A Plan when Dealing with a Resistant Bather.
Preparation counts when assisting a resistant bather, particularly those who have dementia, arthritis or are likely to have emotional reactions to the idea of bathing.
Prepare for the Bath:
First, if the patient is dizzy, unbalanced, sleepy, or very tired, DON’T bathe the patient today. It’s not worth risking a fall for the patient or the caregiver.
Be sure to tell them that it is bath time, and to prepare them to accept it before it happens. Take your time. Ask what they would like, a tub bath, a shower bath or a sponge bath.
Adjust the room temperature before the bath. Adjust the temperature of the water before entering the bathtub or shower. Have washcloths, towels, soap, and a robe within reach.
Simplify the bathing process for resistant bathers by using no-rinse bath products, like Septi-Soft.
Make the mood calming, with low pleasant music.
Use spray room deodorizer to hide unpleasant odors and to give the room a pleasant scent.
Have the person bathing seated on an adjustable shower bench, or a bath lift seat.
Some people with arthritic joints suffer pain when they lift their knees or bend over to get in a tub. Allow time to put a warm water bag or a heating pad on their knees or shoulders to loosen up those joints before getting in the bathtub. A sponge bath at the sink while seated or a wipe-off in the bed could be an alternative on days when moving is painful.
The Bathing Process:
Coach them through the steps calmly and slowly. Ask the person to watch you and do the same. Gently guide them to wet themselves gently, apply soap and then rinse. Don’t scrub; gently wipe.
Eliminate embarrassment and shivering by covering the patient with a towel and wash beneath the towel.
Limit the time when the patient is sitting completely wet. Help them out of the tub safely and into a chair or wheelchair then wipe off with towels. Grab bars positioned around the tub/shower are a great help to bathers and caregivers when getting up and out.
Face and hair:
Though many nurses have been taught to bathe a patient from head to feet by washing the face first, with some patients, it is best to wash the face last. This keeps them calm throughout the whole bathing time, and saves the least enjoyable part to the last of the session. Avoid getting water in the patient’s eyes. Don’t cover the face with a washcloth.
Let the patient hold the washcloth and wash his own face, if at all possible. An unbreakable mirror could help them to wash their own face. The mirror could be held by the caregiver or mounted on the shower or bathroom wall.
Use a comb and comb water through the patient’s hair with the patient’s head erect while seated on a bath bench. Washing short hair in the shower or bath is certainly doable. However, when assisting patients who have long hair, it might be best to shampoo at another time in the sink.
I hope this information gives caregivers a few more ideas about making bathing less difficult, particularly for the resistant bather. Next, we will give you a gentle towel method of bathing in-bed. Stay tuned!