Post by norbert1 on Jun 26, 2006 8:37:01 GMT -5
This article was originally posted by pepprockk----
I found the following article from Alzheimer's Association:
Bathing
Bathing is often the most difficult personal care activity that caregivers face. Because it is such an intimate experience, the person with Alzheimer’s may perceive it as unpleasant, threatening, or painful and, in turn, exhibit disruptive behaviors such as screaming, resisting, and hitting. These behaviors often occur because the person doesn’t know what bathing is for or doesn’t have the patience to endure such unpleasant aspects as lack of modesty, being cold, or experiencing discomfort. Try the following:
Do everything you can in advance to make the process easier, such as increasing the room temperature and having bath towels nearby.
Make the person feel in control. Involve and coach him or her through each step of the process. You may need to experiment to determine if the individual prefers showers or tub baths and what time of day is best.
Create a safe and pleasing atmosphere. Place nonslip adhesives on the floor surface and grab bars in the bathtub to prevent falls. Test water temperatures in advance to prevent burns.
Respect the person’s dignity. Some individuals may be self-conscious about their nakedness. Allowing the person to hold a towel in front of the body, both in and out of the shower, may ease anxiety.
Don’t worry about the frequency of bathing. It may not be necessary to bathe every day. Sponge baths can be effective between showers or baths.
Be gentle. The person’s skin may be very sensitive, so avoid scrubbing and pat skin dry instead of rubbing.
Be flexible. You may experience the most difficulty when attempting to wash the person’s hair. Use a washcloth to soap and rinse hair in the sink to reduce the amount of water on the person’s face.
----------------------------------------------------------
Tips On ... Bathing from Eldercare On Line
by Edyth Ann Knox
www.ec-online.net/Knowledge/Articles/bathtips.html
…
Safely bathing an individual affected by Alzheimer’s Disease can be a challenging task and a source of frustration for a caregiver who is concerned about maintaining her loved one’s dignity and hygiene. What complicates matters is that the individual with dementia may find bathing a frightening and uncomfortable process. Remember: no one ever died from not getting a bath. Here are some tips to giving your loved one a bath while avoiding as fuss as much as possible
1) A shower is generally easier and safer than a bath: Giving a person a shower instead of trying to lower them into and lift them out of a bathtub full of water is generally easier to manage. It is also considerably safer. Getting a wet person out of a slippery tub puts both of you at risk for injury.
2) Hand-held shower head: Equipping the shower with a hand held shower head can help to ease your loved one’s fear and prevent some of the struggle. The water coming down from a regular shower head on a person’s head can set them up for a panicked response. Most hand-held shower heads also have an on and off switch so you can have to water running only when you want. Be sure to get one that you can have some control on the flow of water coming from it as slowing the water down when washing the hair and other more sensitive areas is advisable.
3) Have a shower chair: Sitting your loved one down on a shower chair can help make them feel more secure and helps you to wash them more effectively. The chair helps to stabilize the person being washed and gives both of you something to hold onto.
4) Rails in the shower: Having strong and secure handrails in the shower that both of you can hold onto while maneuvering in the shower area. The rails also give the caregiver something solid to hold onto while washing.
5 Anti-skid decals and mats on the floor of the shower: Small rubber anti-skid decorations can be used as a substitute for the rubber mat. The mat covers a larger area but is generally raised and can be a tripping point.
6) Prepare the bathing area ahead of time: It really helps to have everything all set up for a bath ahead of time. That way once you can quickly move your loved one into the area without having to pause to get things ready. It is a good idea to make the bathroom warmer and test the water temperature ahead of time.
7) Respect your loved one’s privacy: Sitting nude in the shower with someone makes a person feel vulnerable and perhaps violated, even when they are a close family member. This is even true when the caregiver is a loved spouse of many years. Wrapping a towel around your loved one or even leaving their underwear on can help make them feel less violated. You may give your loved one a washcloth and verbally direct her to wash her more private areas. Don’t get preoccupied with getting it done "perfectly." There should be enough water flow that the areas were sufficiently washed even without a thorough scrubbing. Stay in direct sight while washing the individual.
8) Keep the stimulation to a minimum: Bathrooms are generally small areas with a lot of things going on: running water, echoes, soapy wash cloths, differences in temperature, and strange people. Mirrors make it look as if there is a whole crowd in the room just watching them in the nude. Covering the mirror on the medicine cabinet may reduce the feeling of "being watched." Keeping the sink and toilet free of objects may also help. Avoid slippery throw rugs and mats.
9) Make bathing as pleasant as possible: Aromatic soaps and lotions can be pleasing and calming. Try soap-free products such as St. Ives body wash and lotion or Aveeno’s body wash product. Both products were soap-free and clean the skin without drying it our. Place some fragrant oil or lotion in a sink of warm water and rub on them after the shower. Relaxing music and somewhat dimmed lighting can reduce the harshness of the bathroom. Shampooing hair is often a special challenge. Try to shampoo with a small amount of the product and keep the water pressure low, being careful not to get water in the person’s face. A no-rinse shampoo can remove one step and still do a satisfactory job.
10) When all else fails: Sometimes no matter how much you try or what you do, bath time is a total disaster. Don’t feel that this is a failure on your part! Most dementia caregivers experience difficulty with bathing at some time in the disease. Picking your fights is important and insisting on a shower is not needed. The stage the Loved One is in will change and you will be able to get them into a shower in a different stage. Sponge bathing can do as well as a shower. Try giving a sponge bath in a different room. Many times the bed room is a better place for the Loved One. Let them do most of what they can do with a sponge bath and then you just help with the areas they can not do. Not taking a shower will not kill them. You mainly want to keep the private areas clean, wash the face, hands and feet. Don't make bathing into a struggle. Get what you can and try again another day or time.
-------------------------------------
Other tips:
Do not use the word bath. Use “cleanup” instead
Do not get in an argument or discussion about it. Simply tell them it is time for their cleanup. Follow a routine – wash at the same time on each bath day. Minimize the emphasis on bathing when announcing time for the bath. Say, "It's time for cleanup. After cleanup we can go to the kitchen and have some ice cream." Never ask, "Do you want to . . ." Sometimes we can give a simple choice, "do you want to bathe now or after breakfast."
Some families need to use rewards/reasons to get the person to bathe - Tomorrow is Sunday, or you need to cleanup before going out to the store (or what ever). Some caregivers get a note from the doctor that the person must bathe once or twice a week.
When standing for shower, have grab bars for the person to hold. (also keeps the hands busy)
The all white shower/tub can be frightening for a person with visual perception problems. Consider a lightly colored bath mat. Geri suggests using the rubberized "lace" non-slip shelf liner material.
#1 - people with alzheimers do not like water coming at their head from a shower head. It provokes a reaction. (fight or flight) That’s why a tub bath, on a raised seat (ie. Not down in the tub) is usually a better place for cleanup. Use a hose sprayer on very low flow or a washcloth for the rinse.
Hand a wash cloth to the person so they can do their own face washing and washing of private parts. Later in the disease, place your hand over the persons hand and guide the motion. They feel better if involved in the process.
Distractions – use music, give the person something to hold, maintain a distractive conversation during the bath.
They also react badly to getting their head wet. Save hair washing for last and have the person cover their face with a dry wash cloth to keep water off their face. Also keep water out of the ears. You may have to wash hair separately.
When hair washing is really an issue, wash it seperately, at the sink, at another time. Or skip hair washing and have it done at the beauty parlor.
If embarrassment/modesty is a problem, allow the LO to wear a loose fitting top and simply wash under it. They can even leave on their underwear if necessary and wash under it at the proper time. (a caregiver invented a bathing garment called "honor guard". It is described on the alzonline site.)
People with alzheimers react badly to temperature changes. Do everything possible to keep the person warm, covered, etc. Nursing homes have something called a bathing blanked for this (for bathing while seated)
To make the job easier and quicker, buy no-rinse soaps and shampoo.
Some families resort to hiring health care aides to come in once or twice a week to give the bath.
In later stages, caregivers switch from bathing in a shower to bathing in the tub, seated on a bathing bench. Most recommended are the long benches that allow the person to sit down outside of the tub and scoot into the tub. Wash with a washrag and gently rinse with a bath wand on a flexable hose.
Norbert
Another very good source of bathing information ---
Alzonline.net (from the University of Florida)
alzonline.phhp.ufl.edu/en/topics/#T_ADL
The actual bathing article
alzonline.phhp.ufl.edu/en/reading/tet_bathing.php
Bathing lecture/slide show
alzonline.phhp.ufl.edu/class_viewer/index.php?cid=36
Following a several year academic study on Bathing, a professional program and video was developed on difficult bathing issues in the nursing home. This video explains how the institutional bathing room can be a bad environment for the resident. It gives tips on more successful interactions to make bathing a less distressing time. They also developed a procedure called a towel bath to bathe difficult residents in bed with moist towels and no rinse soap. This is presented to the resident as a spa session. (A copy of this video was sent to every current nursing home and alzheimers chapter in the U.S. ) (Something they did not mention in the video, they first put "chucks" under the person before doing the process. )
The name of this video is "Bathing without a Battle"
www.bathingwithoutabattle.unc.edu/
Also available from the Alzheimers Store
www.alzstore.com/alzheimers/bathing-without-a-battle-vhsdvd.htm
I found the following article from Alzheimer's Association:
Bathing
Bathing is often the most difficult personal care activity that caregivers face. Because it is such an intimate experience, the person with Alzheimer’s may perceive it as unpleasant, threatening, or painful and, in turn, exhibit disruptive behaviors such as screaming, resisting, and hitting. These behaviors often occur because the person doesn’t know what bathing is for or doesn’t have the patience to endure such unpleasant aspects as lack of modesty, being cold, or experiencing discomfort. Try the following:
Do everything you can in advance to make the process easier, such as increasing the room temperature and having bath towels nearby.
Make the person feel in control. Involve and coach him or her through each step of the process. You may need to experiment to determine if the individual prefers showers or tub baths and what time of day is best.
Create a safe and pleasing atmosphere. Place nonslip adhesives on the floor surface and grab bars in the bathtub to prevent falls. Test water temperatures in advance to prevent burns.
Respect the person’s dignity. Some individuals may be self-conscious about their nakedness. Allowing the person to hold a towel in front of the body, both in and out of the shower, may ease anxiety.
Don’t worry about the frequency of bathing. It may not be necessary to bathe every day. Sponge baths can be effective between showers or baths.
Be gentle. The person’s skin may be very sensitive, so avoid scrubbing and pat skin dry instead of rubbing.
Be flexible. You may experience the most difficulty when attempting to wash the person’s hair. Use a washcloth to soap and rinse hair in the sink to reduce the amount of water on the person’s face.
----------------------------------------------------------
Tips On ... Bathing from Eldercare On Line
by Edyth Ann Knox
www.ec-online.net/Knowledge/Articles/bathtips.html
…
Safely bathing an individual affected by Alzheimer’s Disease can be a challenging task and a source of frustration for a caregiver who is concerned about maintaining her loved one’s dignity and hygiene. What complicates matters is that the individual with dementia may find bathing a frightening and uncomfortable process. Remember: no one ever died from not getting a bath. Here are some tips to giving your loved one a bath while avoiding as fuss as much as possible
1) A shower is generally easier and safer than a bath: Giving a person a shower instead of trying to lower them into and lift them out of a bathtub full of water is generally easier to manage. It is also considerably safer. Getting a wet person out of a slippery tub puts both of you at risk for injury.
2) Hand-held shower head: Equipping the shower with a hand held shower head can help to ease your loved one’s fear and prevent some of the struggle. The water coming down from a regular shower head on a person’s head can set them up for a panicked response. Most hand-held shower heads also have an on and off switch so you can have to water running only when you want. Be sure to get one that you can have some control on the flow of water coming from it as slowing the water down when washing the hair and other more sensitive areas is advisable.
3) Have a shower chair: Sitting your loved one down on a shower chair can help make them feel more secure and helps you to wash them more effectively. The chair helps to stabilize the person being washed and gives both of you something to hold onto.
4) Rails in the shower: Having strong and secure handrails in the shower that both of you can hold onto while maneuvering in the shower area. The rails also give the caregiver something solid to hold onto while washing.
5 Anti-skid decals and mats on the floor of the shower: Small rubber anti-skid decorations can be used as a substitute for the rubber mat. The mat covers a larger area but is generally raised and can be a tripping point.
6) Prepare the bathing area ahead of time: It really helps to have everything all set up for a bath ahead of time. That way once you can quickly move your loved one into the area without having to pause to get things ready. It is a good idea to make the bathroom warmer and test the water temperature ahead of time.
7) Respect your loved one’s privacy: Sitting nude in the shower with someone makes a person feel vulnerable and perhaps violated, even when they are a close family member. This is even true when the caregiver is a loved spouse of many years. Wrapping a towel around your loved one or even leaving their underwear on can help make them feel less violated. You may give your loved one a washcloth and verbally direct her to wash her more private areas. Don’t get preoccupied with getting it done "perfectly." There should be enough water flow that the areas were sufficiently washed even without a thorough scrubbing. Stay in direct sight while washing the individual.
8) Keep the stimulation to a minimum: Bathrooms are generally small areas with a lot of things going on: running water, echoes, soapy wash cloths, differences in temperature, and strange people. Mirrors make it look as if there is a whole crowd in the room just watching them in the nude. Covering the mirror on the medicine cabinet may reduce the feeling of "being watched." Keeping the sink and toilet free of objects may also help. Avoid slippery throw rugs and mats.
9) Make bathing as pleasant as possible: Aromatic soaps and lotions can be pleasing and calming. Try soap-free products such as St. Ives body wash and lotion or Aveeno’s body wash product. Both products were soap-free and clean the skin without drying it our. Place some fragrant oil or lotion in a sink of warm water and rub on them after the shower. Relaxing music and somewhat dimmed lighting can reduce the harshness of the bathroom. Shampooing hair is often a special challenge. Try to shampoo with a small amount of the product and keep the water pressure low, being careful not to get water in the person’s face. A no-rinse shampoo can remove one step and still do a satisfactory job.
10) When all else fails: Sometimes no matter how much you try or what you do, bath time is a total disaster. Don’t feel that this is a failure on your part! Most dementia caregivers experience difficulty with bathing at some time in the disease. Picking your fights is important and insisting on a shower is not needed. The stage the Loved One is in will change and you will be able to get them into a shower in a different stage. Sponge bathing can do as well as a shower. Try giving a sponge bath in a different room. Many times the bed room is a better place for the Loved One. Let them do most of what they can do with a sponge bath and then you just help with the areas they can not do. Not taking a shower will not kill them. You mainly want to keep the private areas clean, wash the face, hands and feet. Don't make bathing into a struggle. Get what you can and try again another day or time.
-------------------------------------
Other tips:
Do not use the word bath. Use “cleanup” instead
Do not get in an argument or discussion about it. Simply tell them it is time for their cleanup. Follow a routine – wash at the same time on each bath day. Minimize the emphasis on bathing when announcing time for the bath. Say, "It's time for cleanup. After cleanup we can go to the kitchen and have some ice cream." Never ask, "Do you want to . . ." Sometimes we can give a simple choice, "do you want to bathe now or after breakfast."
Some families need to use rewards/reasons to get the person to bathe - Tomorrow is Sunday, or you need to cleanup before going out to the store (or what ever). Some caregivers get a note from the doctor that the person must bathe once or twice a week.
When standing for shower, have grab bars for the person to hold. (also keeps the hands busy)
The all white shower/tub can be frightening for a person with visual perception problems. Consider a lightly colored bath mat. Geri suggests using the rubberized "lace" non-slip shelf liner material.
#1 - people with alzheimers do not like water coming at their head from a shower head. It provokes a reaction. (fight or flight) That’s why a tub bath, on a raised seat (ie. Not down in the tub) is usually a better place for cleanup. Use a hose sprayer on very low flow or a washcloth for the rinse.
Hand a wash cloth to the person so they can do their own face washing and washing of private parts. Later in the disease, place your hand over the persons hand and guide the motion. They feel better if involved in the process.
Distractions – use music, give the person something to hold, maintain a distractive conversation during the bath.
They also react badly to getting their head wet. Save hair washing for last and have the person cover their face with a dry wash cloth to keep water off their face. Also keep water out of the ears. You may have to wash hair separately.
When hair washing is really an issue, wash it seperately, at the sink, at another time. Or skip hair washing and have it done at the beauty parlor.
If embarrassment/modesty is a problem, allow the LO to wear a loose fitting top and simply wash under it. They can even leave on their underwear if necessary and wash under it at the proper time. (a caregiver invented a bathing garment called "honor guard". It is described on the alzonline site.)
People with alzheimers react badly to temperature changes. Do everything possible to keep the person warm, covered, etc. Nursing homes have something called a bathing blanked for this (for bathing while seated)
To make the job easier and quicker, buy no-rinse soaps and shampoo.
Some families resort to hiring health care aides to come in once or twice a week to give the bath.
In later stages, caregivers switch from bathing in a shower to bathing in the tub, seated on a bathing bench. Most recommended are the long benches that allow the person to sit down outside of the tub and scoot into the tub. Wash with a washrag and gently rinse with a bath wand on a flexable hose.
Norbert
Another very good source of bathing information ---
Alzonline.net (from the University of Florida)
alzonline.phhp.ufl.edu/en/topics/#T_ADL
The actual bathing article
alzonline.phhp.ufl.edu/en/reading/tet_bathing.php
Bathing lecture/slide show
alzonline.phhp.ufl.edu/class_viewer/index.php?cid=36
Following a several year academic study on Bathing, a professional program and video was developed on difficult bathing issues in the nursing home. This video explains how the institutional bathing room can be a bad environment for the resident. It gives tips on more successful interactions to make bathing a less distressing time. They also developed a procedure called a towel bath to bathe difficult residents in bed with moist towels and no rinse soap. This is presented to the resident as a spa session. (A copy of this video was sent to every current nursing home and alzheimers chapter in the U.S. ) (Something they did not mention in the video, they first put "chucks" under the person before doing the process. )
The name of this video is "Bathing without a Battle"
www.bathingwithoutabattle.unc.edu/
Also available from the Alzheimers Store
www.alzstore.com/alzheimers/bathing-without-a-battle-vhsdvd.htm
