Bathing and Toileting Elderly With Dignity

How do you get your elderly relative or client to allow you to assist them in the bathroom? This can be tricky. Here are a few tips:

• Approach it as naturally as you approach making them a meal. Your relaxed and matter-of-fact approach will make it part of the routine.
• Assume they will accept your help. I swear this works wonders. If you assume they will fight you; they will. If you assume they will let you help them, they somehow sense this is the right thing to do.
• Look into their eyes while assisting them. Make every effort not to openly stare toward private areas. This takes a little practice!

• When assisting into and out of the shower, use a towel around them both to keep your cold hands off delicate skin, and to help protect some dignity.
• Only have uncovered what has to be uncovered at any given moment. I always place a towel over my clients' front side while working on the back. Often they clutch this to their chest - which indicates it is a valuable and thoughtful action. (I put the towels into the dryer during the shower whenever possible. There is nothing like being wrapped in three hot towels after a shower!)
• Keep conversation to a minimum while bathing them. Nervous chatter makes them think you are uncomfortable, which is a cue for THEM to be uncomfortable. State what you are about to do. "I'm going to wash your hair now. Put this over your eyes." But don't fuss and chatter and sing. Oh gosh - please don't sing. Ha ha - story about that later. Singing is great for the bedside; not as nice in the shower.
• State what you are about to do, clearly. "I am going to check to make sure all is well down below" I cheerfully say as I double-check the hygiene after a bowel movement. This is always met with quiet acceptance. If the person has Dementia, and they don't "get" that vague statement, you will be more direct. "I am going to see if you got completely clean while wiping. Your skin must not have anything on it that might make you sick." Pop on that glove, grab a wipe, and do your job quickly.
• Smile. I'm serious. I have watched a wary Dementia or Alzheimer's client relax into my care when I lean in and smile right in their face - sincerely. "I'm the potty police!" works very well.
• If there is an accident - treat it very lightly. Be upbeat and positive. This can cause great distress, and if you show a hit of disgust or frustration, you will hurt their heart. If it's appropriate, adopt the crude but funny quote I always use with Martha. "$@#& happens!"
• Think of these toileting duties as part of the overall care. You do the laundry, make the dinner, wipe the bottom. It's all valuable service.
• Watch your internal conversation. Speak words of affirmation as you perform what may be highly unpleasant duties. Your internal conversation is reflected in your external demeanor. I often think to myself; "This man served his country - I can serve him by having the honor of helping him in this personal function." Trigger words like "honor, privilege, joy, deserving, gentle..." cause your hands to provide nourishment for their soul.