Starting the process
- The person you care for may no longer realise that they need to wash or change their clothes. They may have memory loss and not realise that they have not washed for some time. They may have lost the ability to ‘initiate’ washing or dressing (unable to start to do something unprompted or unaided). They may have very strong beliefs that they are continuing to keep clean as they always have done.
- It’s really important to bear these thoughts in mind when you start to help a person who has dementia and needs help with their personal care. It may explain why your efforts may sometimes be met with resistance, alarm or disbelief!
- A closed question such as ‘Would you like me to help you have a wash/bath?’ may be met with a rather final ‘No thank you’. You could try a gentle reminder or prompt , or devise an occasion or outing which would encourage the person to want to be doubly sure about personal hygiene.
- Finding an approach that works can be trial and error. Some carers find chatting about a pleasant event whilst getting a bath ready works well.
- Using familiar language for an activity can also help things along. Families often have esoteric language associated with the bathroom and these words can act as cues as to what to do.
- Arranging the setting for personal care is another consideration. A person may want to make sure that they feel private. And that it is warm enough to start getting undressed.
Taking part
The person you care for is more likely to take part in their personal care and bathing if:
- Your approach is ‘person centred’.
- The environment reinforces the purpose of washing, bathing etc
- The surroundings and equipment used are what the person is familiar with.
- The person is not in pain or discomfort or has a physical illness which affects their mobility.
- There are no distractions whilst washing/dressing/bathing. Privacy is observed and the person’s dignity maintained.
- You ‘cue’ the person in to the action of washing or ‘mirror’ the action yourself.
A few Do’s and Don’ts
- If you know what music the person enjoyed and relaxed to, try playing that whilst in the bathroom. Or try soothing, nature sounds.
- Try singing together! This has been found to be a really effective way of helping a person relax whilst washing and dressing.
- Don’t have the bath filling up when the person enters the bathroom – dementia can distort how a person experiences sound and the noise can be very alarming.
- It may be helpful for the person to have something in their hands whilst you help wash them – such as a flannel, sponge or washable soft toy.
- Regularly remind or prompt a person who forgets to go to the toilet. Be alert to their responses and reactions, monitor regular patterns of, for example, going to the toilet. Watch for visible cues such as restlessness, grabbing at clothes, facial expressions that may indicate the person needs to use the toilet.
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