Showering and hygiene are at the heart of one of the most common challenges I run across in my field of work. I find that failure to shower often stems from one of two common causes.
One cause is that our loved ones may either forget to shower or have trouble recalling if they’ve already showered. As a habitual activity, showering is often something we don’t think about any given day. At times, we may have a hard time remembering details about a shower we took yesterday, let alone last week.
Forgetting to shower is more common for seniors with dementia, especially those who live alone. Even if they’ve showered routinely for most of their life, people with memory impairment become complacent about self-care that includes preparing healthy meals and exercising proper hygiene. With no one around to notice any given day, showering can be quickly forgotten.
Memory as a cause can be addressed with controls and memory devices. A phone call reminder, a calendar, or a checklist may be things to try with our loved ones in this situation. They may be embarrassed and resist if we call them out for smelling badly, but good diplomacy and showing respect should help address the situation without significant stress.
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The other common reason people fail to shower regularly is from some underlying cause. Often, seniors dislike the shower because it’s accompanied by anxiety or stress. Once this happens, it can be almost impossible to get a person with dementia into the shower.
That’s when it’s time to put on our sleuth hats and figure out what’s really going on.
Showering may seem simple, but it can become stressful with age and dementia. Water on the face may now trigger stress when it never did before. The shower spray can be scary for someone with dementia because the water may occur as invisible and cause discomfort.
Shower time can also lead to anxiety for someone with dementia for environmental reasons. Perhaps the shower itself has a step on entry or presents a scary situation to enter safely. Maybe the water pressure or nature of the spray from the showerhead is too strong and causes discomfort.
Even if you have a family history of dementia, a healthy lifestyle and environment might avoid symptoms later in life. Common factors identified in lifestyle include diet and exercise, along with drinking less alcohol and not smoking. To achieve this, however, is challenging for some and quite natural for others.
Being showered by others, sometimes the water is too hot or too cold. It’s easy to become anxious at the thought of showering if it’s consistently uncomfortable. Worse, when caregivers become frustrated, those in their care may become more resistant to showering and more anxious at the thought of it.
Keeping a routine and planning extra time can reduce stress. It also prevents us from rushing or conveying a sense of hurry, which itself causes anxiety. Take time to check the temperatures of the water and verify that the water spray isn’t too harsh on the skin. Supplies needed — such as shampoo, body wash and a towel — should be easily accessible.
Try to stay positive throughout the shower experience. Warm the room and water in advance. Use a handheld showerhead to prepare the water temperature and flow before spraying it on your loved one. Play soothing music. Use a shower chair. As our loved one’s age, standing in a shower becomes more demanding and less safe on slippery surfaces.
It’s helpful to use a calm, soothing tone. I often find the words “freshen up” are less onerous than let’s go shower for someone with a history of actively resisting showers.
Hobbies are incredibly useful because they offer a sense of purpose, an avenue for creative productivity beyond work but that is also not quite pure relaxation.
If your loved one needs to sit while waiting, put a towel over the toilet seat to insulate them from the cold. Help your loved one out of their clothes, which could otherwise prevent them from wanting to shower.
Remember that your job is to avoid surprises. Give step-by-step guidance during the shower experience, letting your loved one know what you’re doing and what comes next. This gives them a sense of control and can help to reduce anxiety.
When working to get our loved ones to shower, keep communication short and simple. Don’t use reason or logic. Instead, shift the conversation to something positive. For example, focus conversation on the activities you will do after the shower rather than talking about the shower itself.
If your loved one still refuses to shower, don't argue. Redirect the conversation and try again later. Remember it’s impossible to win an argument with someone with dementia and trying to do so will only leave everyone more frustrated.
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