Taking a shower is second nature to most of us and can become an automatic response once the alarm clock goes off every day. In the very young and the very old, though, they may have to be reminded, cajoled and finally nagged to get the job done. While this is expected of children, you may have trouble reconciling yourself to the fact that mom or dad just don’t have this habit anymore, whether because they don’t get out as often and feel the need to bathe and change their clothes or other issues, such as safety concerns, memory loss or just a diminished sense of smell.
You may be surprised that something that comes as second nature to most people is suddenly a battleground issue. Consider the fact that a shower may not be part of your elderly parent’s daily routine: they don’t have a job to go to, and the only reason they may have to bathe and look presentable is a doctor’s appointment or social engagement. If your parent has dementia, that throws an added element of memory into the mix: people with Alzheimer’s have long-term memory but very little in the short term; and if they only took a bath once a week in their childhood, this routine may replace the daily baths established in their adult years.
Although dry skin is common in the elderly, which may reduce the need for a daily bath or shower, hygiene is still part of keeping mom or dad healthy and happy. In the skin folds of unwashed areas, yeast cells can develop, which can lead to scaly, red patches under the armpits or in the groin area, with the potential to break down the skin and become sources of infection. Poor hygiene may also be keeping someone, who was formerly social and assiduous in keeping their medical or hair appointments, increasingly isolated from activities they once relished or that were essential to their well-being. At this point personal hygiene becomes a question of physical, as well as mental health, to maintain one’s independence.
Broaching this topic to your elderly parent may be a source of embarrassment to you, and you may have put it off for this reason. Or if the subject was raised, it was considered nagging by your mom or dad, a definite role reversal, especially for those in the “sandwich generation,” who are suddenly confronted with two sets of dependents: their children and their parents. Those with Alzheimer’s or age-related dementia may have distorted reasoning when it comes to taking a bath: they may be afraid that they’ll melt once the water hits them or be sucked down the drain. If this is the case, you can’t reason with them sensibly as you would a child: “Gosh, when’s the last time you had a bath? Phew, you’re a little stinkie. Let’s go get you a shower.”
This is when an outside party, such as a home care agency, can come in handy. Caregivers who work primarily with the elderly understand the disease process of age-related dementia and what may or may not work to engage this type of client. Gradually introducing the patient to the idea of a gentle foot bath, perhaps in a non-threatening location such as a sunny seat outside, may get the patient more open to the idea of adding more personal care. Consistency is also a factor: just like children, those with dementia need a schedule and predictability to give reason to an often bewildering pattern of daily events. Even if a client can’t remember the name of the person who shows up every other day or why the lady is there, if the patient associates that person as a kind and caring individual, the interaction can be a nurturing and open one, as opposed to an encounter with a stranger. Then getting a shower or a sponge bath becomes a warm and friendly interaction, and your parent can maintain a consistent regimen of hygiene and personal care for the best outcome.
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