This article will cover the many reasons why the elderly may refuse to shower. Following this, we will highlight strategies that can be used to convince them to bathe and maintain their personal hygiene.
Reasons Seniors Refuse To Shower
Many seniors bathe less frequently because they:
- Lost their sense of smell – some seniors may have a hard time detecting body odor if their sense of smell is affected by medication, aging or other medical conditions
- Are afraid of falling – getting in or out of the bathtub and shower can be challenging for those with coordination, strength and balance impairments
- Have a bathroom that is not senior friendly – some seniors have trouble maneuvering their rollator walker inside the bathroom if the doorway is narrow and spaces are tight
- Fear losing control – some elderly refuse to ask for help because they are afraid they will be sent to a nursing home
- Are raised in a culture that values independence – Some seniors try to save their pride by not seeking help even when they struggle with bathing and other personal care tasks
- Lead a sedentary lifestyle – seniors may not sweat as much because they engage in fewer activities, and could bathe less frequently to maintain their personal hygiene
- Have poor memory – individuals with dementia and other memory impairs may incorrectly estimate when they last showered, and feel that they do not need one again
How To Convince The Elderly To Shower
Some strategies and bathing aids to improve a senior’s compliance with bathing include:
- Equip the bathroom with safety devices – make seniors more confident that they will not have a fall by using bathing equipment
Common bath seats include:
- Shower chair with back – large sitting surface with height adjustable rubberized feet and a backrest for support
- Shower stool – compact height adjustable sitting surface without a backrest
- Tub transfer bench – sit on this bench and slide across to enter the bathtub for a seated shower
Common bathing transfer aids include:
- Tub rail – latches onto the side of the tub and grasped for support with stepping in and out
- Grab bars – installed onto the wall, this can held to boost steadiness and balance
- Security pole – placed outside the bathtub or shower, this pole can be grabbed for support
- Bath lift – a remote controlled sitting surface that lowers someone into the bathtub and lifts them out
- Sliding tub transfer bench – sit on and slide along this large bench to get into and out of the bathtub
- Setup a bathing schedule – have a routine in place that encourages regular bath times
Having a set routine or habit that occurs regularly can be used to remind those that have memory deficits that it is time to bathe.
It is well known that those suffering from dementia may lose the ability to remember information and past events. However, they may still remember practiced skills from their youth and adulthood such as playing a piano. These skills are known as implicit learning and are stored in a portion of the brain that is less impacted by Alzheimer’s disease.
Using a bathing schedule is one way to teach those with memory impairments a new pattern of learned behaviors. When something is practiced repeatedly at the same time of day, the pattern becomes ingrained as implicit learning within the brain and the person becomes more likely to participate in the behavior.
For example, if someone establishes a routine where a bath occurs every morning as they get out of bed, an elderly individual with memory deficits may become more receptive to engaging in their personal hygiene over time.
- Get professional support – sometimes seniors may be more receptive to encouragement and support with bathing from an outside care worker
As well, many family members do not feel comfortable with seeing their relatives naked and washing them. Given that bathing is a very personal activity, some individuals may feel vulnerable if assisted by family.
For this reason, it is not uncommon for seniors to be more receptive to a trained health care aide assisting with bathing, rather than a family member.
As well, some seniors with dementia have a learned response of resistance to help from their relatives. In these situations, an outsider such as a healthcare aide from a home care agency may have an easier time convincing them to have a bath.
- Use a fall alert button – get help quickly if you have a fall while bathing by pushing a button on a wrist or neck worn alert system
Fall alert buttons come with a wide variety of functions and features.
The most advanced systems have an automatic fall detection feature that calls for help even if you are unable due to injury or unconsciousness.
These systems have a regular monitoring fee to keep the service active, but allows a monitoring centre to contact emergency services even if family or other personal contacts are not available.
Stand alone fall alert buttons rely on an auditory noise to summon nearby caregivers to render aid and contact emergency services if needed.
While these systems typically do not have a monitoring service fee, their use is dependent on the proximity and availability of a caregiver to assist you if and when you need support.
- Shower with bathroom door open and a caregiver nearby – some seniors feel more at ease with bathing if they know that help is close by should they need it
Many seniors are capable of bathing themselves and transferring into the shower, but they have a fear that they may encounter difficulties and require help.
To put them at ease, the bathroom door can be left unlocked and open while they bathe, so that a nearby caregiver can periodically check in to make sure everything is alright. Having the door open also allows sounds to travel more easily throughout the home, so calls for help can be more easily heard.
If a senior lives alone, they may opt to shower and bathe when family visits to help with other household chores such as cleaning the home.
- Declutter the bathroom – Clear walking paths in the bathroom and around the tub or shower to make room for transfers and mobility
To make the bathroom more safe, it is important to make the environment senior friendly.
This includes removing clutter from the space to allow seniors to maneuver inside the bathroom with any mobility aid they need to use. Any rugs or items that could pose a tripping hazard should be removed.
Many older homes have narrow bathroom entrances, so some seniors rely on holding the sink counters and walls for walking support when their mobility device will not fit through the door.
Unfortunately, this is unsafe as counters can be wet and are a difficult surface to grasp for support. As a result, it is a good idea to make the bathroom doorway at least 32” inches wide so a walker or wheelchair can pass through easily.
By being able to use one’s prescribed mobility aid in all rooms of a home, one’s risk of falling is greatly reduced.