We wish we’d known we could let the shower go away much earlier in our caregiving journeys.
As caregivers for our loved ones with Alzheimer’s and other types of dementia, we’ve learned bathing and dressing can become significant challenges. These activities are often early signs of transitioning from the initial phase of the caregiving journey where we’re simply prompting and helping them, to what we call the “messy middle”, when we begin asserting more control.
We are Nancy Treaster and Sue Ryan. Through our experiences, what we’ve learned from support groups, and others on their journeys, we’ve developed four important tips to help you navigate bathing and dressing for your care receiver.
Before we dive into our tips, it’s helpful to learn a few signs of what to expect with bathing and dressing in dementia care:
Your care receiver may stop automatically showering and/or changing their clothes.
They may dress inappropriately for the season or put their clothes on incorrectly.
You may notice changes in their personal care routine including body odor, realizing they haven’t actually used soap when bathing.
This phase can be frustrating for both you and your care receiver as you both adjust to this new reality.
Nancy’s Experience:
“I wish I’d known that the shower was going to completely go away. If I’d known that, I would have stopped pushing my husband so hard to take a shower when he was so frustrated and there was so much angst around it. I would have saved us both months of struggle and frustration.”
Sue’s Experience:
“Signs they need help with bathing and dressing are that they don’t automatically shower. They don’t include all the items in their normal bathing routine. They don’t automatically change their clothes, or they’re changing their clothes incorrectly. My dad was diligent about showering every day and washing his hair. I first began noticing his hair wasn’t combed and didn’t look washed. When he came out of the bathroom after his ‘shower’, wearing the same clothes he’d worn the day before and his hair wasn’t wet, I knew something wasn’t right.”
Here are four tips to help you navigate this phase:
Tip 1: Simplify Instructions
As the journey progresses, your care receiver may begin struggling with multi-step instructions.
Nancy’s Experience:
“In the beginning, you may say something like ‘Hey, we’ve got to leave in about 30 minutes. Why don’t you run in and take a shower and get dressed and then we’ll go.” Soon enough, you’ll figure out this is no longer working. They go into their bedroom and when they come back out, they haven’t taken their shower and dressed correctly. You realize they don’t actually know how to do what you just asked them to do.”
Suggestions:
Start giving one instruction at a time.
Break down their tasks into smaller steps.
Simplify clothing choices (e.g., slip-on shoes, pants without belts, pullover shirts).
Consider adaptive clothing options.
Tip 2: Gradually Insert Yourself into the Process
As their challenges increase, it’s time to become more involved in their bathing and dressing process.
Sue’s Experience:
“With my husband, I began staying in the bathroom while he went through his bathing and dressing process, observing him initially to see where he was struggling, and casually beginning to help him. I started by talking about something that used a word or phrase to trigger him to his next step without directly saying anything to him. I began setting his clothing and shoes out.”
Suggestions:
From early in their journey, if you haven’t already learned their natural bathing and dressing routines, observe and note them.
Depending on your relationship with them either stay in the room(s) with them, or simply ask them to tell you about their bathing and dressing routine.
Prompt or assist them in their routine order.
Provide positive reinforcement throughout the process.
Set up the bathroom to make it as easy for them as possible to bathe (if you normally keep everything put away, put the items out where they can see everything they’ll need),
Put their clothing out. (Tip: When I began putting my husband’s clothing out, I began putting my clothing out as well, explaining to him I had heard this was a great tip to simplify dressing, and wanted to try it myself.) This helps maintain their dignity.
Prepare everything needed for their bathing and dressing in advance.
Consider marking the preferred shower temperature on the faucet.
Tip 3: Transition to Sponge Baths
At some point, traditional showers or baths may become too challenging or stressful.
Nancy’s Experience:
“My husband hasn’t had a shower in three and a half years. I had a nurse come in not too long ago. And the first thing she said is, ‘He smells great.’ And I said, ‘Well, isn’t that interesting? He hadn’t had a shower in three and a half years.'”
Suggestions:
Use non-rinse bathing wipes for body cleansing.
Try non-rinse shampoo caps for hair washing.
For facial cleansing, consider products like Burt’s Bees Micellar Water.
Maintain a regular schedule of cleaning, even if it’s not a full bath every day.
Tip 4: Assist with the Dressing Process
As with bathing, dressing will require more assistance over time.
Sue’s Experience:
“The sooner that you put them into [adaptive clothing], the easier it’s going to be. When you’re dressing them though, the more that you can have them participate in any of the processes, the better that it is.”
Suggestions:
Transition to adaptive clothing when appropriate, especially once incontinence begins.
Ensure safety during the dressing process (e.g., have them seated when putting on socks).
Be attentive to their comfort, including temperature preferences.
Encourage participation in the process as much as possible.
Final Thoughts
Navigating bathing and dressing challenges in Alzheimer’s and dementia care can be difficult, especially in the beginning. With patience, observation, and the right approach, it becomes more manageable.
Suggestions:
Simplify instructions and clothing choices.
Gradually increase your involvement in the bathing and dressing process.
Be open to alternatives – like sponge baths – when traditional methods become too challenging.
Prioritize safety and comfort during the dressing process.
Give yourself and your care receiver grace as you navigate these changes.
Reach out for support when needed, for emotional support and/or to learn proper caregiving techniques.
If you have tips you think others would benefit from, please share them on our Facebook page or Instagram page. You can find the links in our show notes.
If you’d like more information on this topic listen to the podcast here.
You can find links to the products we reference in the show notes of our podcast.
We’re all on this journey together.
Additional Resources Mentioned
- Episode 11 – Cleaning Your Care Receiver here
These resources contain affiliate links so we may receive a small commission for purchases made at no additional cost to you.
- Adaptive clothing
- Disposable incontinence underwear
- Adult washcloths/wipes here
- No-rinse bathing wipes here
No-rinse shampoo caps here
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