Support for activities of daily living (eating, bathing, toileting, dressing, ambulating) looks different for every caregiver-care partner engagement. The partnership is rarely a 50-50 interaction. As human beings we transact differently depending on relationships. Successful provision of care for someone living with dementia is the result of a caregiver leaving his/her “my way or the highway” mindset at the door.
What is one of the most challenging interactions caregivers and care partners face? “It’s time for a shower.” Let’s break it down.
- It is embarrassing to strip naked in front of another person.
- Being naked means feeling cold. Feeling cold is uncomfortable.
- Water temperature is easily too cold or too hot.
- Adults don’t need shower assistance. Adults with dementia still believe they should bathe in private.
- Soap and water can make eyes hurt and sting.
- Wet floors are slippery. Falls happen.
The best case scenario for the care recipient is that he/she is at home in familiar surroundings. The bathroom is small, cozy and easy to heat with soft towels, fragrant soap, non-slip bath mats, and lights that can be dimmed or brightened.
The worst case scenario – I saw it and experienced it firsthand last week with my client. We were in a memory care unit. My client’s bathroom does not have a bath or shower for safety reasons. To take a shower, think old school college dorm bathroom at the end of the hall. Think how overwhelming it must feel at age 80+ to be led from a familiar space to a door that an aide has to unlock. The room is sterile with a strange looking bathtub and a shower stall with no door or curtain. No bath mat, no fragrant soap, no fluffy brightly colored towels in sight. And an aide, someone you don’t recognize, tells you to get undressed. Where is your laundry hamper? Where is anything that looks familiar and inviting? Of course my client refused shower assistance.
No wonder our loved ones with dementia don’t want to shower. Actually I think they may but in their own time, in their own way, in their own space (in a home where they lived a long time ago), with Mom, not an aide, nearby.
Long-term care residential facilities and corporations, I challenge you. Up your game. Think outside the box. In the name of “shower assistance” make small but meaningful changes behind that locked “spa” door. And for heaven’s sake, stop calling that cold, impersonal room a spa. I was in that space last week. That definitely was not a spa. Allocate enough of an aide’s time that the shower won’t be rushed. Coach that aide to be respectful and patient and gentle. Use color, soft textures, fragrance, a gentle touch and a quiet voice. I want our elders, not senior living corporations, to win this battle.