Tag: shower

The Shower…Tips For Reducing The Stress – Part 3/3 (Final)

Brett0 comment

3. AFTER THE SHOWER

Place a floor mat down and ensure the person stands on the mat for safety. I usually place the mat on the floor under the heat lamps if possible, as it is nice and warm.

Pass the open towel to the person and allow them to start drying themselves if capable.You may want to place it over the person’s shoulders as well. It all depends on the individual and their own personal routines. It is great if they can dry themselves as much as possible.

Go over the person’s entire body with a towel even if they have already dried themselves. This will ensure the person is as dry as they can be. It is important to dry them quickly in this case as they may argue that they have already dried themselves. It is all about being subtle and discreet.

I mop up any wet areas of the floor asap to reduce the chance of a fall. I may use towels or a mop if handy. I tend to do this task when the person may be drying themselves so it does not appear that I am ‘over caring’ for them. I believe they need to feel like they have washed and dressed themselves with only some minor assistance from the carer.

Be aware that spray deodorants may annoy people and they may prefer a roll on deodorant (if anything at all). If you are going to spray the person you to need to prepare them by telling them what you are about to do first.

Keep praising and remain positive at all times. If something goes wrong it is best to apologize and take the blame for it EVERYTIME. This will diffuse any frustrations for the person with dementia.

I like to dress the person outside the bathroom as the clothes are more likely to stay dry and it is a safer environment to do so. I will close the blinds/curtains and any doors for their modesty.

Dressing the person can be a stressful time also. Observing body language can really help by watching what frustrates the person when dressing them and establishing routines to make things easier.

Always ensure clothes are not inside out before putting on the person. If you have to take the garment off and on several times it can really irritate a person with dementia.

When placing pull-ups or pants on I tap the wall, get the person to hold the wall or rail (to steady themselves) then assist as required. Buttons on shirts are a flashpoint for frustration. Do not get concerned if the buttons are done up wrongly, you can adjust later if required.

When placing a shirt on the person I run their arm up one sleeve of the shirt and then quickly hold open the other sleeve from behind to ensure a fast and smooth action. I aim to make this ‘hotspot’ procedure as seamless as possible. I usually let the person try and do their own buttons up to empower them. Who cares if the buttons are not quite right? I may adjust them later depending on the person’s mood.

The key to dressing someone is to be ahead of the game and anticipate any frustration areas and practice your techniques. Everyone is different so there is not a ‘one size fits all’ solution to the best way to dress a person with dementia. As the disease progresses you also need to adapt to the person’s nuances and habits as they are ever changing.

I always ask the person first if they want to perform an action eg ‘put their shirt on’ before doing it for them. I believe it is really important to empower them and retain their dignity as much as possible. If the person does not react or respond, I will then perform the action but do so in a way that they are actively involved in the process. This way they feel they have dressed themselves and not treated like a baby.

The Shower – Tips For Reducing The Stress – Part 2/3

Brett0 comment

2. HAVING THE SHOWER

Find out the person’s previous shower routine and washing habits where possible. eg what order they like to wash their body parts and try and do in a similar order.

Make sure you have a rubber mat down to ensure they do not slip over.

Get the person to hold onto hand rails in shower if you have them.

Showers with a flexible head that can also be attached to the wall are preferable. This gives you the freedom to be ‘hands free’ if required, or be able to reach difficult places of the body with the flexible head.

Turn on the water and test the temperature before the person goes under the water.

Be wary of the water pressure. It can be a scary event for a person with dementia as to them they may see the shower as a jet of water blasting from the wall that may harm them. Try not to hit them in the face with the water straight up.

Allow the person to feel the water before entering the shower. If the person is refusing to get undressed, turn the shower on as a ‘trigger’ that it is shower time.

If they feel the water first with their hand it can sometimes be instinctive for them to then remove clothes.

Let the person feel part of the process and empowered by allowing them to wash themselves if they are able. Place soap in their hands and guide them to wash selected parts of their body.eg “now do under your arms”. (*note – this may not be possible as the disease progresses)

Remove clutter from within the shower. The person can sometimes grab the shampoo bottle after you have already done their hair and re apply. If you remove the bottle after you use it, it will reduce the temptation for them to grab it. This may be the same with soap.

Make sure you go over all the areas of the body with soap even if the person has already
done them. This will ensure they are as clean as they can be.

Avoid confusing the person by talking too much or giving too many instructions in
the shower.

Clean very quickly across private parts or get them to do it themselves if possible.
Prepare the person by positively talking to them as you shower them.

Praising the person (not in a child-like manner)as they do things is really important. It
keeps the person upbeat and more likely to be less difficult.

If the person is becoming negatively focused on the shower process you may need to distract them by chatting about something else, asking them to hold something etc.

If the person is refusing to take their pants off for example (due to their cognition) you can try tricks like discreetly wetting their pants with the shower head. The pants will become heavy and the person may naturally remove them because of this.

I prefer to let the person remove their own pants if possible. It is a sensitive area and the person may be reluctant.

Many carers are hit when they do not warn the person as to what they are about to do. eg removing pants/underwear. Be respectful of their modesty.

 

The Shower – Tips For Reducing The Stress – Part 1/3

Brett0 comment

Probably the ‘no.1 hotspot’ for frustration for people with dementia (and their carers) is the bathroom. Showering is difficult and exhausting, and everyone seems to end up wet. I have decided to share my favourite showering tips across 3 sections :

1. Preparing for a shower
2. Having the shower
3. After the shower

There are no set rules as to showering but you need to remain flexible. As the disease progresses you may need to change your showering methods as the person may have less mobility, less cognition or be experiencing health factors. Please feel free to comment with any tips you may have.

1.PREPARING FOR A SHOWER:

  • People with dementia DON’T seem to like taking showers. A big mistake to make as a carer is to waste energy on trying to convince the person to have the shower and arguing with them.
  • They will more than likely refuse to take a bath or shower every time you ask. As a carer you need to ACCEPT THIS. If they take the shower willingly…consider it your lucky day!
  • It is better to attempt to shower the person everyday, as opposed to twice a week. With people with dementia establishing the ROUTINE cannot be underestimated. It doesn’t matter if you succeed everyday, but is great if you can establish a pattern (eg shower the same time each day).
  • How often should they have a shower? No set rule…but I would aim for at least 3 times per week. Some cultures do not have showers for weeks. having a regular shower will reduce the risk of urinary infections etc.
  • BE ORGANISED – prepare some fresh clothes in advance inc pull-ups, pads etc…I usually lay out the complete outfit (inc shoes) and make sure everything is unbuttoned, untied and facing the right way prior to showering – this will keep things efficient.
  • Pre-prepare your towels and flannels. I take in 3 towels (one for foot towel, one for face/hair, one for body) and 2 flannels. It is worth the extra towel washing afterwards to have a smooth shower experience within the bathroom.
  • Have all toiletries on hand and mentally run through your routine to ensure you have items lined up in order ready to go. I start our routine by brushing the teeth first at basin, then moving straight into undressing, then showering.
  • Warm the environment – turn on the lights and heat lamps and make the bathroom a cosy place to be in. Maybe even have some soft music playing.
  • Some people are very modest when it comes to taking a shower. As carers we need to RESPECT THEIR DIGNITY and do small things to protect their modesty. eg turn your head away where possible, cover them up quickly etc
  • Expect the “No’s!” when it comes to showering – try and keep things light hearted and relaxed and say something like ” Let’s get all nice and clean, and then we can make you a nice breakfast”. Keep everything POSITIVE and remind them how good it feels to be clean.
  • Avoid lengthy explanations, keep it short and simple where possible.
    When ready to take them to the shower, gently approach them and try and get their attention, aim for some positive rapport and keep things light and happy. Then reach your hand out to them (palm facing upwards) and wait for them to take it.
  • I like to emphasize that “WE are going to have a shower now”. I believe that if you do it as a ‘team’ it is a shared experience and will make them less likely to resist (as we are doing it together).
  • If in a care facility, I prefer to have less people in the bathroom ( is less confronting for the person with dementia). If two carers are doing the showering I would rather have one carer making the bed while the other washes the person. The carer not in the bathroom needs to be super alert as to what is happening inside the bathroom and be ready to fetch an extra towel or lend a hand if the carer doing the showering calls for them. Effectively the 2nd carer will act as their support person/assistant and is a critical role to how smooth the shower process goes.
  • Don’t be bossy when showering! You are better to calmly GUIDE THEM.

Xmas in Hospital – 2015

Brett2 Comments

FullSizeRender

These images highlight a very special Xmas and really capture life in Ward R8. Believe it or not, the 90 minutes spent with Dad was the highlight of Xmas for me and I want to share it with you to show you how little things count . My son Zak and I went into visit Dad in hospital before we had our traditional Xmas lunch at my sister’s house with our extended family (which was fabulous).

We turned up to the ward to find Dad slumped in a chair in the hallway flanked by his nurse. He was heavily medicated and could not lift his head at all so we decided to sit on the floor so he could see us. Surprisingly he remembered how to open a present, to reveal a brand new Port Power cap.

Dad then stood up and did some more laps of the ward with 3 of us in tow.He was groggy and slightly agitated. We had been unable to shower him for several days as he would lash out whenever we attempted. Today was different though – when I asked him to clean his teeth and have a shower I could tell his body language was in ‘auto pilot’. This meant I had a ‘window of opportunity’ to get him in the shower and the chance to get him back to a respectable condition that would make him look and feel comfortable. This was the ultimate goal for me today.

In the bathroom we worked as a team with Zak and Rashmi (nurse) running towels, toiletries and clothes into me so fast I could hardly keep up. Being organised and fast in the bathroom is something you need to master when caring for someone with dementia. What often happens is Dad may walk out of the bathroom at any moment (whether dressed or not) creating an undignified scene for other patients etc…I was totally soaked by the shower, but I couldn’t care less. To watch him just enjoy the warm water pouring on his face was another highlight as he had some relief from his frustrations for those few seconds.He became increasingly agitated as I put his shirt on and missed the armhole on the first attempt (you only get a couple of shots before he lashes out). He was so confused he tried to hit me away and actually hit himself in his own leg (thinking it was mine).

Today was special…We had success! He was showered,with new clothes on, and even let me shave him. Who would have thought something as simple as giving Dad a shower would give me such pleasure? In Dementia World we celebrate ‘small wins’ and today was no exception.

Merry Xmas Dad……

FullSizeRender (5)