Most of what I know about Alzheimer dementia care I learned through experience. For example, I discovered how to make shower time successful and to overcome “resistance” if and when there was any by understanding where the resistance came from – mostly it was fear.
Maybe Mom had scalded herself in the shower when she was on her own, or couldn’t find a towel when she got out and was cold, or put face cream in her hair (which she almost did one time when I was with her before I stopped her just in time), or who knows what else might have happened? But I know Mom was afraid: afraid of getting soap in her eyes, afraid of the temperature of the water not being right and not knowing how to adjust it, etc.
I made the audio recording below 14 days after I moved in with Mom (in her own house), to be her care partner in November 2011. Prior to moving back into the family home, I had never been in the bathroom with Mom when she showered. But it only took two weeks to get a bit of a routine in place. I learned to do some things differently over time – I was still pretty green at the time I made this recording – but even so, I did lots of stuff that “worked” and made the process easier on both of us, even in those early days.
Here are 15 off-the-top-of-my-head tips (there are real-life examples of both rights and wrongs in the audio clip):
1) Act normal
Become comfortable with something that is initially inherently uncomfortable (i.e. guiding / helping or giving your parent or spouse a shower or bath). The more comfortable and natural you feel (if you don’t feel it, fake it), the more comfortable and less anxious your care partner will feel and the less resistance you are likely to encounter. Act as if it’s the most natural thing in the world that you should be helping them.
2) Get ready
prepare the environment to make it pleasant (i.e. the right temperature, right lighting, everything where it should be so no one needs to search for stuff)
3) Let go
Give her/him as much control and power as possible. For example, toward the end of the recording below, I say: “You are like the Queen, and I’m the lady in waiting.” 🙂
4) Be a cheerleader
Say and do things in a way that makes him/her feel competent and confident rather than incompetent and unable
5) Support don’t act
Be helpful and supportive, only take action and do something if and when absolutely necessary
Gently guide and suggest rather than telling / commanding / ordering
7) Use the right tone of voice
Use a light, natural, even tone of voice (record your voice and play it back later to check your tone because we are often unaware in the moment when we are using a counterproductive tone of voice)
Encourage and agree; don’t contradict or argue. This applies to EVERYTHING 🙂
9) Prompt and cue
Use prompting and cueing to guide through the steps of the process.
10) Don’t criticize
Avoid pointing out “mistakes,” shortcomings or flaws
Give compliments and praise for everything, even things that would have been simple for her/him to do previously. AND, remember your tone of voice. Make her/him the expert (E.g. I hadn’t thought of using the washrag to clean my face like you do. I like the way you’re doing it. I’m going to try the same myself next time.)
Reward desired behaviour without being patronizing or condescending. (E.g. “Now that you’re finished with your shower, we can have a nice cup of tea / bowl of ice cream / bag of chips or go for a walk / watch the birds / read a book / do a puzzle or 101 other activities.)
13) Make it pleasant
Do everything you can to make it a positive experience rather than a chore. Do what s/he likes, not necessarily how you would do it. If s/he likes Irish Spring soap and you prefer lavender, go with with Irish!
14) Reinforce positive outcomes
Remark on the positive outcomes from her/his point of view (E.g. “How do you feel now? You have always enjoyed having a shower, being fresh and clean. I bet you feel great.” Or: “I find having a shower makes me feel wonderful and energized. I wonder if you feel the same…”)
15) Learn as you go
Review/debrief yourself on what worked and what didn’t and do more of the former and less of the latter next time. Build on the good things you did that seemed to work. Remember they might not work every time and that it’s important to be flexible. Congratulate yourself on a job well done; focus on your successes; learn from your failures.
More tips here:
Image copyright: mheim301165 / 123RF Stock Photo