How do I bathe a dementia patient who is becoming increasingly aggressive?

9 answers | Last updated: Sep 25, 2016
Brenda-cape may nj asked...

Although your bathing suggestions have worked for me in te past I still have to fight with my husband to bathe. He is getting a little more agressive and afraid he will hit me. Home health care is not an option at this time. What can I do to stop the fighting each time? He says he already showered.

Expert Answers

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

If you haven't tried this already, pretend you have promised to give him shower that particular day: "Hi sweetheart, I promised to help you with your shower today. Is now a good time or do you want to eat lunch first?" - or some variation of that.

He may have reached a point when this no longer works. In that case you may have to switch to a sponge-bath, which works as effectively as a full shower in actually getting a person clean. Remember it's okay to get really creative. You don't have to bathe all of him all at once; you can spread it out over a couple of days. You can give him a sponge bath in "steps" "“ torso at one point, feet and legs at another time and middle-section while you're helping him with his brief. And you can give him this sponge bath wherever it seems least disturbing to him: in the kitchen, the living room or even in the garden, if you have privacy. If this still doesn't help you, you can go to "no-rinse" cloths and shampoo.

Community Answers

A fellow caregiver answered...

I posted a sign in my mothers room which had a bath day schedule. Like Wed. and Sat. were bath days, so she could read it. So when it came time for bath and she would give me a hard time I would show her the sign and just state "See today is Wed, we take a bath. It seems to work so far.

Elviraskin answered...

Posting a sign with the bath schedule often works before people reach the more advanced stages of Alzheimer's. However, in the late stages, this may no longer be effective and we need to look for alternatives and get creative.

Frena answered...

Brenda, you need to take seriously what you yourself said, that your husband might hit you. usually, when husbands at home with dementia hit, it's their signal for, "You should've backed off -- now look what you made me do!" men with dementia usually only hit out when they feel invaded, pressured or pushed beyond their capacity to manage. the shower is often at the heart of this struggle. we underestimate the effort, stress and difficulty of showing with dementia. and we also don't always read the fear and discomfort that a person may be feeling. it's important to invite, suggest and inveigle, rather than be pushy. also, i'd suggest you use a handheld shower, not an overhead one. the overhead shower experience is notable distressing for dementia people, for whatever reason. get a handheld shower fitment (not expensive) and then start at his feet and work up, instead of the head down. and talk nicely in a soothing kind of way, "I bet that feels good, honey, doesn't it. Now let's get the water...blah blah blah," it just takes the threat out of the proceedings. always remember, aggression in dementia means great fear is in your person. and the shower routine is very often the biggest issue in dementia care.

Ca-claire answered...

What about pretending like you are on your honeymoon and 'showering' together? That may work - make it about both of you, rather than just him.

My Aunt used to have to put on a swimsuit with our grandmother and get into the shower with her to get her clean.

Luckily, my parents, although they both have Alzheimer's, both insist on showering daily. We are told by their Assisted Living Facility that this is quite unusual - they have people that only want to shower once a year, and they have to sponge bathe them to get them clean once a week.

All the best.

Jytte lokvig answered...

@ CA-Claire. Some more progressive facilities give their staff to be creative with residents, including getting into the shower with a resident. Another is to give a sponge bath while the resident is being distracted. I recently spoke to a couple of professional caregivers who had gone through "role-reversal with residents" as part of their training. One of the experiences they found most disturbing was having someone else in control of the handheld shower.

A fellow caregiver answered...

If you live where the climate is mild, you can shower outside some of the year. This works well if you have privacy between your neighbors, and you use brands of soap and shampoo which are safe for your lawn and garden, such as are sold in camping stores.

Rig up a narrow hose (not a full-capacity exterior-type hose) to run from an indoor faucet, out your bathroom or kitchen or utility room window, into a safe and private seating area, covered or open to the sky.

This area should have a drainage system so the water will soak into the lawn and make a muddy pond, and so the water and soap will not create a slipping hazard on your path.

Not everyone has such a living situation, but if you do, try this on warm weather.

Your loved one will usually be very intrigued by the breeze and foliage and birds, to the point where the shower seems like a return to summer camp, or a trip to the rain forest.

Brenda-cape may nj answered...

Love all the answers I recieved.....he won't let me in shower with him...I even have to cover his private area with a cloth so I can't see him...Once I get his hair washed while he's sitting on the tub seat I remove the seat and then he washes himself....I quickly pull back the curtain and check to see if he's clean before he shuts the water. By this time he is calmer from the soothing water and will let me help. Then he covers again to come into BR to dress. He even states that he enjoyed the shower....It's just getting him in there that's the problem. Thanks again for all of your suggestions. God Bless everyone. Brenda

A fellow caregiver answered...

It seems that men more often than woman get irritated when it bath time and yes they can get aggressive. Perhaps use the method of what type of mood he is in. If you find that he is easier to handle first thing in the morning or even mid afternoon just say, why dont' we take a walk into the bathroom so that I may adjust your hair, or even ask "did you brush your teeth today". Have the water in the tub already prior to taking him in. This way the water may seem inviting to him. It seems that men that always kept themselves' clean prior to, have a hard time with it when the Alzheimers' kick in. Make it a pleasureable time. Even have a radio on with music that he likes so that he feels soothed. If you find that this just isn't going to work then leave it be. Evenings are often usually the worst time to try anything with them. You are wrong and they are right. Dont' argue with him because you feel that its time, if you do he feels threatened by the person who he feels is their to protect and help him. Perhaps if you have another family member that doesn't mind doing this it may work. Its' so very hard when your on your own trying to make things run smoothly and they dont'. Pls. dont' take it out on yourself, this is not your fault. When you feel this way he will pick up on your emotions. I live in Ontario and I have homecare for my father in law who comes in and sponge bath him one day and the next time he has a bath. Yes he will complain and say hes' not dirty however he wont' argue with a stranger. He will complain once she is gone however I myself try and turn a deaf ear so that he knows that I am agreeing with his care. If you have an Access Centre in your area pls. do call them. You may be eligible for Home-Care. Another thing, when you feel that your hubby is getting hostile always have a cushion in front of you so if he does lash out you have some sort of cover. My heart goes out to you in all that you are doing and I am sending you prayers'. Again, whatever you do, dont' blame yourself, you will get depressed, exhaust yourself and become ill. Take care my dear.