A senoir refusing to bath.

[mandihere]

Have a client refusing to bath. He claims it causes him pain. He has received sponge baths but has not had a shower in months. We are be told to push the fact that he needs a shower but no one has had success getting him to agree. He's a very independent man and could basically shower without any assistance. Any suggestions?

[amoLucia]

Have you tried asking any family to encourage him - maybe they can convince him. What if he got some new clothes, would that provide any incentive?

[P_RN, ADN, RN]

The gerontologist my mother went to, suggested telling her that he skin was very dry and that she should have lotion applied for 20-30 minutes, and then have it washed off either in the shower or by one of her caretakers using sufficient warm water so the lotion would't make her slip. A roundabout way but it worked.

[Aeterna, BSN, RN]

Maybe he really is having pain or is anticipating pain with the shower. Is there a way to better control that? What is causing the pain?

Or, talk to his family if possible. See if he ever showered at home and if he had any sort of rituals or anything that made a shower worth having. Perhaps he just doesn't like showers or prefers them done a certain way or a certain time.

Then, there are some people that you just can't shower, no matter what. When I worked as a PSW at a nursing home, we had a resident who was a Holocaust survivor on top of having dementia. She kept thinking we were trying to kill her and became defensive even with a sponge bath. Can you imagine what her reaction would be if we told he we were taking her for a shower? So we never showered her; we just did our best to sponge bathe her well.

[jadelpn, LPN, EMT-B]

Patients at the begining stages of Alzehiemers also have a fear of water. Other elderly gentlemen don't want a "strange woman" bathing them, no matter what. Some patients feel as if showering equals freezing cold for hours after a shower. Still others think they are going to fall. I would employ the help of family--grown son? Wife? Show the patient the shower chair that goes right into the shower. Maybe team up with them. Put at towel on the patient's lap for privacy. Have warm blankets available for after. If he still outright refuses, then a good scrub down with lots of warm water and that is all you can do.

[Been there,done that, ASN, RN]

What are his diagnoses? Is he refusing to bathe himself , but will allow a sponge bath?

Some pieces of the puzzle missing are missing.

[sharpeimom]

Would he allow himself to be wiped and cleaned with those disposable shower/bath wipes? You can just stick the package into the microwave for about two minutes, and they're nice and warm, but not hot. The same company makes shampoo caps

that you heat for 15 seconds and they get warm and sudsy. You don't have to rinse after either the shampoo cap or the bath wipes.

I keep a few of the caps on hand because I have limp, fine, straight, very oily hair and sometimes if we decide to do something on the spur of the moment, it's quicker that a second shower just to wash my hair.

The brand of shampoo cap is No Rinse Shampoo Cap and the other one is No Rinse Bath and Body Wipes. Prices vary widely.

I buy the caps online and if you'd like the store and/or 800 number, just PM me.

[xoemmylouox, ASN, RN]

Does he have anything PRN he can take prior to bathing.. It may only take a time or two before he realizes that it isn't so bad. Personally I would see the loss of independence as being a huge hurdle. Some don't think that our patients took care of themselves most of of their lives.. In privacy. In comfort. Now they must be nude in front of strangers. They are in unfamiliar places, and shower rooms look nothing like a regular bathroom. I would ask the family if they know of anything that may comfort your patient. Otherwise.. Bed baths it is.

[SaoirseRN]

Do a very, very wet sponge bath. Lots of soapy water. Have him sit in the bathroom or on a commode with incontinence pads on the floor and soak him! Not quite a shower but a little bit better than a typical sponge.

[amygarside]

I agree with SaoirseRN. Getting the patient to have a very wet sponge bath is the best alternative to making him shower. Perhaps it is also a good idea to inform his family about the dilemma. They might have some information that could help you solve the dilemma. Good luck!