Battling the Bath With Alzheimer’s

August 2, 2024

Ann Margaret Johns is a Certified Public Accountant and author of the book Counting Steps: The Alzheimer’s Journey of Pat in the Hat. She was a caregiver to her mother Particia who was diagnosed with Alzheimer’s in 2017. The following essay is an excerpt from her book.

As my mother’s caregiver, one of the hardest tasks was convincing her to bathe. The days went by, and she simply had no idea it had been a week since she had showered. Mom certainly wasn’t alone in her reluctance to bathe — poor personal hygiene is a common symptom of Alzheimer’s disease; patients may lose all perception of time, not comprehending how long it has been since they last took a bath or shower.  

I tried different approaches over several months to win the battle of the bath. I tried bribing, spa days with scented products, and guilt. I found nagging to be extremely counterproductive. 

When the stars aligned and I got my mom into the bathroom for a shower, she seemed fearful. Once she got past the fear of stepping into the bathtub and the water came on, she put her hands up defensively, like she was protecting herself. She would become agitated, I would lose confidence, and “operation shower” would be abandoned. 

Mom couldn’t understand the need to shower. She found the bathroom cold, the water scary, and being naked in front of me embarrassing. The fear of falling into the bathtub only compounded her reluctance. And so, the battle to bathe continued.

I learned quickly that trying to reason with my mom was impossible. If you are going through a similar situation with your loved one, I can offer you these words of advice — lower your standards. As hard as it is, as humiliated as Mom would’ve been if she didn’t look or smell good, trust me when I tell you she wasn’t humiliated now. I was the one who was humiliated. 

After much trial and error, I finally found solutions that worked for us. I purchased a non-slip shower mat and a space heater. Before leading my mom into the bathroom, I turned the space heater on high, turned the water on hot, and shut the bathroom door to warm up the space. I realized that putting my mom in the shower facing the showerhead and then turning on the water startled her. One time I tried leading her into the bathtub backwards, as far away from the showerhead as possible so the water wouldn’t touch her. 

Once we were both inside the warm bathroom, I adjusted the hot water temperature down, and helped her to undress. With the water running, I steadied her as she stepped over the edge of the bathtub, facing backwards away from the showerhead, and pulled the shower curtain three quarters of the way shut. 

“Back up towards the water Mom.”

She complied. Water hit her calves.

“Back up a little bit more, Mom. Almost there.”

Finally, the water hit her back. On her own, she backed up even more. 

“Oh, does that feel good?” She closed her eyes.

I picked up a shower sponge from the corner of the tub and squeezed body wash on it. I was unsure if I should wash her myself. I wanted to soothe her, but was reluctant; afraid of the reaction I was going to get. Looking back, I suppose it was fear of rejection that stopped me. 

“Here you go, Mom.” I offered her the soapy sponge.

She began to wash herself, running the sponge up and down her left arm. 

I shut the shower curtain to give my mother her privacy.

“Are you still here?” She called out, concern in her voice.

“I’m right here, Mom.” 

I cracked the shower curtain at the front of the tub and grabbed the shampoo. 

“Hold out your hand, Mom.” I gave her a wink and squirted some shampoo into her hand. 

“What am I supposed to do with this?”

“Wash your hair with it, Mom. I’ll be right back.”

If Mom finished her shower and saw her clothes on the floor, she would want to put them back on, so while she washed her hair I picked her dirty clothes up off the floor and tossed them into the washing machine. I didn’t want to start the machine right then for fear it might change the water temperature and startle her. I headed back into the bathroom.

“I’m back, Mom.” 

“Can I get out?”

“Of course.” I grabbed a towel from the towel basket, reached in and turned off the water. 

“It’s so cold,” she said, her arms wrapped around her body. She was shivering, in spite of the extremely warm temperature in the bathroom. I wrapped a towel over her shoulders and helped her sit on the toilet. Once she warmed up in front of the space heater, I helped her get dressed in fresh clothes.

Not all of Mom’s showers were this successful, and that was okay. I learned it was best to take it one shower at a time.