Thursday, May 19, 2016

The Shower Struggles

Since last fall, I have been going over to Mom's house 3 times a week to help her through the shower. This was a result of her going days without showering. My dad, of course, would help her get in a couple times a week, but at that time Mom was still on somewhat of a schedule; or, at least, she knew day from night. This presented a challenge because if Dad showered her when he got home from work at night, Mom became confused. Showers signaled morning time for her. Bathing her in the morning was difficult for Dad for a couple reasons: 1. Mom was often still asleep when he left and 2. It made him run late out the door. In trying to lift my dad's load, I volunteered to go over a few times a week to help her get through the shower.

In the beginning it was pretty simple. I would help her get undressed because she wouldn't voluntarily take off her clothes to hop in. Once in the shower, she was able to go wash her hair and her body on her own. Nevermind that she used 1/4 of the bottle of shampoo, conditioner and soap each time; she was getting the job done.

Over the course of the past 9 or 10 months, Mom's abilities to shower herself have decreased. At first it was just cutting out the conditioner, then forgetting to wet her hair before she poured the shampoo on top. All of these changes have forced me to get a little more involved with the showering process. My dad put on a detachable shower head to make the job a little easier.

Our latest routine is this:

I arrive at Mom's house after I drop the kids off to school. I get all of her clothes ready and laid out on her vanity where she can see them. She gets very anxious if she doesn't see clothes laid out for her. I change out all of her towels and washcloths in the bathroom. The towels have become an issue...for some reason Mom uses them to wipe herself now. It's gotten to the point where (just this week) we bought her separate washcloths to leave in there for the sole purpose of her wiping and we take all of her shower towels out now after we are finished with showering. I get her blow dryer ready and make sure everything is set to go; once she's in the shower, I can't leave her (I used to prep everything while she was in the shower). Only once everything is ready to go do I begin the strip down. I remove her mismatched earrings and adjustable "wedding" ring from her finger. She isn't too happy about that, especially because I think she knows what is to come once the jewelry comes off. I remove her shoes and socks, then the rest of her clothing, with no help from her. It's like removing clothing from a struggling toddler, only she is bigger than me. She will sometimes try to grab the clothes back from me or out of the hamper, so I have to be assertive and redirect her. We are fortunate that she doesn't get aggressive with us (aggression is common in many forms of dementia). I have to gently push her into the bathroom, where I turn on the shower head and she shakes her head at me, "no, no."

Once I get her in the shower, she kind of stands around, not sure what to do. The bathroom is very small; there is just enough room for the shower stall and the toilet. There isn't much room to maneuver around in so I've had to be creative in getting the job done. I usually step onto the toilet and lean over the top of the shower, removing the shower head to wet down her head. Usually she will grab the empty bottle of shampoo that sits on the shelf and then I take the full shampoo bottle, which sits on the back of the toilet, and pour it into her hands. She will slap it onto her head and put her hand out for more, so I put the conditioner in her hands. She doesn't make any efforts to rub it in anymore, so I lean over while she reaches for her loofah sponge and I quickly scrub her head. She holds her sponge out for me to put soap on, which bottle also sits on the back of the toilet (we moved it all outside the shower because of the incredible amount of soaps she was using). She used to wash her whole body herself, but now she runs it quickly across her chest and then hangs the sponge back up and turns off the water, without rinsing. This is where it gets tricky. I stand overhead with the shower head, trying to rinse her hair quickly, but once that water gets shut off she is ready to get out of the shower. This leads me to opening the right side of the shower door, turning on the water again, while Mom grabs the squeegee to wipe off the shower doors. It fascinates me that with everything she's forgotten, she still attempts to wipe down the glass doors with the squeegee! While she is distracted with that, I grab her loofah sponge and quickly try to wash all of her body parts, and yes, I mean all of them. This can be a bit uncomfortable for me, but I'm learning to deal with it. Sometimes she is done before I can wash all parts, so I have to physically get in there and put my foot against the door so that she doesn't open it. Last Friday, I forgot that important step in the process (putting my foot to block the door) and in an attempt to jet out of the shower, Mom opened the left side shower door and slammed it into my head. It hurt like heck and left a pretty good goose egg just above my eyebrow! You can kind of see it in the picture, it's kind of hard because I do have make-up on, but if you look closely you can see it (I was going to an 80's dance with my son, so don't mind the gobs of make-up and 80's accessories, ha ha).
It's a struggle to get her washing and rinsing completed, but I usually win, though I'm usually wet by the time this whole process is over. I've learned to take off my shoes and socks and usually come over in my work out clothes now.

Mom then grabs the towel and begins drying off. She used to be very thorough at drying herself, getting every nook and cranny. Now, she leaves herself very wet so I take the towel and help her to dry off her body and squeeze the excess water from her hair. Just as I used to do with my children when they were toddlers, I help my mom get dressed. I prep her underwear and bring it down to her feet where she can step into them, holding onto the wall. Then I put on her undershirt as she lifts her arms over her head and dives her head in the hole of the neckline that I have stretched open for her. Next comes her pants and then her shirt. It has to be in this order or she gets confused. If I hold up the shirt before the pants then she will think she needs to step into them, so I try to keep it in the same order. Up until a couple of months ago, Mom was putting on her own shoes and socks, but that has become increasingly difficult for her. Now, she holds her foot out for me, only raising it a couple of inches and holding her balance on the wall or vanity, while I scrunch up her socks and place them on her feet, stretching them past her heel and up her ankle.

It's becoming a bit trickier to get the job done, but between my dad and me, we seem to get the job done and come up with creative ways to make it happen. We've contemplated putting her in the bathtub rather than the shower, but I think that would be harder because she doesn't know the bathtub, she knows the shower. Since she doesn't really know day from night anymore (she is up in the middle of the night almost regularly), I think it might be easier for my dad to just hop in there with her at night and shower her; not that I'm trying to get out of helping...I'm happy to help. I'm just brainstorming the most effective to handle the situation. It is working for right now...but it gets more and more difficult with each passing week.


  1. The logistics of this sound so overwhelming! Thank you for sharing to help people understand just how complicated it is to care for someone with cognitive impairment. Unless you've been there, it's just difficult to grasp how every little thing has to be carefully considered, coordinated, and altered along the journey.

  2. Agree with Kathleen that people who have not cared for loved ones with dementia in the home don't realize how complicated a simple task like bathing can become. Thanks for sharing the details!

    A shower bench and having secure handles installed in the shower can help with the bathing process some, but it all depends if the person is willing to use such aids. In between showers, I found the rinseless body wash to be pretty good; the dry shampoo stuff can leave a residue.

  3. Thanks for your blog. We are just now crossing over into the reality of missed details, daily disconnections from tasks and mishaps of every day life with dementia. While my mom is not quite as declined, this scene plays out with much familiarity. I now remind her to remove her slippers and robe before showering (or she won't) and often find myself scrubbing and rinsing hair properly. Every day I now find myself scrambling to keep her making safe choices. And floored at what she mixes up or forgets. I'll remember about using towls instead of toilet paper. I can see how that could happen. Grab bars as towel rack. Im grasping at understanding. Thanks for sharing your journey.

  4. Thanks so much for this post. You really have some good tips. We are in this exact same stage with our mom. Keep posting please because I am learning new tips that may work for us. Thank you.