Skill Builder: Bathing and Grooming

This ElderCare Skill Builderä is intended to give the eldercaregiver background information on special skills that caregivers may need on a daily basis. While these guides are primarily intended for caregivers of people with Alzheimer’s Disease, they can be used for any frail or dependent elderly person. When caring for an elderly loved one, always treat them as an adult, with dignity and respect.
You should use this guide for educational purposes and as a supplement to any professional training, guidance from a home care provider, or instructions from a qualified health care professional. As a caregiver, you will likely be the first to notice any important changes in physical attributes, eating habits or health status. Please notify a qualified health professional immediately if you notice any changes.

Bathing

Things That May Cause Problems With Bathing

Tips and Techniques

Undressing Tips and Techniques

Grooming

Tips and Techniques

Hair

Shaving

Make-up

Nails

Teeth

Bathing

Things That May Cause Problems With Bathing

Depression, that often causes a lack of interest in personal care.
Presence of an illness.
Temperature of water or room that is uncomfortable.
Inability to find the bathroom.
White tub, white tile, white floor, white shower stall could cause confusion.
Lack of privacy.
Embarrassment about having someone else in the bathroom.
Fears, such as falling, fear of the sound of running water or the water itself, fear of soap, fear of shampoo and its purpose.
Belief that the bath has already taken place.
A change in daily routine.
The sense of being rushed.
Being kept waiting too long while the caregiver prepares the bath.
Forgetting how to perform the task.
Tips and Techniques

Bathing an individual may be an awesome task if the caregiver is not alert to some of the common problems. The caregiver must adapt to the special needs of the person receiving the care. Bathing should be a regular routine, done at the same time of day, and using the same steps. Some techniques that may help with bathing include:

Many people prefer a shower to a bath – it’s easier and feels safer. If you use a tub, fill it with four to six inches of water and stay with the person. If the person is startled or agitated when they enter the tub without having seen it being filled, let them stay in the room while the water fills the tub. If running water frightens them, fill the tub with four inches of water and lead them to the bathroom and into the tub.
Stay calm and take it step by step. A bath may take all morning. Remember that if only the important parts get washed, the bath is a success. Some people in the early stages of Alzheimer’s Disease enjoy being in the tub. If you put a comfortable chair in the bathroom, their relaxation time may give you time to relax as well.
The sound and feel of the shower may frighten some people. Others enjoy the soothing relaxation of the water.
After a while some people with Alzheimer’s Disease lose depth perception. They may not realize that the water in the tub is only four inches deep. They may fear drowning and refuse to get into the tub. Keep the tub drained of water and use a rubber hose shower nozzle.
Sometimes it is a question of modesty and as long as a person is covered with a towel or shower blanket, he or she will tolerate bathing. Helping from their side rather than from the front may feel more natural, since a person’s own arms was from the side. Sometimes bathing needs to be limited to a weekly session with sponge baths the other six days.
Don’t use slippery oils or bubble bath.
Provide support – handrails, a bench, non-slip strips, etc.
Wash in the same order every time.
Make sure the bathroom is warm.
Have everything ready ahead of time – bath water, towels, clothes, etc.
Provide adequate lighting.
Keep the bath area safe by removing electrical appliances, using non-slip bath mats, using a bath/shower chair and removing locks from the bathroom door.
Allow the person to do as much as s/he can for him or herself. Give simple instructions, not long explanations. Modify assistance as needed.
Avoid forcing or arguing.
Wash genitals thoroughly – sponges or mitts may help. This area needs to be kept clean, even if it’s the only area you clean that day. Tell the person that you are going to wash their private areas before you go ahead and do it.
Help the person wash and then dry in the same order from top (head) to bottom (feet).
Undressing Tips and Techniques

Try some of these suggestions with a person who resists getting undressed for a bath:

Sometimes a person can be encouraged to undress to prepare for a reward or a nice experience, such as a refreshing bath or a cool, comfortable bed.
Distract with a simple, funny story or a song. As soon as the clothes are off, they should be taken from sight, following the rule, "Out of sight, out of mind." Only the clothing to be worn next should be in view.
When a person clutches clothing so it cannot be removed, put something in his hands to distract. Drinking juice or looking at a book can draw attention away from what else is going on.
Grooming

Tips and Techniques

Good grooming is important to a person who is elderly or has Alzheimer’s Disease and to his/her caregivers. Here are some tips for making grooming easier:

Hair

Keep hair in an easy to care for style. Washing hair at the kitchen sink may be easier than in the tub or shower. Get a hose/spray attachment to make rinsing easier.
If the barber shop or beauty parlor has been an important part of the person’s former routine, continue having him/her go to the same place, at a regular appointment time. Visits to nursing homes or other care facilities can be arranged with some salons.


Shaving

It may be difficult to shave the person, so try to supervise the shaving as long as possible. An electric razor may simplify the job.
In addition to helping women shave their legs and underarms, you may need to help those who have facial hair either pluck or shave their chins.


Make-Up

Most women stop using make-up early in the disease. But a woman who has always worn make-up will feel better about herself if she continues using it.
Use light tone lipstick and a bit of powder. Eye make-up is too hard to attempt.


Nails

Encourage people with Alzheimer’s Disease to continue trimming fingernails and toenails. When you take over, do it twice a month.
You may get more cooperation if you trim nails while the person is watching television or listening to music.
Difficulty with toenails, bunions or calluses may cause discomfort or problems with walking. A visit to a podiatrist every six months might be helpful and may be covered by insurance.


Teeth

Encourage twice-a-day brushing.
If a person has dentures, encourage continued care and regular check-ups. Ill-fitting dentures can contribute to poor nutrition and result in constipation or mouth sores.
Schedule regular visits to the dentist

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Thanks for the info, TB, as we are now in the stage of helping Old Navy with showers and personal cleanliness.

Mundee, I'm glad you could use the information.

TB - My husband and I are doing pretty well with his showers. I started helping him about two months ago. The only problem is he wants the water almost cold. If it is the least bit warm he thinks he is being scalded. Should I just bathe him in cold water, and try to keep the bathroom as warm as possible? (Oh boy, bathroom heaters and hot flashes. Troubles come it twos!!!!)

DiDi, if he is comfortable that way...and, you keep him warm with heaters... I see no reason not to go with the flow.

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