How often should an elderly person bathe?

elderly bathing towel

While the frequency of bathing depends on an individual’s environment and personal needs, with the progression of dementia, it can become increasingly difficult. For example, one may not be able to keep track of bathing and brushing schedules. In care homes, sanitation may become an issue with residents who need may help with such tasks due to problems with communication and staffing.

People with dementia may also have agnosia which is the inability to interpret sensations or recognize things, which may further the neglect of hygiene. For example, agnosia can prevent people with dementia from recognizing their clothes are dirty. According to R.C. Hamdy et. al 2018, “they may see the food stains and discoloration of the clothes but be unable to deduce that their clothes are dirty and need to be changed. They will, therefore, resist attempts to get them to change clothes, especially if these clothes happen to be their favorite ones. This often causes caregivers to become frustrated, especially, if it represents a change in the patient’s previous habits of only wearing clean clothes.”

How to get people with dementia to bathe?

Whether at home or in a care institution, it is important that hygiene is not neglected. Various organizations provide tips on how to ensure bathing for people with dementia. Arjo, a global supplier of medical devices, services, and solutions that improve the quality of life for people with reduced mobility and age-related health challenges suggests the following tips:-

1. Establish a consistent bathing routine.

While the value of having a routine life is different for every individual, it is of particular importance for people with dementia. According to Alzheimer’s Society Canada, routines help the person with dementia know what to expect, and help her to continue to do things on her own. People with dementia may eventually lose the ability to carry out everyday activities and need help. Routines can act as reminders of daily tasks and support bodily autonomy. This will help them feel good about themselves, with greater dignity and confidence.

Example of a bathing routine is to have the individual bathe at the same time each day. Break down the tasks into simple steps. Lay out the soap, washcloth, and towel in the order they will be used so it is easier for the individual to follow.

2. If the person resists bathing, avoid giving too many choices.

It can be difficult for people with dementia – especially in the later stages – to make choices. According to Hamdy et. al. 2017,  “they often become acutely confused when faced with too many options because they are not able to retain in their working memory enough information about the various individual choices available.”

Thus, rather than asking if he or she wants to take a bath, simply prepare the bath and invite the individual to begin. Care must be taken, however, to ensure that the individual isn’t forced into doing anything against his or her will.

3. Provide privacy and as much independence as possible.

Have the individual participate by holding the soap or washcloth, washing and toweling as much possible. According to Alzheimer’s society, where possible, caregivers should support the person’s independence rather than taking over. This increases the person’s wellbeing and helps maintain their dignity and self-esteem, rather than making them feel helpless or worthless.

4. Use natural lighting so the resident feels comfortable in their surroundings.

Use high-contrast colors on the outline or frame of the bathing system, doorways, and benches, so they are easy to see. Good lighting is especially important for people with dementia.  According to the social care institute for excellence, “aging eyes need twice as much light as young eyes – and people with dementia need even more. For older people, contrast is reduced and some colors are hard to see.”  Impaired vision may bring anxiety and distress. Proper vision, on the other hand, aids people with dementia in making sense of their surroundings through recognition of everyday objects and familiar faces.

5. Make safety a top priority.

Have the resident sit on a shower or bath bench while bathing and drying off. Keep disinfection and cleaning liquids in a locked cabinet. According to NHS inform, people with dementia are more likely to experience problems with mobility, balance and muscle weakness. They are also at a higher risk of falls “because of delirium, unfamiliar environment, changes in their daily routine and caregivers” (Lim, 2017). Thus, special care should be taken to ensure that the person with dementia is both physically safe in the environment, and also feels safe in terms of familiarity and comfort.

In summary, there is no single way to ensure that the upkeeping of sanitation and hygiene. What is most important, is to ensure the safety and dignity of the individual. Using person-centered care is key, and this means using a combination of the suggestions such as the ones mentioned above, and more to determine what works best.