March 21, 2023

Alzheimer’s in the Philippines…

As Alzheimer’s disease progresses, even the most conscientious fashion plate can devolve into a slob extraordinaire. Bathing is a battle royal; removing dirty clothes is a wrestling match. Your loved one is completely content ‘as is,’ threatens you if you get too close, and refuses to bathe.

Alzheimer’s Disease & Bathing

Alzheimer’s patients can be extremely sensitive to loud noises, particularly multiple noises at once. Bathing becomes terrifying due to echoes off the tiles in the stall shower, background noise from a radio or TV, screeching children, and clanging kitchen sounds. When assisting with bathing, speak normally and avoid yelling. Running water, flushing toilets, temperature changes, heaters, drafty windows, steam, fans, vents, and strange people are all part of the bathroom experience. Water is falling on their heads, something is being rubbed into their hair, everything is slippery, and they are afraid of falling. They’ve taken off their glasses and hearing aids; they can’t hear or see clearly, and something is dripping into their eyes. Mirrors reinforce the idea that people are watching, that there is no privacy, and that they will not let you wash them ‘down there.’

Alzheimer’s disease vision has issues. The patient is perplexed by a bathroom with a white tile floor, tub, and shower. They are unable to tell where the white tile floor ends and the door to the white tile shower begins due to a change in depth perception. If the floor, tub, and shower tiles are all the same color, place a different colored rug or towel at the tub or shower entrance so they can tell them apart. The water in a bathtub can appear to have no bottom, which is terrifying. If possible, fill the tub with four to six inches of water after they get in. They are frequently afraid of water for whatever reason.

Get the house quiet before starting a shower or bath, though soothing background music may help. Prepare everything ahead of time so you don’t have to stand around half-dressed waiting. The bathroom temperature should be comfortable; tumbling a robe and towel in the clothes dryer for a few minutes is soothing. A shower chair is available at medical supply stores if desired. Use a handheld showerhead to control the flow of water and move around the body. First, check the water temperature. Turn off the shower before your loved one enters; it may be less disturbing if they do not have to step under the water. Lay out all new clothes and keep dirty ones hidden. Putting a book, toy, or anything else in their hands to distract them will make it easier for you to remove their clothes.

Stick-on decorations and shower and tub floor mats are useful. Install handrails early on so that you have enough time to learn how to use them. Allow your loved one to bathe in underwear or a wrap-around towel for modesty. If possible, keep your glasses and hearing aids on. Gels with pleasant scents and a net sponge are appealing. Try using a gentle baby shampoo. If you are unable to wash their hair, use dry shampoo. There are dry and no-rinse shampoos and body baths that can be left on, all of which are available at your local store or online.

You can enter the shower first and coax a loved one in, staying as long as necessary. Give them something to occupy their hands, such as a rubber ducky, a piece of plastic, or a washcloth so they can ‘help’ themselves wash—but not a bar of slippery soap. Tell them where you’re going to wash your clothes next. Despite your desire to work quickly, do not rush your loved one. Responses and comprehension are becoming slower.

Again, sprayer and shower chair if desired, plastic floor mat, and, again, not too much water, four to six inches is enough; sometimes it helps to let them see the water going into the tub rather than having it already there, or allow them to get in before filling the tub. Remember to use handrails to help you get in and out. No one needs to bathe every day; once a week is plenty, with a sponge bath in between, perhaps in bed—but don’t let them see the basin of water. A treat is always welcome. ‘As soon as we finish, we’ll drive over and get some chocolate ice cream,’ you promise.

When only a sponge bath is possible, try to keep your face, hands, feet, and genitals clean. It is frequently difficult for one person to do these things on their own. Call an agency or ask around at Alzheimer’s organizations, support groups, care facilities, and senior centers for people who will come to your house just to bathe; it may still take two of you. Never leave a loved one in the tub or shower alone! Whatever or whoever is interfering with you can wait until you finish.

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