Goals and Benefits
Bathing a resident with dementia is not a simple task that can be done mechanically in the same way for all residents. It is a craft requiring complex skills, assessment and creativity to make it a pleasant experience that is dignified, resident-centered, and based on individually assessed needs rather than just a universal ritual of practice or care-routine.
For the resident
- Prevent agitated behaviors.
- Provide an enjoyable interaction with caregiver(s).
- Maintain cleanliness, good skin integrity and prevent odor and infection.
For the staff
- Promote their ability to provide optimal resident care with safety to them and residents.
- Promote opportunity for positive interaction with residents who become upset during bathing.
- Prevent agitated behaviors while providing required care.
Elements of the program
- When a resident consistently objects to being bathed, or it is obvious that bathing is an unpleasant experience for the resident, bathing approaches are evaluated using the EDGE Resident Assessment for Causes of Agitation during Bathing (PDF, 33KB, 1pg.) to try to find a way to provide a more acceptable bathing experience.
- First the question is considered: "What can be done to make the bathing experience more pleasant for the resident"? Environmental Considerations for Gentle Bathing (PDF, 211KB, 3pg.)
- Privacy and comfort during bathing are priorities. Attention is paid to the resident's complaints and perceptions. For example: if the resident complains that the water or room is cold, the complaint is accepted as valid. An appropriate response is made to validate the resident's concern, and if possible remedy the problem, even if the caregiver's perception is different from that of the resident.
- If bathing continues to be unpleasant after making changes in the approaches and environment, a second question is weighed: "When, how and how often does the resident need to be bathed to prevent infection, to promote social acceptability, and because it usually makes a person feel better?"
- The bathing method currently used is assessed to determine if it causes the resident pain or discomfort.
- To understand why a resident with dementia dislikes bathing, caregivers are encouraged to try to see the experience through the resident's eyes by observing and listening to verbal and nonverbal language expressed by the resident.
- Bathing or some part of it, may be perceived as a threat by a resident with dementia who then reacts with a normal defensive response. This is often interpreted as "disruptive and aggressive" behavior by staff. When the resident's requests to stop bathing are ignored, it is understandable that the resident may become fearful and angry.
- Family is consulted to learn about the resident's past experience and preference concerning bathing. Learning about any convictions and fears held by the resident concerning bathing, such as "you shouldn't bathe in the winter" or a fear of drowning, is helpful in planning successful approaches.