Notice a theme?
Just to clear up any confusion, cats love bathing more than people living with dementia do. By a lot. Most any care partner who’s ever been the in position of trying to get a person living with dementia into the shower knows this.
Continue reading below, or watch the video (no cats were involved in the making, promise!).
At first glance, this is one of those Seriously? Why? things, along the lines of Why do so many older adults die during heat waves? (They’re afraid of incontinent episodes, so they purposely dehydrate themselves, plus their internal thermostats don’t work so well anymore, so they tend to be cold even when it’s 100 degrees.)
Or, Why do hip fractures lead to death? (Your hips are the hinges that allow you to sit upright. When one is healing post-surgery, you have to lay almost flat on your back…which makes conditions ripe for pneumonia, which can lead to death, especially in people with impaired immune systems, such as older adults and those living with dementia.)
Back to showering: people living with dementia typically don’t like it one little bit. Here’s why:
They think they already did it. Their brain tells them it already happened. Your brain (bizarrely) tells you that if you just tell your parent or partner that she actually didn’t do it, she’ll believe you.
Yes, your brain says, just throw in some reason and logic, and that’ll solve the impasse. The part your brain leaves out is, Reason and logic work so well in every other circumstance involving dementia, right? Hahahaha!
If you love arguing, grab onto this with both hands. You’ll have hours of entertainment. (But also a very ticked-off person living with dementia.)
You’re not the boss of them! If it’s your parent, she changed your diapers and powdered your butt and you will not win this. If it’s your partner, he or she took vows with you.
The “in sickness” part was a vague idea about a very far-off future that happens to a few unlucky souls, nothing applicable to the two of you. It certainly had nothing to do with being dependent on you, or following your orders.
Why would they get naked in front of a stranger? At a certain point, one of two things will happen: your back (or shoulder or knee, etc) or smaller-by-comparison size will prohibit you from being the shower helper, necessitating the need for a professional.
Your loved one will likely not recognize this person from visit-to-visit. Your loved one may also get to the point where she doesn’t recognize you. The vast majority of us won’t willingly take off our clothes in front of a stranger; your parent or partner is no different.
It hurts! As we age, we lose elasticity and firmness in our skin. There’s a multi-billion-dollar beauty industry that will attest to this, and how undesirable we find it. Still, it happens.
The result is that our skin takes on the consistency of tissue paper, and I’m not talking double-ply. Now, add what feels like a spray of needles shooting down on tissue paper-thin skin, and you can imagine how painful that feels, right?
It’s too cold in the bathroom. Your own internal thermostat either isn’t broken, or is perhaps subject to power surges. Either way, you prefer a crisper environment. Your parent or partner doesn’t, because his internal thermostat is shot, and the default is “It’s COLD!” Remember the last time you saw snow and thought, “I should take my clothes off!”? I didn’t think so…but that’s essentially how our proposal to take a shower comes across.
The water’s too hot. Or too cold. This is a point of personal preference, and it needs to be just right *before* your loved one is under it! Most import, it needs to be Goldilocks perfect according to them, not you.
It’s dangerous. A few months ago, I got a new scrubbie and thought my heels could use a brisk rubdown. That, plus a squirt too much of shower gel had me windmilling on a slick surface in no time flat.
Blessedly, the previous homeowner was an elderly lady who’d installed a grab bar. I still took down the shower curtain, but that was easier to put back up than getting rid of the adrenaline rush that lasted for hours afterward.
Most people living with dementia have had at least one experience with a fall or a scary near-miss. Unfortunately, those are the types of memories that can stick.
It triggers a flashback. Water doesn’t have a pleasant connotation for everyone, especially when their brain is under attack and new “memories” are easily formed by conflated unrelated events. Here again, reason and logic are useless. That said, there are also veterans living with dementia who’ve survived wartime torture involving water.
They haven’t done anything that requires a good scrubbing. You, with your hotshot cellphone and fancy indoor plumbing, think everyone needs a shower everyday, because that’s how you grew up. But plenty of people didn’t.
I had grandparents who escaped the Dust Bowl, who were migrant farm workers. They grew up getting one bath a week, on Saturday night (so they’d be clean for church in the morning). If they were lucky, they got to be the first one in the tub–but usually they were the fifth or sixth kid using that same bathwater.
When you consider that context, and apply it to trying to get someone into the shower, someone who hasn’t done much of anything all day–certainly not working in the fields, or the mines, or the factory–it’s easy to see why you sound like a wasteful spoiled brat, right?
They hate feeling done unto. Just like all of us, people living with dementia don’t like feeling helpless, like someone is doing something to them, versus with them. I’ve known plenty of family care partners who just hopped on into the shower, too, recognizing that it was the easiest way to answer the charge of, “If it’s so great, why aren’t YOU doing it?”
They hate being so vulnerable. And who wouldn’t, right?
Want the secret sauce to overcoming all this? Watch the video (skip to the 10:00 min mark).
What’s worked for you? Help others and share your best ideas in the comments!
Christy Turner is the founder of DementiaSherpa.com (CTC Dementia Care Management) and has enjoyed the privilege of working with 1,100 people living with dementia and their families. Follow on Facebook, Google+, Instagram, Periscope, Pinterest, Twitter, and YouTube. Content varies daily across platforms.