BATHING YOUR LOVED ONE

By Alice D. Domar, Ph. D.

Your bathroom can be a dangerous place and happens to be the one room in the house where most falls occur. A wet floor, damp walls and countertops, plus a steamy, soapy tub or shower make the bathroom a challenging place to navigate for even the “steadiest” family members.

The bathroom can be particularly hazardous when you’re trying to help your loved one with bathing. But with careful planning and knowing your and your loved one’s limitations, you’ll be able to handle this very personal, sometimes difficult task safely and sensitively.

Plan Ahead

Before getting your loved one into the tub, follow these steps to find out the best way to handle bathing, including creating a safe environment that makes your job easier and your loved one feel comfortable.

Get Expert Guidance

As the caregiver responsible for bathing your loved one, you should contact his/her physician or an occupational therapist (OT) to get instructions and/or training on how to do this safely. Ideally, arrange for the OT to come to your home to show you the best ways to get your loved one in and out of the bathtub, as well as provide information for safety items, such as grab bars, handrails, a transfer bench or bath seat, and a hand-held shower head/sprayer.

If your loved one recently had surgery, his or her physician can tell you about proper cleansing techniques for the affected area. Ask the doctor about any prescribed medications that could affect your loved one’s balance and trigger a fall. If your loved one is taking a medication that could make him or her feel woozy or dizzy, be sure to schedule bath time prior to administering it. Knowing if there are any precautions to take will help you make bath time a safe, manageable, and less stressful experience for you and your loved one.

Make Safety a Priority

A safe, accessible bathroom is a top priority, so your loved one can move easily in and out of this room and the tub. Here are some tips to ensure its safety:

Remove any loose rugs on the floor
Be sure the room is well-lighted
Unplug electrical appliances that are in or near the tub
Use wall-mounted racks to hang bath towels near the tub
Securely mount handrails or grab bars on the wall—outside and inside the tub
If your tub has a glass door enclosure, remove it and hang a shower curtain—remember to draw back the curtain before entering the tub
Set a non-skid mat or safety treads on the bottom of the tub
Put liquid soap and shampoo in plastic bottles; set them within easy reach
Remove unneeded bath items from around the tub, such as extra soap, shampoo, conditioners, body scrubs or safety razors
Place a transfer bench or comfortable bath seat—a stool, chair or reclining seat—inside the tub or shower
Install a hand-held shower head/sprayer to better control and direct water flow
Take a portable phone into the bathroom, so you can call for help in case of emergency

Consider Your Safety in the Bathroom

Now that you’ve made the bathroom safe for your loved one, you need to consider your safety as well. Be sure bathing your loved one is a task you can handle physically. If he/she is a much larger person than you—relative to body size and weight—bathing your loved one may be difficult and risky to your health. For example, you may not be able to support his/her weight, particularly if you need to move him/her in and out of a bathtub.

You may have to consider other options, such as having another family member or an in-home health care professional assist with bathing. Also “special lifts” are available for use with loved ones who face physical challenges, such as obesity and significant mobility issues. Unfortunately, lifts are heavy and occupy a lot of space. If your home has a small bathroom, a lift may not be a realistic possibility to get your loved one in and out of a bathtub. Again, talk with your loved one’s doctor or an occupational therapist about ways you can tactfully and realistically manage this situation.

Talk to Your Loved One

Your loved one can also help you make his/her bath a pleasant experience! Before bathing, ask him/her about preferences, but make sure you put safety ahead of these preferences. For example, if you know your loved one is difficult to deal with during the late afternoon or early evening, don’t offer this time as an option for bathing; rather, schedule a bath for a time when he/she tends to be more relaxed and compliant with your requests. Sample questions you should ask include:

Do you like warmer or cooler water?
What type or brand of soap and shampoo do you use?
How often do you need to have your hair washed?
Do you want to hold a towel in front of your body before, during and after your bath?
For men, how often do you prefer to shave?

If you’re a woman caring for a man—other than your spouse or significant other—you should ask him if he would prefer a male caregiver do the bathing, and follow through as he requests.

BathTime

Now it’s time for bathing your loved one. Knowing his/her concerns and desires can help you make this a dignified experience.

Getting In the Tub

It may be difficult for your loved one to have you assume responsibility for bathing him or her, particularly if he or she has been independent until recently. You both should start slowly and be patient with each other, and as the caregiver, respect your loved one’s need for privacy. Follow this routine—or a similar one—to safely get your loved one into the tub:

Make sure the entrance to the bathroom is clear of “movable” rugs or any object that could cause a fall
Check the room temperature and be sure it’s “not too cold” or “too hot”
Pre-fill the tub to a comfortable level (one-third to one-half full) and temperature (usually around 100 degrees F)
Ask your loved one to use the toilet before bathing
Have him/her sit on the closed toilet seat or bath chair to undress
Help with removing his/her clothing, as needed
Use a “safety” belt to help your loved one get into the tub. This can be a flat bed sheet, folded lengthwise, or a thin, long towel, also folded lengthwise.
Wrap this soft “safety belt” around your loved one’s waist. Tie it at the back. You will be holding the belt at the back.
When you’re both ready, seat your loved one on the side of the tub with both feet on the floor
Ask him/her to swing one foot at a time into the tub; if he/she needs assistance, you can lift his/her legs into the tub
Make sure your loved one is “steady” before easing him/her slowly into a seated position in the water
To do this, he/she can put his/her hands on both sides of the tub or hold a grab bar or handrail with one hand and use the other hand to hold your forearm
The safety belt may help you lower your loved one into the water.
Another consideration: depending on your loved one’s size and physical abilities, you may need to have another person’s assistance or use a transfer bench or special lift to get your loved one into the tub. If a transfer bench is used, your loved one should sit on the seat outside the tub, hold the handrail and then slide across the seat into the tub
Once in the tub, remove the towel or sheet (unless your loved one prefers using it for “privacy”) and let him/her do the bathing if he/she’s capable while you sit nearby. Never leave your loved one unattended.
If your loved one cannot manage bathing on his/her own, gently wash—don’t scrub—his/her face first, and genitals last

Getting Out of the Tub

If your loved one needed your assistance getting into the tub, he/she will also need your help getting out. Here’s what you can do to make this task easy and safe:

Drain the tub to reduce the possibility of your loved one slipping
Securely place the “safety belt” around your loved one’s waist
Ask your loved one to put his/her hands on both sides of the tub or hold a grab bar or handrail with one hand and use the other hand to hold your forearm
Help him/her to a sitting position on the side of the tub; both feet should remain inside the tub
Have him/her gently take one foot out of the tub at a time, or you can assist with this task while holding the safety belt
If you needed another person’s assistance to get your loved one into the tub, you’ll need this help again
If your loved one is sitting on a transfer bench, he/she should hold the handrail and slide across the seat from the inside to the outside of the tub before standing up with your assistance
Be sure your loved one feels steady enough to stand, so you can move and seat him/her on the closed toilet seat or bath chair
Softly dry him/her starting with his/her face and finishing at his/her feet
Apply powder, deodorant, and/or moisturizing lotion
Help your loved one to dress: remember to set out his/her clean clothes before a bath, so he/she can be dressed promptly and not get a chill
Accompany your loved one to his/her room or another comfortable place in your home
When you’re finished, wash your hands and clean-up the bathroom

Alternative Bathing

Most people do not need a full bath every day. A sponge bath is a refreshing alternative. Just be sure to wash daily your loved one’s face, hands and genital areas, and provide him/her with fresh undergarments. The frequency of bathing will depend on your loved one’s level of activity and ability to use a toilet, so you can increase or decrease the need to bath depending on these factors.

Bathing your loved one can be a difficult, time-consuming and sometimes unpleasant task. But with planning and patience, you and your loved one can manage it together.

Resources

National Institutes of Health Senior Health Personal Care

Alzheimer’s Association Tips on Personal Care