Your Eldercare Compass
Helpful tips for family caregivers

Bathing and dementia

Bathing brings many discomforts.

Bathrooms can feel cold and drafty when a person is wet. And running water can be noisy.

Nudity makes bathing very intimate, which can be distressing when a modest person needs help and may not recognize the helper.

Plus, bathing is a complicated process with many steps in a specific order. People with dementia may become confused and frustrated. They also may forget about the purpose of cleanliness.

Here are some tips to ease bath time:

• Guard the senses. Sometimes people with dementia are hypersensitive. Heat the bathroom ahead of time. Be gentle and avoid scrubbing. Check the water for temperature—too hot?—and the water pressure from the shower—too hard?
• Promote independence. Encourage your loved one to do things themselves. If you do need to take over, tell them what you are going to do before you do it. And give them a role so they can participate, such as holding the soap.
• Preserve modesty. Even if you are helping a spouse, have a towel at the ready for undressing and dressing.
• Maintain a routine. Most families notice that certain times of day are better than others. Bathing at the same time each day may make it easier.

Sponge baths work just as well. In terms of hygiene, all that’s needed is a twice a week wash, and even that can be just the highlights: armpits, folds of skin (under the breast, on the belly), groin, genitals, feet. Remember to keep the rest of the body covered with warm towels to minimize any chill.

Get creative

• Try singing together. Or play music or old radio shows for distraction.
• Consider using bath wipes. Warm by putting an open package in the microwave for 10 seconds.
• Call it “spa time.” Use no-rinse soap on moist, warm midsize towels and massage in gently. Wipe off with warm, moist washcloths.

Can Mom live safely on her own?

Has your family member said, “I want to stay home no matter what”? That’s a common wish. No doubt, you’d love to oblige. But if home care tasks are starting to pose problems, you may be wondering what’s realistic. The Independent Living Assessment makes it easy to get an unbiased appraisal of your loved one’s need for assistance.

The survey was developed by Boston University’s School of Public Health. It takes only about 10 minutes to complete. It assesses an older adult’s ability to accomplish typical activities by:

• Asking about an individual’s difficulty with walking, lifting, and bending; daily personal tasks such as bathing, dressing, eating; and life tasks such as socializing and managing money
• Identifying problem areas
• Suggesting the level of assistance needed
• Delivering a downloadable report (a pdf) personalized to your loved one’s situation

To keep abreast of changes in your loved one’s abilities, use the free online tool as often as once a month. You won’t be answering the same questions each time. The assessment questions change in response to changes in your loved one’s abilities.

If memory loss is a concern, check out the Alzheimer’s Association’s CareFinder interactive tool. On the basis of your input, it will suggest the key questions to ask service providers to ensure your loved one’s needs are met.

If it looks like help is needed, you can use these tools as an objective starting point for a family meeting.

Reducing salt in Dad's diet

Has your family member been advised to reduce the salt in his or her diet? Do you have doubts about your loved one’s ability to follow through? Food, after all, is one of life’s pleasures. And salt (sodium) is a key flavor enhancer. The simplest solution is to remove the main sources of salt, add new flavors in its place, and eliminate commercially prepared foods.

Remove the main sources of salt. (These two steps reduce salt intake by 30%!)

• Take the saltshaker off the table.
• Remove the salt supply from the kitchen.

Add flavor with herbs and spices. Experiment.

• At the table: nonsalt dried herb blends, lemon juice, balsamic vinegar, freshly ground pepper, toasted sesame oil.
• In cooking: fresh or dried savory herbs (basil, thyme, sage), exotic spices (curry, ginger, chipotle pepper), citrus juice, and grated citrus rind.
• Do not provide a commercial “salt substitute” without the doctor’s permission.

Eliminate commercially prepared foods. An entire day’s “salt budget” can be blown in a single serving of prepared dinners, luncheon meats, quick breads/cereals, and common condiments and marinades. But you don’t have to spend hours in the kitchen, cooking from scratch. Consider instead:

• Cooking in bulk. Roast a whole chicken, pork roast, or meatloaf. Leave the leftovers for sandwiches. Save the bones and bits for a savory soup base.
• Cooking slowly. A slow cooker allows flavors to develop in stews and casseroles. Put the ingredients together when it’s convenient for you. Use fresh, frozen, or low-sodium foods.
• Creating toppings. Sautéed mushrooms, browned onions, homemade pesto or chutney. Freeze in small portions that are easy to grab and warm at mealtime.
• Making mixes. Make your own mixes for pancakes, cornbread, and muffins with low-sodium baking powder.