The Memory Unit OT

It’s no secret that assisting with bathing tasks with individuals with dementia can be incredibly challenging. As the disease progresses, many individuals often develop an aversion to water/getting wet, and the entire process can become emotionally distressing for both the resident and the care partner.

When we think critically about how to improve the quality of our dementia care, a great place to start is to imagine what it might be like to actually have dementia.

So let’s think through bathing. I want you to imagine that you’re in a building that seems somewhat familiar to you, but you can’t think of the building’s name or the town that you’re currently in. Taking a shower is not at the forefront of your mind.

Now imagine that someone you don’t really know approaches you and tells you that you need to take a shower. This could result in a lot of different feelings. All of a sudden, you’re in a cold room with this stranger who is now helping you get undressed and then sprays your hair with water. You’re probably feeling quite distressed at this point. And things don’t get better, they only remain; because now you’re still sitting in this room with cold, wet hair while a stranger washes you body.

So how do we prevent our residents and patients from feeling this way during bathing tasks?

To start, I like to make sure the environment is comfortable and warm.

I line the shower chair with a towel. I turn the heat lamp on. I play music.

Once the resident is undressed, I wrap them up in a nice warm bath blanket.

Handheld shower heads are ideal, I make sure to keep the water stream away from the resident until I’ve tested the temperature with my own hand/forearm. Then I encourage the resident to feel the temperature with their own hand.

Start with the feet first and work up.

This is my best kept secret. Keep the parts that you aren’t actively washing wrapped in the bath blanket. Only remove the blanket when you’re ready to wash that part, and then cover back up once rinsed of soap.

I love this series of strategies because together they keep the resident comfortable and provide a more supportive sensory experience. I also find that they help to improve the resident’s tolerance of the shower, meaning he or she is often willing to remain in the shower long enough to wash the entire body.