Dementia and Resistance to Bathing: How to Cope

My Mother has Alzheimer’s disease and refuses to take a shower.   What can I do?

When a loved one has dementia, family caregivers may struggle with resistant behavior.   The person with dementia refuses to eat, or argues relentlessly about personal care. One of the most difficult issues facing caregivers is the resistance to bathing. Their loved one’s refusal to get into the shower or tub is seen as stubborn, difficult behavior. The result is often a frustrating battle to get the family member cleaned as quickly as possible.

If we look deeper, we will see that there is always a reason for the refusal to bathe, and that reason differs with each individual. So, whenever resistant behavior occurs, it is important for the caregiver to ask, “why?” What might be triggering this response?

Usually, the answer is fairly basic. The individual may be cold and uncomfortable when his clothing is removed. Or, his nakedness is embarrassing and causes him to feel vulnerable. In either case, put a heater in the bathroom to warm the space. Purchase a thick bathrobe and slippers that can be worn right up to the time the individual steps into the shower. Warm up the towels in the dryer to make them soft and cozy. Remember that individuals with dementia often feel colder than the general population. A warm body may be much more inclined to cooperate.

Other individuals may resist bathing due to their fear of falling. Those with dementia often feel off-balance and vulnerable to falls. A bathroom is full of hard surfaces that could cause serious injury. Keep a tight grip on the individual while in the bathroom, so that he feels safe. Install grips and grab bars wherever needed. Place bathmats on the floor that do not slide. Make sure the bathroom is well lit, so that the individual can see where he is walking. Place a sturdy seat in the shower so that the individual can sit, rather than stand while showering. Most importantly, watch the person closely so that you know when his fear of falling is most prevalent.

Be aware that bathing is a multi-faceted task that can easily overwhelm a person with dementia. The faucet must be turned on, the water temperature checked, water pressure adjusted and supplies gathered. Some individuals resist bathing because the task is just too daunting. If that is the case, prepare the room ahead of time. Have supplies gathered, and assist with filling the tub or adjusting the shower. This may help to reduce frustration and make the whole experience much more enjoyable.

When bathing becomes a struggle, consider the following tips:

  • Match lifelong habits as much as possible. If the individual always took showers in the morning, don’t be surprised if he resists an evening bath.
  • Allow enough time for bathing. If you rush the person with dementia, you will likely get resistance.
  • Make bathing a fun experience. Play music or sing songs. Put bubbles in the tub.
  • Be aware of pain issues. Some skin is hypersensitive to the shower, and the person may actually feel pain. If that is the case, consider treating for pain prior to bathing.
  • Use baby shampoo that doesn’t sting the eyes, and avoid spraying water in the person’s face.

When resistance to bathing occurs, always look for what may be triggering the response. In doing so, changes can be made to reduce frustration and fear, so that bathing becomes a more pleasant time for all involved.