So, how do you give a shower to an elderly person? In parts 1 of this series, I've covered some reasons why your elderly loved one might not want to take a shower.
In part 2, I covered some solutions for the issues that lead to shower refusals.
Now it is time to implement what we have learned, and get that shower done. If you are a new caregiver, and you've never helped bathe another adult before, then this should help you feel more comfortable with your new task.
Here is a step-by-step guide, with some helpful tips:
Head-to-Toe--Showering the Elderly
1. Prepare Yourself
If you are caregiving for a senior that hates showers, then you will need to make sure you are properly fortified. Drink some caffeine, put on something that won't shrink if it gets wet, and take a deep breath.
2. Prepare Your Loved One
Well before you begin the actual showering routine, make sure the rooms are heated. (Not just the bathroom, remember. Make sure your loved one is warm wherever he or she is.
Mention to your loved one that today is shower day. Instead of asking whether they want to, ask instead:
- What do you want to wear today?
- Are you looking for forward to (insert x ritual or event to be done) after your shower?
- Would you like a shower or a bath?
- What are you in the mood for? Lavender or vanilla soap? (whatever choices.)
Be prepared for an argument, an excuse, a sudden illness or whatever they are known to think up. Pretend you didn't hear. Keep your happy face on.
3. Prepare Bath Stuff
The bathroom should already be warm. Make sure you have everything else you need laid out, such as nail clippers, towels, cloths, etc.
Tip: Some people with dementia are anxious around mirrors. If possible, remove or cover bathroom mirrors before showers.
4. Turn the Water On Before You Get Them
"Your water is running." basically means no more stalling. Plus, running warm water before you get them in means that the temperature is adjusted and the shower chair seat is no longer cold!
5. Help Your Loved One Get Ready
Once you are in the bathroom, help your loved one undress, or let them do this themselves if they are able. Be patient. Chat.
6. Double Check the Water Temp
Never put an elder in the water without making SURE it is safe and comfortable.
7. Get Them Into the Shower
Offer plenty of physical support and guidance to get them into the shower safely.
If they have dementia or other cognitive issues, reassure them verbally.
"This is going to feel so good! The water is nice and warm, and we are going to use your favorite shampoo today. Isn't your hair going to smell fabulous?"
Keep up that positive vibe. Hardest part is over!
8. Wash From Clean to Dirty
This is a standard way to cleanse other people of any age. Start with the cleanest areas first (face, neck, torso).
Next clean arms and legs from to top to bottom. Clean the genital area and perineum last.
If your loved one has any sort of infections (such as c. diff or a fungus such as athlete's foot that can be spread) wash those areas last, and do NOT reuse the cloth to clean any other part of the body.
I recommend using white cleaning cloths that you can bleach after use to minimize contaminating other surfaces.
If your loved one wishes to help with their showering, then that is excellent! Even if they aren't able to do a thorough job, encourage them anyhow.
"Can you wash your arms while I wash your back?"
Once the basic cleaning is done, ask whether or not they would like help shaving, if they still shave. If not, then wash their hair and condition if needed.
If your loved one becomes more relaxed after they are in the shower, then spend more time. (maybe a thorough scalp massage while shampooing the hair, or just letting warm water run over their back or achy joints. )
If they get more agitated once they are in the shower, then promise them you will be very fast. Apply the shampoo first, then wash them quickly from top to bottom, quick rinse the remaining shampoo, and help them out.
Tip: If your loved one is very modest in the shower, wrap them in a thin towel before they get into the shower. You can then uncover only the parts you are washing at the moment, so they don't feel wholly exposed.
At some point during this process, you will spray yourself with the shower head. Most likely in the face.
Keep smiling.
For a Bath:
Baths are pretty much the same. Some elders prefer them because the extra water adds more privacy, but whether or not you choose baths or showers is something you will have decide based on your loved one's limitations.
If giving a bath, wash in the same order. But if they have very sensitive skin or skin that is prone to drying out, limit the time spent soaking in the water, and be sure to rinse away all soap residue with clean water.
9. Getting a Wet Person Out of a Shower Without a Mishap
This is a tricky part of caregiving, depending on whether or not the person you are showering can easily step out of the shower.
If they become lightheaded after a shower, then leave them seated in the shower chair and wrap them in a towel. Dry their hair and face with another towel until they are strong enough to move.
If they are ready to get out, make sure they are at least dry enough that you can get a firm grip on them.
Do NOT put lotion or oil on their skin until after you have them safely out of the shower.
Take your time, and transfer them slowly out of the tub/shower and onto another seat. (and make sure that other seat has a towel or other warm cover over it. No one wants to set a warm, naked bottom on a cold, plastic seat.)
Now you can finish toweling them dry, or letting them air dry if they prefer. Remember, they have delicate skin, so don't towel dry them like you are sanding a wood block. Just pat gently at the damp spots.
Again, if they have any sort of infection, dry that part last, then place the towel with the soiled washcloths to be laundered separate from other clothing.
10. Commence with the Grooming
Now you get to do all the other stuff. Do they like lotion?
Warm lotion and oils in your hands before applying it to warm, freshly showered skin.
- A nice, gentle massage with lotion can help relax the muscles and soothe dry skin. It can also make a pleasant reward.
- Blow-drying and styling wet hair is a great way to add a little extra warmth and comfort to your loved one's day. Wet hair can feel icky and cold once they leave the now super-warm bathroom.
- Roll-on deodorants are more humane than cold spray on types.
- Trim nails while they are still soft.
- Apply any medicinal creams or ointments they use now.
- Add any additional grooming they might like/need, such as tooth cleaning, makeup, cologne, etc.
10. Dress Your Elderly Loved One
Keeping your loved one wrapped in a towel or a bathrobe while doing all the other grooming tasks gives their body time to dry so that it is easier to get clothes off and on.
Skin tears can happen when a person pulls clothing too roughly over fragile skin, or when zippers or buttons cause a scrape. Make sure to protect your loved one by keeping your hand behind any metal or Velcro fasteners as a buffer zone.
The easiest way to dress an elder safely is by having them remain seated. Here is how we did it everyday:
Man:
- First put on a shirt (or shirts if they like two)
- Next, put on underwear and pull up to the knees or to the hem of the towel.
- Do the same with pants.
- Next, put on socks and skid-proof shoes (or house slippers)
- Lastly, stand to the side, sort of behind the person and help them to stand, if needed. Pull the underwear and pants up from the sides.
- This is a little more dignified for them, and in plain speak, it makes it easier to get the pants over the bottom.
- Fasten garments if needed.
Woman:
- Put brassiere or undershirt on first.
- Put on shirt or dress.
- Put underwear on first, and pull it up to the knees or under the edge of the towel (or dress). Then do the same with pants or a skirt.
- Next, put on socks and skid-proof shoes. (or house-shoes)
- Help them to stand, then stand to the back to pull up pants or skirt, or to pull down a dress. Fasten garments if needed.
You're Done!
Except for mopping up puddles and stuff, that is. Now you just escort your loved one to wherever they want to go next, and do a secret happy dance that you managed a shower day.
A Note to New Caregivers
If taking on the full time care of a loved one is in your future, then no article can prepare you for the awkwardness of those first few showers. Even if you have children, even if you have worked as a medical professional and bathed total strangers, it is still as weird as heck to bathe a parent or grandparent.
But you will get used to it. They will too. If you don't have a very strong stomach, you may have problems at first, especially if your loved one hasn't bathed in awhile. Its okay. Even if you gag, that doesn't mean that you don't love them. It doesn't mean you aren't going to be a good caregiver.
It just means you are human.
You are going to have to see, smell and touch. But it will just seem normal after awhile.
To make it easier in the beginning:
- Relax
- Talk about something enjoyable.
- Respect their modesty
- Be patient
- Allow plenty of time
- Make them comfortable
- Help them feel safe
Use shower time to watch for things like cuts, bruises, swelling or anything abnormal that may normally be hidden by their clothing. But don't get too up close and personal--just a quick glance over should suffice.
Bonus Tip:
Provide a fun activity that your loved one enjoys, that can come directly after a shower. For example, that time after showers might be the time you read aloud to them, or watch a movie with them, or sit down and share pie and coffee.
Share Your Own Tips
There may always be a struggle to get your loved one to shower, but if you've read this series, then hopefully you have found some tips that will at least help on some days!
If you have anymore tips or tricks that you have used with success, please share them in the comments!
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