reach is adequate to use a peri bottle.
I appreciate any suggestions.
It can become more difficult to wipe and wash if she doesn’t have as much flexibility and strength as she once did.
For everyday toileting, it may help her to use disposable wet wipes instead of dry tissue to clean up. Please note that even those labeled flushable generally aren’t – over time, flushing these wipes can cause plumbing issues.
In the shower, she might need help reaching the area with the water spray to give a throrough wash. If she doesn’t already have one, a handheld shower head would help her direct the water to rinse the area thoroughly.
To make it easier, it may help for her to be seated while she showers. A shower chair with a cutout for the bottom might be helpful.
Another thing is to rule out bowel leakage. That’s a possible cause of not being able to completely clean up.
Hi I’m caregiver for Alzheimer’s male .when he refused shower I tell him if you shower I will give you ice cream after he says yes… shower with no problem … if I keep asking you wanna shower not good idea behavior gets really bad. Ask only twice … and come back later on ..I have learn alot from watching videos. .
That’s a wonderful approach! It’s a good idea to not make it an issue and to try again later. Thanks for sharing these helpful tips 💜
I need help getting my husband to take baths.He has deminta but he can still walk and do most things for his self.But i cannot get him to bathe.He gets hostle to me. does medicare pay for someone to help with this?
This is definitely a tough situation. It often takes a bit of trial and error to find strategies that help someone be more cooperative with bathing and changing. Hopefully the suggestions in the above article will be helpful.
Hiring someone to help him bathe might help. Some people feel more comfortable having a “stranger” help them rather than a spouse. Unfortunately, Medicare doesn’t pay for non-medical in-home care.
You could also try establishing a regular daily routine that includes bathing. It will take time to get used to, but it’s possible that bathing could become a regular and expected part of his day. More info here: 5 Ways Caregiving Routines Make Daily Life Easier https://dailycaring.com/5-ways-caregiving-routines-make-your-life-easier/
I am a caregiver for a sweet elderly lady with dementia. I have no issues with her on any other subject except for when it’s time for bathing. She absolutely refuses to bathe. And it’s got to the point where she smells really bad. I will definitely try these ideas to see if maybe I can convince her the shower.
We hope these suggestions are helpful in convincing her to bathe and that they’ll make the process easier and more pleasant! It’s great that things are going well overall.
My mother has dementia. She refuses to take a shower and won’t let us bathe her because she says she can do it herself. When she gets in the shower herself, there’s no way to know if she actually showered. What can we do to help her get a shower when she refuses and is capable of doing it herself and won’t let anyone help her shower?
Many people don’t want help in the shower because it’s an understandably private activity. One possibility is that she would be more comfortable allowing a professional caregiver help her rather than a family member. You may need to ease into that slowly by starting the caregiver on non-personal tasks like meal prep, companionship, etc. Slowly move toward more personal activities like dressing, etc. Then move on to bathing.
Another idea is to very slowly get her used to having a family member around when she showers, ideally the person that she’s close to and feels comfortable with. For example, start by helping her arrange the bathroom with some extras, like a heater, and then leaving the room. Over time, gradually extend the time you’re in her presence by finding things to do that are “needed” for her bathing experience, like laying out a towel, or handing her the shampoo while she’s actually bathing.
You could also try calling the Alzheimer’s Association at 800-272-3900. They may be able to offer additional advice since they speak with so many caregivers going through similar situations.
If by chance he is a veteran, they will pay for three bath visits per week. And a respite visit as well.
If in Australia, get ACAT assessment for some in home assistance with caring.
My Husband has late stage dementia and is in a nursing home. He gets very combattive when the CNA’S try to change his clothes or shower him. I think the CNA’S are afraid of him and rightly so. I’m afraid they will not keep him. I need help and suggestions. Anybody experiencing this and what will I do if the day they can’t keep him. Desperate!
This is definitely a tough situation. It often takes a bit of trial and error to find strategies that help someone be more cooperative with bathing and changing. I hope the suggestions in the above article will be helpful.
Here are some articles that may also be helpful:
— How to Approach Someone with Dementia: 6 Tips for a Positive Care Experience [Video] https://dailycaring.com/how-to-approach-someone-with-dementia-6-tips-for-a-positive-care-experience-video/
— 4 Steps to Calm Stress and Distress in Dementia to Make Care Tasks Easier [Video] https://dailycaring.com/4-steps-to-calm-stress-and-distress-in-dementia-to-make-care-tasks-easier-video/
— 4 Ways to Get Someone with Dementia to Change Clothes https://dailycaring.com/4-ways-to-get-someone-with-dementia-to-change-clothes/
— 14 Ways of Dealing with Aggressive Behavior in Dementia https://dailycaring.com/14-ways-of-dealing-with-aggressive-behavior-in-dementia/
— What to Do When Someone With Dementia Lashes Out Physically https://dailycaring.com/what-to-do-when-someone-with-dementia-lashes-out-physically/
My Mom gets angry and combative and I think the CNA’s give up. She will not wear underwear and I wash her clothes so I know when she has worn the same clothes for days and days. She had developed a skin infection before and I can’t stand to see her this way. How should I handle this with the care givers.
Does your mom have Alzheimer’s or dementia? It sounds like she may have some cognitive impairment that’s causing this behavior. It will likely help if the caregivers are trained in how to help someone with dementia. Fear of bathing and anxiety and agitation in general are common in people with dementia.
If you’re using an agency, you could ask if there are CNAs with more experience in dementia care. If she’s in assisted living, it’s important to bring this issue up with the administrator because it’s not acceptable for them to let her develop a skin infection.
Hopefully, the tips in the article above will help the caregivers get your mom to bathe. In general, remind them that they should go very slowly and be gentle. It takes extra time for someone with dementia to process information.
Here are some additional articles with helpful information and suggestions:
— How to Approach Someone with Dementia: 6 Tips for a Positive Care Experience [Video] https://dailycaring.com/how-to-approach-someone-with-dementia-6-tips-for-a-positive-care-experience-video/
— Challenging Alzheimer’s Behaviors Solved with Expert Communication Tips [Video] https://dailycaring.com/video-difficult-alzheimers-behaviors-solved-with-expert-communication-tips/
— How to Talk to Someone with Alzheimer’s: Use Short, Direct Sentences https://dailycaring.com/how-to-talk-to-someone-with-alzheimers-use-short-direct-sentences/
PATRICIA some times after shower they refuse put cloth on that could be our mom case…. we caregiver’s try do the best we can. .. ❤ safe is number one
My grandmother is in late stages of Alzheimers and still at home, with the help of daily CNA’s through her Hospice agency she receives a few showers a week. However she is becoming much more agitated and very combative with her techs. To the point they are almost afraid of her. She is quite adamant about not showering and its getting harder to coax her into the shower. I wish any of these tips helped but shes to far gone at this point I’m afraid. But good for those with early onset.
I’m sorry this is happening. It’s possible that she’s becoming more afraid of what’s happening because her ability to understand the situation is declining.
You could ask if there are CNAs with more experience in dementia care who could help. Or, you could advise the current CNAs to move slowly, say what they’re going to do (but use few words), and non-verbally indicate what they’re going to do so she won’t be startled by their actions.
If she’s becoming so agitated that it’s affecting her quality of life, it might be helpful to work with her doctor to carefully experiment with medication that could help her feel more calm and safe.
OK so I just read all the obvious steps to take and things to do and say aka thing I’ve already tried and I’m sure many others have too.So what are the tips to be used once the obvious is done?
These suggestions are also a starting point to brainstorm your own creative ideas. You know your older adult best and are the best person to know what does and doesn’t motivate them and what’s important to them. As an example, someone who loved their job might be willing to bathe if you said that it’s time to get ready for work and bathing was part of their daily routine at that time.
My dad won’t wash and I think he’s beyond almost all of the suggestions above. He doesn’t understand a single word said to him so no amount of “we”, positive reinforcement, or reasoning with him make the blindest bit of difference. He just knows he doesn’t want to. We try and get him to have them once a week but these attempts are often unsuccessful. We run the bath, leave towels out, help him out of all but his underwear, provide fresh clothes and take away the old ones so he can’t change back into them. What would a carer do in this situation? Or what would a care home do? He’s not so far gone that he’d just sit passively through a sponge bath, indeed he would find this surprising and no doubt react aggressively.
This is definitely a tough challenge. You’ve done great work in trying to get him to bathe. Perhaps he would respond better to an authority figure like a doctor? You could pretend that the doctor has written a “prescription” instructing him to bathe twice a week — maybe even making up a “reason” related to any medical conditions he has. If he won’t believe you, perhaps his doctor would be willing to help and tell him these instructions in person. Then you could use a calendar to mark those “prescribed” days.
This is a bit of a crazy idea (and its effectiveness will depend on the stage of his dementia), but you could pretend that the police have requested that he bathe twice a week because it’s a law that applies to everyone.
For additional suggestions, it might be helpful to speak with someone at the Alzheimer’s Association who has more experience with tough situations like this? They’re available 24/7 at 1-800-272-3900.
I found that adding a few cups of apple cider vinegar to a bath greatly helps to encourage the Alzheimer’s patient to get into the bath tub, with much less fussing. Maybe the water is more soothing with the addition of apple cider vinegar (it might soften the water somewhat)? Please note that apple cider vinegar must be used, and not white vinegar. This patient stopped complaining almost immediately when immersed in a warm bath mixed with apple cider vinegar – however, he did complain mightily when he had to take a shower. It seemed as if the spray bothered him quite a bit.
Our mom will not shower and goes weeks without a shower. She insists she is taking daily showers, she knows that “if you don’t you risk infection, body odor” etc! She can appear like she knows what she is talking about but her Alzheimer’s isn’t allowing her to process or recall she isn’t showering. She is physically capable of showering herself, but simply will not do it because “she showers every day!”. Also, along with this she is wearing the same clothes day after day. Any suggestions?
I’m so sorry this is happening. When someone refuses to bathe, it can be very tough to convince them to do it. It sounds like reasoning won’t work with her. I hope that some of these suggestions can help her to overcome her fear or reluctance. Sometimes when you take a different, more subtle approach, it can work better than directly asking someone to bathe. For the clothing, you could sneak in new clothes when she changes for bed or for the day. Take away her dirty clothes and replace with fresh clothing. Some people find it helpful to buy multiples of the same clothing items so the person is less likely to notice that the clothes have been switched.
Have you tried responding with “well sometimes it’s nice to take an extra shower, I like taking an extra shower if it’s a (cold/hot) day”. can always take them out for a walk and then remark that the best way to warm up after a cold walk is to take a warm shower. Offer to let her take the first shower, if she is anything like my dad, you probably won’t need to shower as she will forget that you said you were planning to shower too. Women, especially elderly women, have poor circulation so sometimes warm water is the best way to warm up… a walk outside might prompt her. Or you could do something slightly messy like ask her to help you with bathing a pet.
I found that adding a few cups of apple cider vinegar to a bath greatly helps to encourage the Alzheimer’s patient to get into the bath tub, with much less fussing. Maybe the water is more soothing with the addition of apple cider vinegar (it might soften the water somewhat)? Please note that apple cider vinegar must be used, and not white vinegar. This patient stopped complaining almost immediately when immersed in a warm bath mixed with apple cider vinegar – however, he did complain mightily when he had to take a shower. It seemed as if the spray bothered him quite a bit
That’s an interesting idea, perhaps the scent is pleasing or the slight coloring that the water gets from the vinegar makes it easier to see. Before trying this though, it’s best to speak with the doctor to make sure apple cider vinegar won’t be harmful to your older adult. For people who have skin irritation or infections or other health conditions, it might not work well.
Thanks For Sharing!
You’re very welcome! I’m so glad this article is helpful 🙂