Overcoming Challenges Faced by Elderly People with Dementia in Home Environments

Sally Madeley-Carr, OT
01 Jan 2021

---

As the average age of the UK population steadily increases, there is a corresponding growth in the number of conditions which are associated with old age.

Dementia for example, impacts one in 14 people over 65 years of age, and one in six over 80.

Alzeimer's disease is the most common form of dementia, with around 850,000 people in the UK living with the disease.

Because of the growing numbers of OAPs in the population, that number is currently projected to reach 1.6 million in the next 20 years.

Confusion associated with memory loss is the key symptom of dementia, making it difficult to conduct a host of daily tasks.

These include reading and writing, number recognition and many others.

Thinking logically and organising oneself may become very challenging, as will tasks requiring a fair amount of attention.

Bathing and hygiene

Some people with dementia may become quite fearful and resistive to certain daily routines.

Maintaining hygiene and cleanliness is one such area which may present challenges.

If the individual suffering with dementia has a carer and is resistive to bathing or showering, it could be for a number of reasons.

It may be something as fundamental as a fear of water, or simply a loss of the ability to communicate decisions and the frustration that this leads to.

Feelings of embarrassment may also cause distress in the bathroom, or the general feeling of loss of control.

The person may not have a clear understanding as to why a carer may be present, which again may lead to distress.

Carers

Carers for people with dementia have a list of special considerations. When it comes to bathing or showering, here are some tips to consider:

Be well prepared and have sponges and soap all ready, plus drying bits and pieces like towels and a robe. Large cape-like towels are useful, as they cover the body and provide quick warmth.

Make sure the bathroom itself is at a comfortable temperature. Remember the individual may not be able to communicate any physical discomfort in a logical way.

Create a routine and try to stick to it. If the individual carer is the same person every day, that is useful for both parties.

If possible, give the person the choice of a shower or bath. Some may prefer one over the other. It's important to discuss this with the individual's family to establish and attempt to recreate their previous routine.

The more you can find out about the person's standard practices, the better. They may, for instance, have a long history of having a bath before bed, so if you can stick to this in a care environment, it may prove helpful.

Ideally, the carer should be of the same sex as the invididual. This reduces embarrassment and makes the experience less stressful.

Where ever possible, encourage the individual to wash themselves as much as they can. Even small independent actions are positive, so always bear this in mind.

Be sensitive to the individual's potential to experience pain. Dementia is often accompanied with other physical conditions which the person may have difficulty expressing.

Create a friendly and pleasant atmosphere. Sometimes you might be able to play music you know the individual likes, or set the lighting so that it isn't intensely bright or too clinical.

Humor may be a good way to relax the person if you feel they are tense or stressed in the bathroom.

There are certain products which might help reduce the stress of daily showers or baths. Items like 'no-rinse shampoo' don't require running water, so may be worth considering.

Remember too that not everyone requires a bath or shower on a daily basis. Thorough sponge bathing to certain areas of the body can be a good option.

Safety in the bathroom

With many dementia sufferers also living with other conditions which may impair balance, comfort and safety is a priority in the bathroom.

Providing them with the ability to sit down is one step which may assist them if they are unstable on their feet.

It's a good idea to provide things like stools and seats at different locations around the bathroom. Using seating in the bathroom makes it more comfortable when the individual is drying off.

Perching stools, for instance, are useful pieces of equipment. Positioning one at the seat gives the individual the chance to semi-sit at the sink.

They can perch themselves on the front edge of the seat, taking most of their weight off from their feet while still leaving their hands free.

You can also use seating in the shower cubicle itself. If the person requires their carer to reach their hair for them, this can make it easier.

It's also great to use shower seats if the person concerned is unstable on their feet.

For those in this situation, grab rails are another piece of equipment which may make a big difference to safety in the bathroom.

Bathroom support rails

Rails are bathroom safety products for elderly people or others which balance issues. They provide a point of support in areas of the room where you might lose your balance, even if the individual is being assisted by a carer.

Rails can be positioned on suitable walls if the individual needs to travel any distance within the bathroom, or they can be installed next to baths, toilets or sinks.

Having a combination of rails fitted in strategic points around the bathroom usually makes sense.

It is important to consider exactly where the best locations of rails would be, before having them installed by a qualified tradesman.

In terms of bathing, rails may be fitted on the wall next to the bath, or even to the bath-side itself.

Bathtub side rails can be particularly useful as they provide a point of support midway along the bath's length.

This positioning tends to be handy as one lowers oneself into the water and out again afterwards.

This type of rail usually has an upside down U-shaped design, creating a curved top rail which is easy to grip, especially when supported by a carer.

These are general bathroom safety products for elderly people as well as those suffering with dementia.

In wet rooms or in large shower cubicles, it may be possible for the individual to use wheelchairs or shower chairs as they are washed.

If this is the case, a waist-height portable shower screen may be used, protecting the carer from getting too wet.

Portable shower screens are usually in two or three folding sections, and can be positioned flexibly to suit the space available.

Essential Aids supplies free-standing versions which can be easily folded up and stored between uses.

Shower seat, chairs and stools

Essential Aids also supplies a wide range of shower chairs, many with wheels.

These work effectively as bathroom wheelchairs, allowing the individual to be easily rolled in position within the shower.

These wheeled chairs require shower trays designed for the purpose without raised edges, so the rolling surface is unobstructed.

The component parts of this type of equipment must be non-corrosive, so the bathroom wheeled shower chairs Essential Aids supplies are largely manufactured using aluminium and various plastics.

The same goes for conventional shower stools and chairs. Aluminium is both non-rusting and lightweight, meaning stools made from it are easy to lift in and out of showers.

A wall mounted shower seat is another option. These typically fold-flat against the wall when not in use, making them a great choice if the shower is shared by other people.

These products are great space savers, but it's important to ensure they are fitted by a qualified tradesman.

For those which require extra weight bearing, choose a wall mounted shower seat with legs. These are much stronger and are better for heavier individuals.

Like standard models, they still flip away against the wall and two legs drop down beneath to make contact with the floor when in use.

Fitting support rails in combination with shower seating like this makes a lot of sense.

Non-slip matting is another category of bathroom safety products for seniors. Conventional mats for the bath or shower cubicle reduce the chance of slipping on hard, wet surfaces.

They usually adhere using suction cups or with high friction rubber-like surfaces.

If you want to cover larger areas of the bathroom with purpose built non-slip matting, it might be worth considering the StayPut Anti-Slip Wet Room Matting, available at Essential Aids.

This product is available in rolls which can be cut the exact dimensions required. It is great for those unsteady on their feet, who might be prone to losing their footing in wet environments.

Made using a special PVC foam, it is soft and durable while still free draining. It also has special properties, making it both antibacterial and antimicrobial.

Being soft to the touch, the Stayput matting also provides a little more warmth underfoot, which may also be an improvement to hard tiling.