Advocacy, Antipsychotic drugs, NHBPS, Toward better care

waging war at alzheimer’s bath time

a battle at alzheimer's bathtime

This is one in a series of vignettes based on the Nursing Home Behaviour Problem Scale (NHBPS), which is used to measure agitation in people who live with dementiaThe vignettes are told from the point of view and in the voice of a fictional character called Annie, a woman in her mid-eighties who lives with dementia of the Alzheimer’s type in the mid- to later-stages of the disease. Annie resides in a long-term care facility somewhere in Canada. This vignette is called “rub a dub dub.” There’s a link to a full list of all the vignettes at the end of the post.

Tips on how to better manage these kind of situations may be found here:

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rub a dub dub

I’m alone in a little dining room having breakfast. Bananas and milk. Toast and tea. This is a strange hotel, and the staff isn’t very friendly. One of the maids comes in, the big one that never smiles. She has hair as black as night, and small, dark eyes. I don’t know her name, and for some reason I don’t like her. I can’t remember why.

“It’s time for your bath dear,” she says. She pulls my chair out from the table.

“I don’t want to have a bath. I’m eating my breakfast.” I say. “And anyway, I always have a shower. I have a shower every morning. I do it myself.”

“We don’t have showers here, remember?” she says. “We have a whirlpool bath. You have a bath once a week on Monday morning. It’s morning now, and it’s Monday, and it’s time for your bath, my love.”

“But I don’t want to have a bath, and I’m not your love,” I say. No wonder I don’t like her. Who the hell does she think she is? She grabs my hands and pulls me to me feet. She’s very strong.

“Come on, let’s go hun,” she says.


“To have your bath.” Her voice is louder this time. Why is she raising her voice? I can hear perfectly well.

“I don’t want to have a bath.” She pays no attention. What’s wrong with her? Is she deaf? She takes me down the hall, and into a small room with a huge white tub in it. The water is swirling around. It’s fast and noisy. I feel queasy.

“Here we are,” she says. “Now let’s get you undressed.”

Undressed! “I’m not taking my clothes off.” What kind of a place is this?

“You’ve got to take your clothes off dear,” she says, “so you can have your bath.” She starts to undo the belt of my robe. Why is she trying to undress me?

“No!” I slap her on the arm.

“Don’t hit me Annie,” she says. “I’m just trying to help you.” Her hand closes around my upper arm and squeezes hard.

“Ouch! You’re hurting me.”

“I’m not hurting you. I’m helping you.”

“No you’re not, you’re hurting me. Let me go. Let me go!” I kick her in the leg with all the strength I can muster.

“Stop it Annie! You’re making this harder than it needs to be.” She tightens her grip on my arm, and tugs at my robe with her free hand. I twist my head around and bite her on the wrist.

“HEY! Don’t bite me Annie! I don’t deserve that.”

“Let me go,” I scream. She holds me even tighter. “Let me go!”

“Carol,” she yells over my head and out the half-open door. “I need some help. Annie won’t take her clothes off. She just bit me.”

“Let me go!” I spit, and kick her again. Then I feel someone clutch me from behind…


©2016 Susan Macaulay /

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