In this post, we will discuss the problems you might be facing as a caregiver to an Alzheimer’s patient. You might be wondering why Alzheimer’s patient refuses to bathe?
Getting an Alzheimer’s disease patient to perform basic activities of daily living can be a strenuous job, especially when they are in their later stages of the disease(or aged over 60).
They do want to bathe, brush their teeth, say their prayers, etc but it’s just that they have fallen out of the habit of doing it, and can’t remember why and when they must be done.
Bathing is simply not an activity deemed necessary by people suffering from Alzheimer’s disease. An AD patient develops a lot of fears associated with stepping into the bathtub and exposing him/her bare skin to cold water. There is no one answer to this problem, it depends on what that person is bothered by (from a context of bathing) or whether they have a problem with remembering these basic activities which they have been doing religiously their entire life.
Just because a person has declining memory does not mean they have lost their dignity; undressing in front of a caregiver can be embarrassing and is something they will want to avoid at all costs. For healthy people bathing is leisurely and unwinding. It becomes laborious and painful for AD patients as they don’t remember what the bathing process looks like. Hence, they tend to avoid it unintentionally. 
Let’s have a look at some of the factors why an Alzheimer’s patient refuses to bathe.
1) Safety precaution
An AD patient can anticipate all sorts of accidents and mishaps happening inside this tiny slippery room called the bathroom.
The moment they step inside, they see slippery tiles, protruding taps and nobs, a tub full of water, etc, and their attention shifts from cleanliness to their own safety.
Also if they are co-dependent on their caretaker, they would feel unsafe being isolated in a room, sitting in a tub full of water.
What if they forget to get out within a few minutes and fall asleep in the tub?
If a caregiver is unable to make the AD patient follow a daily schedule, they might become very disorganized and forgetful(Internal link: How does Alzheimer’s disease affect intelligence?).
There are people who were very particular about cleanliness and hygiene before their decline, a germophobe in the past can completely forget about his phobia and will need external help to maintain cleanliness.
The best way to deal with their forgetfulness is to follow a daily schedule no matter what. It’s the caregiver’s responsibility to remind the patient in the kindest way possible. The external force can make them defensive and look at the caregiver’s intentions as an invasion of their personal space.
3) Feeling ashamed of being naked
As adults, most of us have never been in a situation where we had to depend on a family member for changing our clothes or bathing us without clothes on.
It makes an AD patient—who was once upon a time the top-earner/provider of the family— appear weak and helpless and they don’t like it.
Always keep their private parts covered with a towel and without directly looking at them, give word to word instructions on how to take off and put on their undergarments by themselves.
4) People with AD don’t like too cold/hot water
Extreme cold/hot water is seen as frightening by AD patients, as they are not capable of calibrating water temperature—they don’t know that they are supposed to check the water temperature before entering a bathtub or turning the shower knob on.
If the caregiver is not aware of this fact, it can remain an unsolved problem for the patient and they may develop a dislike towards bathing/cleaning with water touching their body.
5) Disruption of daily routine
Most people go through their day following a schedule—they keep mental notes of certain rules and regulations to be followed by them—which keeps them alert and aware throughout the day and helps them to get things done even when they are tired.
A decline in a person’s cognition breaks this flow and they find themselves lost and isolated from events of the world around them.
Unable to remember the most important daily activities, their decision-making muscle gets weak and they avoid doing anything that is uncomfortable.
For Alzheimer’s patients, bathing is not just about cleanliness and hygiene, it’s about personal safety, dignity, comfort, and discipline to follow their daily routine.
Nobody likes to be a burden to others. The people who least deserve to be treated as an outcast are your family members.
Give them personal attention and love even if they don’t utterly deserve it.
You may also be interested in reading this article on non-medical interventions to comfort Alzheimer’s patients.