making bathing experiences better

[ham272]

what do you do to make the bathing experience for residents better. We have quite a few who scream and cry through the whole thing. We also have a gentleman who is very modest and we often have to bath in his underwear. Any suggestions?

[yousoldtheworld]

Honestly, I haven't found a foolproof way to calm down patients who are anxious about bathing.

One thing that can help is to keep them covered as much as possible. Bath blankets are gold. Do the bathing as quickly as possible (though still thoroughly). Make sure the room is adequately warm, and the water is a good temperature.

For dementia residents, it sometimes helps to sing to them, it can distract them.

[PianoGirl20]

I'll just preface this comment by saying my ideas are also FAR from foolproof, but here goes...

1.) I totally agree with what the previous poster said about doing things quickly but thoroughly. That alone can make a big difference, especially with agitated/confused dementia pts. I really try to turn the water on a few minutes early so it's the right temperature, have washcloths/towels/attends ready, and fresh clothing nearby.

2.) This tip primarily works for people (especially women) who aren't (or at least aren't very) confused, but sometimes I find that using from actual shower gel just helps make the whole experience more pleasant. I actually brought in some clearance ($2-3/bottle) Bath and Body shower gel to the nursing home that I worked at this summer and all of the women who got some, as opposed to the depressingly mediocre "soap/shampoo" the nursing home provided, expressed enjoyment and seemed much happier. Some women also respond well to the promise of a little "hairdressing" (blow dry, comb and hairspray afterward).

3.) If pts. are confused and thus "in a hurry" to get done with the bath, sometimes it helps to just give simple, calm explanations. Things like "Mr. Smith, I'm washing your back now" or "I'm drying off your feet" sometimes seem to help.

4.) Try to figure out a resident/pt.'s best time to have a bath. At the facility where I'm PRN, one man will predictably refuse a bath offered before dinner but will nearly always agree to have one right before bed.

5.) If someone is REALLY agitated/confused, try to find out if they have a PRN med like Ativan that could be given by the nurse prior to the bath. Usually, if the nurse is aware of the situation and the pt.'s history they will be open to the possibility.

[mochabean]

I work at a hospital, but I have one patient who really like it when I put a hot wash rag over her eyes.

[callmekipling]

Don't spray them in the face :-P

Seriously, tilt the head back so water stays off the breathing parts. When you have to do the face, do it quickly.

Custom products are great. Look into cheap hair stuff too - depending on how often they get bathed, a little gel (or some brylcreem! haha!) can make the difference between LTC hair and the runway look :)

If your pt is ambulatory and confused, consider leaving the shower head where it is and gently moving the pt around in it (yes, this is tough to do without getting wet!)

Still others I knew (working lockdown'd alzheimer's unit) simply could not be brought to go in the shower willingly. At which point you grit your teeth and accept the fact that if they had their own best interests in mind they wouldn't be hanging out with you in LTC. Ugly, but true, and if they're really that confused I've found they'll forget about it soon enough. But don't use that as an excuse to skimp on diplomacy.

[redhead04073]

Sometimes talking with the resident helps, asking them how many children they had and where they've lived.

[One Flew Over]

For some of the demented residents, they might be afraid of being naked. Try to keep the johnny on and wash/rinse them under it. I used to have one that clung to the johnny and screamed, and I found her much more compliant if I just let her keep it on. At least then that takes away some of their fear of being exposed. Then after the shower just say something like, 'Oh the gown got all wet, wouldn't you rather wear these warm clothes instead?'

It's not perfect, but it worked well :)

Oh, and save hairwashing for last! A lot of dementia patients don't understand the purpose of it, and get very upset. If you do it right off the bat, you may be in for a rough ride.

Besides, with anyone I think wetting their head makes them feel colder faster. So it should be saved for the very end :)

[Atheos]

For some of the demented residents, they might be afraid of being naked. Try to keep the johnny on and wash/rinse them under it. I used to have one that clung to the johnny and screamed, and I found her much more compliant if I just let her keep it on.

If I may interject... What is a johnny?

Hospital Gown???

[One Flew Over]

If I may interject... What is a johnny?

Hospital Gown???

Yup sorry, I guess that's more of a New England term