I have taken a more active role in Grandpa’s bathing routine. Before Alzheimer’s’s began debilitating him, he had his own grooming schedule. After Alzheimer’s’s started debilitating him, he had an erratic and faltering grooming schedule. Basically, he took a shower whenever he thought he needed one, and shaved when he felt he really ought. It has now progressed to the point where it not only can Grandpa not draw his own bathing water but his sense of time (and perhaps his inclination) has become such that he could go weeks without bathing. Of course if it struck him he could bath two days in a row and then go three weeks without a bath, but the fact remains that he wasn’t cognizant of his own needs. On top of that Grandma was no longer convinced that when he cleaned himself he was actually cleaning himself enough.
So I stepped in to take active control of Grandpa’s bathing schedule. This was a point I had concern about at crises of conflict, as Grandpa was modest and preferred to handle his own bathing. But as it turned out it hasn’t been an issue. The modesty was before, and Grandpa’s incapacity has progressed to the point that now he has pretty much (but not entirely) dropped it. It helps that I haven’t just barged in and taken over everything. I am taking it slow, only helping him with some things, getting him accustomed to the presence of help, and the consistent schedule set by someone other than himself.
The schedule is a bath or shower once a week on the weekend. Usually it is Saturday, but sometimes I make an exception (and do it on Sunday). I try to get it done before lunch, because that is when Grandpa has the most energy, and is mentally most together. I allow him the option of a shower or bath but he has gravitated toward showers because he finds them easier. They are easier for him–there is no sitting down–but it is harder for me to avoid getting soaked while helping him.
When he takes a bath I wash his back and his hair and will prompt him on washing himself. If he showers I wash his hair, and direct the shower head to make sure he gets thoroughly wet, and prompt him as needed. When you have to help someone else you start looking at things in a new way. This house was badly designed for elderly people, and those in need of assistance. The bathrooms especially so. There is only one teeny bathroom with a tub right off the main hall. The bathroom is far too small to get a wheelchair in the room, and the hall is so narrow that when Grandpa is riding in the wheelchair and I park outside the door I can only just squeeze past to get from behind to in front where I can help him get out. Then the bathroom doorway is narrow so often Grandpa or I smash into some part of the frame when the two of us are trying to go through at the same time. Then the tub has the sliding stall doors which means only one side of the tub can be accessed from the outside at one time–a real problem if you’re trying to help someone. Further, the tub is right up against the toilet and the toilet makes outside access to the end of the tub with all the faucets awkward from the outside. After struggling with this setup multiple times you begin to think a real genius must have designed the setup. The reality is that it was designed by someone who wasn’t thinking about caring for elderly or incapacitated people.
I have come to realize that the days in which Grandpa can use the bathroom are numbered. When he really needs to use the wheelchair and it is no longer a convenience and helpful item, then stopping outside the bathroom and hauling him the rest of the way by hand to the toilet will be too much. At that time, or maybe even sooner, Grandpa will no longer be brought to the toilet–the toilet will be brought to him in the form of a commode. And, when Grandpa moves from needing some help with his bathing to needing a lot of help–then we won’t be able to use the tub either. Already it is a little bit dicey watching him step into and out of the tub. For someone with deteriorating strength and balance stepping over the side of something is an uncertain procedure. Further, trying to do all the work of bathing someone else when half of the tub is blocked by a sliding partition is madness. With additional reflection I realize that when Grandpa becomes more incapacitated hauling him in and out of the tub will be a lot of work for me, and increasingly painful and dangerous for him. So when Grandpa needs more than some help we’re moving from baths and showers to sponge baths. Of course I realized it would come to that when he became bed-ridden, but now I see the sponge bathing may begin a lot earlier than that.
Grandpa is very sensitive to water temperature. I guess we all are, but he prefers his water significantly cooler than I would. Sometimes it seems to me the water is lukewarm edging on cool when he declares that it is finally not too hot. I always have him check the water before he gets in, and water checking is a procedure I must watch with care. He has a hard time locating the water he is supposed to check. Often he will feel the sink over, and give some declaration about how cold it is, and he has a tendency to want to lift the lid of the toilet and plunge his hand in the bowl. One time recently when I asked him to check the water to make sure it was okay he solemnly lifted his foot and placed it against the side of the sliding door and held it there for awhile before announcing that he thought it felt okay.
Once I have him in the tub there is the problem–as we’re all familiar with–that the water doesn’t always stay the same temperature. For most of us this problem provokes little more than a muttered comment and a quick adjustment of the temperature. Since Grandpa no longer knows how to adjust the water he is terrified of it getting too cold or too hot. It’s not uncommon to hear during bath time “Aaaahhhhh! It’s getting too hot! It’s getting too hot!” Or, “Aaauugghh! It’s freezing! It’s freezing!” Usually the temperature hasn’t changed to the extreme that his comment would seem to imply–but he’s sure it will keep getting hotter until he is fried to a crisp, or keep getting colder until he is frozen to death.
After he is finished in the tub I make sure he gets out safely and give him a towel to dry off. After he has done as good a job as he can manage I finish drying him off. Then I slather him down with baby lotion, because he has a terrible problem with dry skin. I also soak his scalp with baby oil, because he has dry scalp as well. When I’m done he’s all greased up and smells like a baby. My hands do too. I recently realized that I need to switch him over to baby shampoo and baby body wash as well. The shampoo because he’s having more difficulty keeping it out of his eyes, and the body wash because normal soap is too harsh for someone with very dry skin.
When that is all done I get him dressed, come is hair, and then get him a cup of coffee and something to eat. When I first started the bathing schedule he complained a lot about taking the bath/shower because he was always sure the last time we had done it was yesterday. Now that the habit has become more ingrained–and I’ve persistently insisted that we’re only doing it every weekend, not every day–he complies more readily. I think it is a lot of work for him–mentally and physically–but I do think he feels better after we’re done.
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