Resistance to bathing is quite common within the memory loss population.  Common, but not acceptable, creating some horrific battles.  A few techniques appropriately used can change all that by generating positive bathing responses instead.

There are reasons they are refusing to bathe but blaming it on “the dementia” is not one of them.   The emotions behind those reasons need to be discovered, validated, and resolved with the help of unique problem-solving solutions.  Pinnacle to success, their sense of autonomy must remain intact. 

This article expresses the importance of asking your loved one to do something in such a way it elicits the response you want them to give while reinforcing their sense of autonomy. 

A loved one loses a huge portion of their autonomy due to cognitive decline.  Intuitively they know it.  Maintaining a healthy sense of autonomy becomes critical for the loved one because it promotes a sense they are sustaining an acceptable level of success regarding their daily routine in the midst of a continually declining cognitive process (generating a sense of stability).  In other words, it allows them to feel successful through a perceived sense of normalcy.

One of the fastest ways to promote unwanted behaviors is to give your loved one the idea you have usurped their sense of autonomy, real or imagined

Logic is no longer their motivating decision-making factor.  This means your persistence to convince them through its use ….. well simply put, is in itself illogical.  It won’t help the situation, it will only serve to irritate them even more.  It also means you have to learn to pick your battles (if you haven’t already).

You will need to find those “special words” that give your loved one the clear understanding the bathing issue is completely up to them.  Bathing isn’t the question at all.  It becomes the assumption.  You want to only know do they want to bathe after folding laundry or before, for example.

Generating positive bathing responses by how you ask

We have to think outside the box and remain nonjudgmental regarding the loved one’s reasoning.  Actually their first line of resistance may be a reaction to the way you present the topic of bathing in the first place.  

In the example, “Will you go bathe?” you’re asking them a yes/no question and they have every right to give you a yes/no answer.  Nobody can argue with that, right?  You were assuming they would say, “Yes,” as that would be the most logical response, but instead you hear them say, “No.”  You see how quickly you can set yourself up for failure?

If you tell them, “You need to bathe,” they will use their own sense of autonomy to determine the validity of your statement, very often responding with, “I already did” or “No I don’t.”  Now sensing eminent breeching of their autonomy wall, they will become resistant and an argument will break out.  

Generating positive bathing responses through options

One very successful method is to give them options.  Instead of saying, “Will you..” or “You need to…” you ask, “Dad, do you want to watch the news first or shower first?”  “Mom, would you like to eat breakfast before your shower or after you shower?”  Suddenly you may find generating positive bathing responses are now prolific.  A complete turnaround.

This way they make the decision and their brain releases happy chemicals knowing their autonomy remains intact.  Your role now is to monitor in case cuing becomes necessary.  For example, “I see the news is ending, Dad.  Want me to put your clean clothes in the bathroom so they’ll be ready for you after your shower?”  

Most often that’s all that’s needed, but occasionally you will find Dad responds with, “What?  What shower?  I don’t need a shower.  We never talked about me taking a shower!”

You just talked about it.  What’s going on?  Every 60 seconds or so the just created (Short Term) memory fades away leaving the loved one with zero recall of it ever taking place.  Dad’s not lying when he corrects you by saying, “We didn’t talk about me taking a shower!” because in his reality it never happened.

No matter what you say or do, Dad is not going to believe you, in fact he’s going to argue thinking you’ve lost it, especially if you respond with something like, “Dad, I JUST asked you if you wanted to watch the news first or shower first and you said, ‘Watch the news first then shower!’”  Arguing isn’t going to better the moment, it’s only going to make things worse.

Avoid an argument by humbly starting over

What do you do?  You have to go back to square one and start over.  “Oh (maybe insert humble giggle here), sorry Dad.  I meant to ask if you’d like to have another cup of coffee before or after you take your shower this morning.  I was thinking a warm cup of joe just might be the ticket after your shower,” you suggest.  “Yeah, that does sound good, doesn’t it,” Dad confirms.  “Alright,” you agree, “I’ll start your coffee now so it will be ready when you come out from your shower.”  

You can keep repeating options until the loved one finally makes the necessary-to-attain-a-goal choice, which usually is no more than one or two replays.

Many times you will find it helpful to get the loved one’s thinking process redirected in a completely different direction when they first decline to bathe.  Find an activity of interest totally unrelated to this moment:  “Dad, your new Popular Mechanics magazine came in.  Look what’s on the cover!….”  

Allow maybe 5-10 minutes to pass then start the options over again as though it were the first time… “Dad, do you want to shower before you eat lunch or after?…..”

Psychosocial Encouragement

• Regularly tell the loved one qualities you admire in them:: “Dad, all my life I’ve watched and learn from you.  You’re a hard worker who knows how to get things done…”  But compliments need to be 100% sincere or they will backfire on you.
• Always show respect.   Respect through body language is shown by making sure you are always eye level with or lower while conversing.  If they are seated, respect is shown in your stooping, squatting, or sitting down as opposed to standing above them yet magnanimously allowing them to stand dialoguing with you while you are sitting.
• Show respect through your intonations.  Sometimes it’s just too easy to take out the “mom” or “dad” authoritative “Because I told you to” voice.  Instead speak softly and compassionately, acknowledging and validating their feelings whether you agree 100% with them or not.
• Show respect through your facial expressions.  Stay away from negative facial expressions.  I think we all know “the mom face.”  The face that says, “Do as I tell you if you value your life…”  or the “Why must you ensure my life be as miserable as possible…?”  These types of expressions accomplish nothing but resistance.