How can you get a nursing home patient to shower?

What we've found works well with my mother with dementia, is to get her in the shower with some of the clothes still on, then remove the clothes after the shower starts. We seat her in a shower seat.

I'm sure you've tried all the tricks and coersion to get her to take a shower.
The aides in the nursing home don't have time for all that. What you can do is hire a private-paid bath/shower aide or go yourself.
What I find that works with a bath/shower resistant elder is that nothing else is happening until the bath or shower is finished.
This means no tv, no meal or snacks, no games or entertainments, no going out, no socializing, nothing.
Either the shower or bath gets done or nothing else does. You have to wear them down sometimes. I find in my experience when nothing else is allowed until the bath/shower happens it won't take as long as you think. In the case of your mother, it may have to come down to she isn't allowed to leave her room until she showers/bathes.

Some aids Iknow have gotten better results by announcing that it is time for your shower, or I am here to assist you to shower. Also know that 1-2 times a week is adequate, so is sponge bathing. I've notice that some people develop an aversion to the shower. As far as UTI care, good peri care with each brief change, reminders to void on a schedule, or to do a front to back cleansing is helpful.

I have the same problem with my husband with Dementia, but he's still at home with me. I finally gave up and decided it wasn't worth the battle. We now have been blessed with his VA benefits that provide for a trained person to come into our home once a week to shower him and I get 2 hours to do whatever I want.
Guess I would suggest a weekly shower with a notification the night before and the morning of, to remind your mother what's happening the next day.

This forum is great and this topic is so timely for me. Mom is in memory care and has a long history of UTI Infections prior to moving to this ALF and while there. Due to this she is suppose to be showered 3x a week. Hospice sends a CNA for this and I happened to be visiting one day when she arrived. She politely asked mom several times to take a bath and mom refused. I interjected that she must have a shower to stay clean in order to avoid the UTIs. After observing and assisting the CNA with that showering process I have so much respect for what both the CNA and the patient go through. Will try out playing her favorite music, softer lighting, making it more of a treat than a rushed process. Thank you all for your input.

solace: The staff at the facility should be fully adept and quite capable of handling the task of bathing the frightened elder with dementia. I used the word 'frightened' because many elders are scared of the water, temperature, of falling and other things. The trained staff should already be aware of this. In answer to your question, "How can you get a nursing home patient to shower?" - YOU do not, THEY do.

The facility should have skilled caregivers adept at this. Speak with the administration. It is not unusual for this to occur. With some dementia the depth of vision changes as well as body sensitivity to touch such as water....it can actually hurt.... and, hence the anxiety about bathing increases...
Perhaps a compromise could be reached 2 showers / baths a week and then sponge/ bed baths. Or even one shower a week and maybe two bed baths.
Check with her PCP for recommendations.

I researched and found some tips. Gena / Touch Matters

* Realize that staff has limited time. You might want to hire someone who is patient and has more time to manage the process. Your mom may relate differently to a professional than she does with you - from her point of view, which might help her respond more positively.

What do you do when someone with dementia refuses to shower?

Try a sponge bath at least twice a week, if they refuse a bath or shower. You can wash them with a wet sponge or cloth, but without them getting into a bath or under a running shower.
_________________________

* 2x / week is enough: As people get older, they have less energy to get things done each day. Usually, personal hygiene (specifically bathing) is one of those things that gets neglected. So how often should an elderly bathe? To avoid any skin conditions or infections, a senior should bathe at least once or twice a week.
_______________________

IMPORTANT: Fear of drowning; depth Perception off / scary. She may not be able to verbalize these fears / concerns.

What are the potential risks of showering someone with dementia?

Feeling out of control and powerless may add to a person's lack of cooperation with bathing. The person with dementia may fear drowning, particularly if water is being passed over their head. Prepare the bath ahead of time. Check the water level.
_____________________________

Why do dementia patients dislike showering?

Use non-rinse soap products to make the process easier. Fear of bathing may be related to a number of factors such as fear of falling, fear of the water, fear of being cold, loss of dignity in being naked in front of you, or feeling vulnerable in the coldness of a bathroom.
_______________________________

Bathing can be a challenge because people living with Alzheimer's may be uncomfortable receiving assistance with such an intimate activity. They may also have depth perception problems that make it scary to step into water. They may not perceive a need to bathe or may find it a cold, uncomfortable experience.

What to do if a dementia patient refuses to shower?

Establish a daily routine. ... 
Use positive reinforcement and don't argue. ... 
Say “we” not “you” ... 
Make the bathroom warm and comfortable. ... 
Reduce effort and help them feel safe and relaxed. ... 
Use a hand-held shower head to reduce fear. ... 
Use extra towels for comfort and warmth.
_____________________
Before Bathing

Before starting a bath or shower:

Get the soap, washcloth, towels, and shampoo ready.
Make sure the bathroom is warm and well lighted.
Play soft music if it helps to relax the person.
Be matter-of-fact about bathing. Say, “It’s time for a bath now.” Don’t argue about the need for a bath or shower.
Be gentle and respectful. Tell the person what you are going to do, step by step.
Make sure the water temperature is comfortable.
Don’t use bath oil. It can make the tub slippery and may cause urinary tract infections.
_________________________________
During a Bath or Shower

Allow the person with Alzheimer’s to do as much as possible. This protects his or her dignity and helps the person feel more in control. Here are other tips:
Put a towel over the person’s shoulders or lap. This helps him or her feel less exposed. Then use a sponge or washcloth to clean under the towel.
Distract the person by talking about something else if he or she becomes upset.
Give the person a washcloth to hold. This makes it less likely that he or she will try to hit you.
_______________________________
After Bathing

Prevent rashes or infections by patting the person’s skin with a towel. Make sure the person is completely dry. Be sure to dry between folds of skin.
If the person is incontinent, use a protective ointment, such as petroleum jelly, around the rectum, vagina, or penis.
If the person has trouble getting in and out of the

Nursing home should be able to manage without your help. If twice a week is what they get from her, they should be able to do all the other nights with warmed adult body wipes. Emphasis on WARMED wipes. It's possible she's sitting on shower chair and the older folks get quite chilled taking a shower like that.

When my brother was in hospice care in a nursing home, he became too weak to stand for a shower. A hospice aide would come two times a week and bathe him with disposable bath cloths which both clean and moisturize the skin. You can find those on Amazon. They shaved him and I think they used a dry shampoo. He was always clean. Unless she’s doing an activity that builds up sweat I’d aim for two times a week to bathe her instead of three times.

Check out Teepa Snow. She’s a dementia person whisperer, and has many videos on communicating with these folks. There may be one on the clothing issue.

Mum went through a phase where she tried to refuse a shower and would get quite snappy. It was at a point where I’d feel the need to air out the car if we were going somewhere.

She is currently in hospital and has showered there 3 times already (twice with me assisting) and she’s only been in 4 days. Technically one wasn’t necessary as she’d had a shower before bed and the morning staff gave her a shower again not knowing.

I get her into a positive mood beforehand. There is absolutely no point arguing.

At home I basically put on an entertainer front, I put her favourite music on and basically made it a fun experience. Yeah she still would at times say a few nasty words as the water first sprayed her but then she’d calm down. To wash her hair I’d usually have to make it a “spa” type thing where I then also blow dried her hair after. After shower I’d use positive re-enforcement of how good she looks/must feel. Oh and I’d serve her something yummy afterwards.

For the last few months she has suggested a shower out of her own merit as she knows it helps soothe with the incontinence (she has sensitive skin that quickly irritates with the urine) and she basically repeats my re-enforcements. She’s also learnt to associate her favourite songs with the shower.

tonight I gave her a wash at the hospital with one of the nurses, again I put her favourite music on first, she was humming along and then I took her hand and we went into the shower and got to it quickly. I was so proud of her. They are only quick showers and then she gets lathered in moisturiser :) Mum prefers before bed time showers but if washing hair, we do earlier. However, I don’t worry too much about the hair as it’s not necessary that often.

It's not strictly necessary for a person to shower or take a tub bath. Ideally they should, but it's not always possible. A daily bed bath can be just as effective.
I've worked for care clients who were bedbound or whose homes were not equipped for them to be able to use the shower or take a bath. So we did daily bed baths. Maybe your mother would be more responsive to getting 'washed-up' in the bathroom instead of showering.

Fighting is not the answer. Not everyone likes a shower. I am sure you have tried a bath. It was a physical struggle for me and my wife until she got so bad she could not walk or stand. Now we do the wipe thing. You can buy these shower/bath things in a bag. You warm them up and wipe her down.

I think that forcing someone to shower is unnecessary. Yes, a nice warm shower or bath is ideal but there are other ways to stay clean. My husband had ALS which totally paralyzed him and we did not have a bathroom large enough to accommodate a shower chair or a walk in shower to put it in. So you improvise. I would first make sure the bathroom was nice and warm, he would sit on his commode chair, I would soap up a wash cloth with warm water and wash down his body. Then use a separate wet wash cloth to get the soap off. When it was impossible for him to sit up for that long I would use the pre-moistened cloths and just hit the important areas.

I had read somewhere that to a dementia patient a shower feels like glass hitting them. After reading that, I tried giving my husband baths while he was at home. It was a battle. He's now in SNH and he gets sponge baths at least twice a week. He's not a fan of those either. It's a real struggle to get him into the bathroom for any reason. One of his aides calls it "the kryptonite room".

I was a son taking of his mom. No showers.

Every morning, I gave her a warm soapy wash cloth so she could wash her face and arms. Every other day, I helped her change her bra, and washed her back, neck and assisted in washing her breasts. She was incontinent, so at least three times a day, I cleaned her rear end, put Calmoseptine cream on to prevent pressure ulcers, and made sure she had new pull ups. Once a week I soaked her feet and powdered them, cleaned her legs, and put lotion on. Clean pads and sheets on her bed daily. Once a month we went to her hairdresser for some special pampering. Our routine worked and she was clean. She died in January 2022 at age 93.

Drop the shower mandate and discuss with staff a different approach to keeping her clean. If you can, make unannounced visits to monitor the situation. Believe me, staff will pay attention if they know you are on top of things. My mom got a pressure ulcer when she was in nursing home rehab for hip surgery, and boy, did I explode. I vowed she would never get one under my watch. She never did. I wish you all the best.

I only had one Resident who gave me a hard time with getting a shower. I worked 3PM-11:00PM shift. The Nurse Manager had the Day Shift try, and the Resident was fine with getting her shower then. I think maybe they don’t like the spray of the shower, they get cold, water pressure…


My mom was given a bath in a whirlpool when she was in SNF she loved it. She got two baths a week, and if she asked for a bath and they would accommodate her if schedule allowed it.

My mom rarely got a shower and no one could reason with her because there is NO reasoning. I bought adult size wipes with no rinse soap and she washed up each morning while sitting on the toilet. Believe it or not her skin stayed healthy and she was always prone before to rashes and yeast. She permitted her hair to be washed in the sink & we used dry shampoo often. Use powder on skin flaps and do the best you can.

When my father was in a nursing home, showers were routinely given on the 11-7 shift because of work demands on the other shifts. He hated being woke up in the middle of the night especially since he had trouble sleeping most nights. A CNA told me that if the family would say they did not want him to have showers in that time frame they would have to respect our wishes. Once they changed the time for him things were better.

So like others have said.... when a resident says no they can not force them to do anything and it all depends on how various options are presented to them. Perhaps request a "bed bath" or other type of bathing at least once a week when she refuses a shower.

We have the same issue with our father. No, staff cannot force a resident to do anything. He even argues with us when he stays with one of us for a weekend. Part of it is he truly does forget how long it's been since he took a shower, but we also think it's a control thing, that he doesn't like being told what to do. He's supposed to get a shower twice a week, that doesn't always happen. The staff tries, they will come in, grab him clean clothes and say let's go, sometimes it works, sometimes it doesn't.

Is she afraid of the water? Water can dry out the skin, so the alternative is to use lotion or cream to moisturize and clean the skin. Do not force using the shower or tub if she does not want to do it in order to avoid a traumatic event.

Remember that dementia is a disease with loss of reasoning abilities. Place yourself in someone's shoes about forced activities you don't want.

Hi there,

Does she really need to have a bath? The poor soul doesn't like to bathed. Why not give her a good overall wash if this is more acceptable to her?

My husband has dementia and he won't go near water but he has a really good wash every day.

I agree the staff should know how to handle this.

First thing...ask them if they ask her if she wants a shower and the answer is no. If so ask that they don't ask, they tell her "Mrs Jones, time to get a shower" maybe not even that, just walk her to the shower and guide her in.

Second...my daughter, RN, worked in NHs for 20 yrs. She says you allow them to think they made the decision. "Mrs Jones would you feel so much better all clean and fresh clothes on?" She says they may agree and allow u to shower them.

In NHs by law they cannot force a resident to do anything they don't want to. With the shortage of CNAs, I would say when they get no for an answer, they move onto the next resident.

Hello Solace,

Sorry to hear you're facing this problem.

I agree with Greton777, I would have expected the nursing home to have experience with such matters.

Maybe they've tried various things and nothing has worked?

Some video's talk about pretending the experience to be a spa treatment and encouragement by suggesting a nice lunch or dinner afterwards or a hair styling.

They also suggest to be flexible in the time, i.e. if loved one say no in the morning, suggest bathing in the afternoon.

Maybe a sponge bath and then slowly progress to the shower. I don't know if this will work, but it might be small steps for encouragement.

Solace, I really do hope your issue with your mom showering/bathing is resolved soon, with the help of the nursing home.

Love & Peace.

What are the regulations in the State where she lives?
I was surprised that in Illinois the regulation is 2 times a week. So if they are trying 3 times a week but succeeding 2 times that is great.
A Bed Bath can be just as effective as a full shower or bath.
As long as she is cleaned properly after toileting I see no need to worry or insist about showering 3 times a week.
Showering or bath can make the skin drier. It removes oils that are necessary. This can make skin itchy and if she begins to scratch that can be a never ending cycle itself.
I am surprised though that they have a problem. Typically the CNA's or CNA assists are real good at getting people that are non compliant to shower. That said they can not "force" and to do so could be more traumatic and make showering again later more of a problem.
My suggestion...
Let the staff do their job, let them handle the situation.

I'm honestly a little surprised that the staff is having trouble getting her to do this. They should be pretty experienced with this. Hopefully it's not because they are short of help or not trained well enough. I'd talk to the admins and ask their help to "brainstorm" a solution -- this is a diplomatic way of moving the complaint up the ladder. Ask then how they've solved this type of issue in the past with other residents.