What Stage of Dementia is Not Bathing?

Key Takeaways

• Behavioral Changes: Bathing resistance often starts in middle-stage dementia due to fear, confusion, or physical discomfort.
• Practical Tips: Create a calming environment, adapt routines, and use tools like shower chairs or sponge baths to make bathing easier and safer.
• Stages of Impact: Early stages involve forgetfulness, while later stages may require complete caregiver assistance.
• Alternative Solutions: If bathing is impossible, use dry shampoos, wipes, and other hygiene aids to maintain cleanliness without distress.
• Support Resources: Professional in-home care, such as Senior Helpers, can provide compassionate assistance tailored to your loved one’s needs.

Why Do Dementia Patients Not Want to Shower?

People living with dementia may not want to shower. They may forget to shower or bathe, or may forget they need to. They also may forget how to complete hygiene tasks such as washing their hair or body. These individuals may also develop a fear of water which did not previously exist, and there may be a measure of confusion and anxiety if they do not feel safe getting wet.

Identifying the Stage of Dementia Related to Bathing Issues?

Dementia typically follows a progression through early, middle, and late stages. It is important to note that this process is somewhat general and the stages may not fit perfectly into a box. Additionally, not everyone who struggles with dementia necessarily passes through each of these stages. Here is some of what may be expected as it relates to bathing and personal hygiene as a loved one progresses through each phase:

• Early-Stage Dementia

During the earliest stages of dementia, individuals may forget to bathe or forget they haven’t already bathed and need only gentle reminders. People at this stage are usually capable of bathing themselves.

• Middle-Stage Dementia

During middle-stage dementia, personal hygiene often becomes challenging as individuals may resist bathing or become combative during hygiene routines. This behavior typically stems from fear and confusion – they might feel anxious about water on their face and hair, or may not understand why bathing is necessary. While some individuals may still be physically capable of showering independently, they frequently need someone present to provide guidance and help them remember each step of the process.

• Late-Stage Dementia

During late-stage dementia, it is common for individuals to be dependent upon someone to bathe them. When this becomes necessary, it can be uncomfortable for everyone involved. For a family member taking on this responsibility, it is important to remember safety. Having a non-slip mat if the floor is slick can be helpful. A shower chair can also be a good safety measure. A handheld shower head may alleviate some of the fears associated with water in their face or on their head.

What Should You Do If Your Loved One Refuses to Bathe?

Understand the Reason Behind the Refusal

Refusal to bathe or shower is often related to fear or confusion. The individual with dementia may fear getting wet or falling down. There may also be a measure of sensory sensitivity as their perception of sounds, smells, etc. may be different than that of people not dealing with cognitive decline.

The bathroom may feel cold. Being undressed in front of someone may be uncomfortable and leave them feeling vulnerable. They may feel unstable if the shower floor is slick. Some of these discomforts can be alleviated to a degree.

Communicate With Empathy

When a loved one refuses to shower or bathe, their caregiver must respond with calm and reassuring language to help diffuse the situation and take care not to cause agitation by how they communicate. If the individual with dementia resists bathing, it may be good to move on and come back later to see if they are more agreeable.

Adapt the Bathing Approach

If there is resistance, fear, or anxiety around the showering or bathing process, it may be necessary to adapt the bathing approach. Showering daily is not necessary for maintaining good hygiene. A few times each week is probably sufficient for most individuals. In between showers, sponge baths and dry shampoo can be employed to avoid unpleasant smells or oily hair. 

Create a Safe and Relaxing Environment

It is important to feel as safe as possible when it is time for a shower. If they are used to bathing at a specific time of day, consider maintaining that routine. Using non-slip mats might help them feel safer. It also may help to cover mirrors. Playing favorite music, dimming the lights, and/or employing aromatherapy may help with relaxation. 

Seek Professional Guidance

If refusals persist, it may be necessary to bring in professional help. There are professional caregivers who are trained in assisting individuals struggling with memory loss. They have tools and strategies they can tailor to each person based on their needs and capabilities.

Addressing Emotional and Physical Barriers

Safety measures such as shower seats and grab bars may reduce fear or anxiety over falling.  A handheld shower head may minimize water getting in their face when possible These solutions address emotional barriers as well as true physical disabilities. Working with a helper they are comfortable with (a family member, most likely of the same gender, or a trusted professional caregiver) can also help with reducing both emotional and physical barriers.

Common Caregiver Questions and Expert Insights

When Should I Seek Professional Help?

When regular hygiene habits become unmanageable to the individual with dementia and the family members they live with, it may be time to seek professional help. It is always wise to check in with the person’s primary care provider, and seeking help from trained professional caregivers may be beneficial and necessary as dementia progresses

How Often Should Dementia Patients Bathe?

Daily bathing is usually unnecessary. Most individuals can get by with bathing 2-3 times per week. In between baths, dry shampoo, and sponge bathing smell or rash-prone areas can prolong cleanliness. 

When is the Best Time to Schedule Bathing for a Person With Dementia?

The best time of day is going to vary between people. If the person has had a routine of bathing at a set time of day, continuing with their existing routine may be helpful. Many caregivers find the most success bathing clients with dementia during daylight hours. 

Further Support for Dementia Caregivers

Resources for Education and Help

• Alzheimer’s Association: The Battle of Bathing
• UCLA Health: Refusal to Bathe

Professional In-Home Care

Professional in-home care provides vital support for families caring for loved ones with dementia. Many family caregivers find themselves balancing demanding careers and their own household responsibilities while navigating the complex challenges of dementia care. A reliable, consistent caregiver not only offers essential practical assistance but also provides families with much-needed relief and peace of mind. If you feel like in-home care may help you provide better care for your loved one, please reach out to us today to schedule an assessment so we can see how we can serve you.