Battling Bathing

Dementia is a disease that is ever progressing. This disease process may be slowed down or plateau for a while but will eventually continue to progress. As the disease progresses an individual will need more assistance with basic activities of daily living. A sensitive and personal task that most caregivers and individuals with dementia seem to struggle with is personal hygiene, particularly bathing. Tending to personal hygiene can be exasperating for caregivers and is often a source of anxiety for individuals with dementia. For some caregivers, bathing can be the most frustrating activity faced because of the fact that it is a private and personal task. For an individual with dementia bathing can be perceived as a threatening or simply unpleasant experience. The list below describes some reasons bathe time can be a difficult time but it also gives suggestions to managing the difficulties.

Tips to keep in mind:
 

• Doctors recommend older adults shower or bathe a minimum of twice a week to reduce the chance of infection (such as UTI). If you can get them to bathe more, kudos to you. If not, be satisfied with twice a week.
   
• To combat the “NO’s” try to make it seem as if the request is just a routine part of daily life as in, “It’s Tuesday morning. We always take our bath on Tuesday morning. Let’s go get cleaned up, and then I’ll make you a nice breakfast.”
   
• Have everything ready (soap, shampoo, towels, and washcloth) in advance, all laid out ready to go. The room temperature is warm, maybe soft music is playing. You say something on the order of “your bath is ready for you. Here, let me help you with your shirt. Start helping, turn the water on in the tub and temper it and say something like “madam you spa awaits you.”
   
• If there is no other way to get them to bathe. Ask their doctor to write on a prescription pad something like this: “Mr. Smith must bathe two times a week for infection control”. Make several copies of the prescription (in case they tear it up). Show the prescription to them and say “Doctor’s orders.” 
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• The bathing should take place at the time and in the manner the person always used to bathe, meaning if they were a morning bather, then you should have them bathe in the morning. If they were a shower person, then they should have a shower, not a bath, unless medical or physical reasons preclude that.
   
• Some persons with dementia actually grow afraid of the water, especially water coming out of a wall mounted shower head. It becomes threatening to them. If this is the case consider getting a flexible hand held shower head. That way you or your loved one can control where it sprays on them.
   
• Allow your loved one to do as much as they possibly can to wash themselves while in the bath. If they can do a credible job on their own with just reminders from you to wash here and there, let them do that. Even if they don’t do a credible job and you have to redo the washing, I suggest you have them wash themselves first. It gives them “ownership” of the task and gives them something to be successful, even if all they can do is hold a washcloth while you do everything else, let them do that. At least they are participating in the task as much as they can.
   
• Some people need to be distracted with something while you give them the bath or shower. Distractions that could be used are singing in the shower, giving them something colorful to hold and look at while in the shower.
   
• Some people are extremely modest, be aware that that may be the reason for saying “NO”. Respect their dignity by allowing them to cover up with something while in the shower. Perhaps a towel or a sheet or even a poncho. Just wash under whatever they use to cover up.
   
• Safety comes first. There need to be grab bars positioned for them to hold on to while getting in and while bathing and appliqués on the shower or tub floor to give them traction under their feet. If the person is scared to get into the tub because they have to step over the tub wall, try using a “transfer board”. It is a fairly long straight plastic board that you place in the tub with one set of legs outside the tub and the other set of legs inside the tub. Your loved one sits on the outside part and you help slide to the inside part.
   
• ALWAYS PRAISE AND COMPLEMENT THEM AFTER THE BATHING IS DONE. After the bathing is completed and your loved one is dressed, PRAISE AND COMPLEMENT THEM and ask them to cross off that day on a yearlong calendar showing the year by months. Have them do this every time. Eventually you will have visual proof that they have taken their shower or bath every Tuesday and Friday (for example) for months and that it is a normal thing to do. It also squashes the “I took a bath/shower earlier today or yesterday” protest. 

When you are helping someone with dementia to wash, it is important to be sensitive and tactful and to respect their dignity. Caregivers are not there to change an individual’s routine to fit the caregiver; the caregiver’s goal is to assist an individual in activities that will give him or her, a quality of life.

Close to Home

I am writing today about my Aunt Terry. She was a vibrant, vivacious woman who always looked great from her early years to her smart short cut gray hair she sported in her 80’s. She was opinionated and shared her views on everything from politics to the weather and often colored things with her delightful wit. She was a wonderful wife to my uncle and raised my 4 cousins to be good people. The last time I saw her she was standing over the stove showing all the nieces how to simmer the bacon and the onions in the recipe for German Potato salad, a family favorite handed down generation to generation. I will treasure that time with her as I will never have another chance. We lost my Aunt Terry September 17th to Alzheimer’s.
 
In June my cousin Kathy contacted me when she learned I worked for Alzheimer’s Services. My Aunt had been living with her for the past year after developing Alzheimer’s and Kathy was lost. She was unaware of my knowledge and had no local support in her area of Florida. She didn’t have a clue to the challenges, the behaviors, the medications and their effects, the financial burden and the incredible amount of stress it would put on her. She was so grateful for the information I offered. She took my Aunt Terry to Buffalo, our original home town, for a family wedding and left her with her sister for a month and then another sister for a month when the family decided it would be best to place her in a nursing home. The first was not exactly a good match but they were happy with the second nursing home. My aunt was there for just over a little more than a month when Alzheimer’s claimed her. She was the third in the family that Alzheimer’s claimed, my grandmother in 1974 and my Uncle Elmer in 2004. She leaves my Aunt Mary and Aunt Rita who currently have Alzheimer’s and my Aunt Bernie who is showing early signs of it. They were or are all in their 80’s when the disease became evident.  

Research indicates that the disease begins affecting the brain 25 years before the symptoms become evident. At 54 I am at a critical point to be mindful of every precaution I can take to possibly prevent the plaques and tangles from forming in my brain. Having Alzheimer’s on both side of my family, both my mother and her sister are currently affected also, I don’t really worry about it but I certainly make choices that research indicates decrease my chances. A healthy diet, exercise, brain games, socialization, a variety of activities and interests, are all a part of my life. A healthy dose of prayer is my addition to the research. I am hopeful that the research develops interventions and in the meantime am inspired by the families we serve at Alzheimer’s Services knowing we help people on the Alzheimer’s journey every day.

The Other Olympians

For the past week, I've been watching as much of the Olympics as I can. I've been recording coverage during the day and catching up in the evenings, then watching primetime coverage. I'm one of those people who hates commercials. If I can record it and fast forward through the commercials, I will. However, as I've been watching the Olympics, I've been thoroughly enjoying the commercials. My favorites are the Visa commercials with narration by Morgan Freeman and the Nike commercials about greatness. How inspirational!

One promo that caught my eye, though, was for a new show coming up in the fall called Chicago Fire. As the scene unfolds on men working out as "athletes" the tagline, "Some heroes never go to the olympics," comes up on the screen, and we begin to see that these "athletes" are actually firefighters. It got me thinking about the many heroes that never go to the Olympics. The doctors, the soldiers, the mothers, and the ones I see everyday when they walk through the doors of Alzheimer's Services--the caregivers.

An Olympian is defined as majestic in manner, superior to mundane affairs, surpassing all others in scope and effect. Just as Olympians devote hours to training, caregivers devote hours to caring for their loved ones. Just as Olympians sacrifice, caregivers sacrifice their time, their social lives, and many times, their financial stability. Just as Olympians thrive under pressure, caregivers find strength and push through, even in the darkest moments. And just as Olympians rejoice in their victory and see the impact they have on entire countries, caregivers relish the joy of knowing they are making a difference in the lives of their loved ones and inspiring other caregivers along the way.

This week, I'll continue watching as much of the Olympics as I can. I'll cheer for USA to win more medals, and I'll continue to look for Kate Middleton and Prince William in the crowds. I may even try to figure out the rules of water polo. But most importantly, I'll remember the other Olympians--the caregivers--who will never stand on a podium with an Olympic medal around their neck with the national anthem playing in the background, but who are as every bit as heroic as those that will. And I will be inspired to find my inner Olympian.

We're Here For You

“Even if this illness took her memory away from her, it didn’t take the memory of her away from me.” -Annonymous
 
This quote touches my heart tremendously. It captures the loss the affected individual has experienced, but it reassures the caregivers and loved ones that the wonderful memories will never be lost. My grandmother suffers from dementia. I visit as much as possible and she always wants to know what’s going on in my life; of course, I have told her countless times. However, in her mind I am still 12 years old and her pride and joy. At times, I am overcome with sorrow to think that my hero has this terrible disease. But, like in the quote above, I am comforted by the fact the memories of her and I sharing moments together as I grew up will never leave me. 
 
I spoke with a caregiver recently who stated, “No one knows what an Alzheimer’s caregiver feels unless they have experienced personally.” This statement describes the frustration felt by many caregivers and other family members. Alzheimer’s Services of the Capital Area strives to decrease this frustration. We have the Caregiver Network Support Group Meetings as well as our monthly Lunch-N-Learn which gives caregivers a place to discuss the unique situations brought on only by this disease. Alzheimer’s affects many people and many families but it affects each differently. If you or someone you know needs a person to talk to, who can understand the frustration and can offer assistance, please contact us at Alzheimer’s Services. If you are struggling to cope we will do our best to provide hope!


Katherine Schillings, Program Coordinator

A First Week to Remember…

Alright, I have just completed my first work week at Alzheimer’s Services of the Capital Area.  The most appropriate word that describes my experiences is “wow!” It was a great first week filled with a LOT of information about the services the agency provides and as well as all the activities they are engaged in. I am very humbled by the warmth and reception given to me by this great team of people. The dedication and passion the agency has for those whose lives have been impacted by Alzheimer’s is commendable. I got a chance to talk to each of my co-workers about how they individually and collectively contribute to the success of the agency.  I am truly blessed to be a member of this winning team. But I must say that I had two unexpected highlights in my week which were attending the BRAN Meeting at Sunrise and caregiver support group at Magnolia Assisted Living in Gonzales, Louisiana.   

My third work day began at a Baton Rouge Aging Network (BRAN) Meeting. The BRAN Meeting’s activity this month was a personal virtual dementia tour.  Participants got a chance to walk in the shoes of someone who has Alzheimer’s. The activity allowed the participant to experience some of the more pervasive symptoms of the disease such as vision and hearing problems, difficulty in holding or grasping objects; and how these challenges impede completing daily activities. It was an enlightening experience.    

My fourth day at work ended with a caregiver support group meeting. The support group was held at Magnolia Assisted Living facility. It was facilitated by Suzie Richard. Ms. Richard was well received by her diverse group of participants which included Alzheimer’s patients, children of Alzheimer’s patients, caregivers, and a couple who had been married for over 67 years.  The group shared their own personal experiences with the disease. Some participants cried while others shared a laugh. One person described his experience with Alzheimer’s as, “Sometimes you have to laugh to keep from crying.” The group agreed with this gentleman’s comment.  The group was able to vent their frustrations, ask questions, share caregiver tips, laugh, and even cry in a non-judgmental atmosphere. The group may have begun as strangers but they left the group as new friends giving each other support through hugs, handshakes, and/or a gentle pat on the back.  

So to summarize my first week, let’s just say that the bar has been set very high (thanks Julie D!) and I will work diligently to carry out the mission and vision of Alzheimer’s Services of the Capital Area in my work! Thanks again for this wonderful opportunity!

Kristi F. Mellion

Program Coordinator/Respite Administrator