KB Times
Katten & Benson, Your Elder Care Law Specialists
 July 2011 |
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| Did You Know? |
- 63% of bathroom falls occur in or around the tub or shower
- People age 65 and older account for 35% of non-fatal bathroom accidents
- All bathroom injuries account for approximately $67 Billion in lifetime medical costs
Centers for Disease Control & Infection
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| K & B Happenings | |
The office will be closed Monday, July 4.
Presentations
Kim will be talking about Compassion Fatigue at Walnut Creek Country Club on July 6. For more information, contact Karen Cone at 682-367-6248.
Time Off
Steve will be out of the office on July 8.
Good luck, Dana! Dana takes the bar exam in July.
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Splish Splash, I Was Taking a Bath
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Several years ago I became a volunteer guardian for a gentleman named John. He was kind of cranky and curmudgeonly, and the caseworker at Guardianship Services (you know who you are) assigned me to him because he was difficult, and he lived in a nursing home when I met him. One thing about John is that he was always cold, and he always had a winter coat on, even in the middle of August.
Often when I visited him in that first nursing home, before I even got to his room, the charge nurse would chase me down, complaining that John would not take a bath, and demanding that I "make" him take a bath. Now, if you know someone with dementia, you know this is a common thing.
I think there are a lot of reasons people with dementia don't like to bathe. In John's nursing home, they would undress the resident in their room, sit them on a rolling bath chair, drape a sheet around them, and push them into the shower room. Not exactly dignified, and certainly not making an effort to keep him warm.
In a lot of nursing homes, people are bathed according to a schedule developed for the staff's convenience, not taking into account the person's preference. I like to shower in the morning. If someone comes along and tells me I have to take a bath at 3:00 pm, I'm going to be unhappy about that. We forget that people with dementia do still have preferences.
Just imagine how you would feel if you were being wheeled through a public hall in nothing more than a sheet--embarrassed, out of control, cold, possibly in pain. How would you react?
So at bath/shower time, observe the behavior the person with dementia exhibits to try and discern the specific trigger that prevents bathing. For John, it was being cold. I wonder what would have happened if the nurses would take him to the shower room before undressing him. Back then, most shower rooms were pretty cold and antiseptic looking; now most facilities have tried to make shower rooms more home-like or spa-like.
Occupational therapist Kim Warchol has a good
article that outlines some ways to help reduce bathing challenges. She suggests doing things to help reduce pain, to help reduce fear, and to provide better communication about what will happen. The University of North Carolina has a good website with examples of different interventions, products, and even a book.
Good luck, and happy bathing!
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| Bathing at Home | |
Bathing at home can also be a challenge for caregivers, and sometimes requires a lot of creativity. Many homes do not have walk-in showers, or if they do, they are not truly walk-ins (mine has about an 8-inch step), or they are so small there is no room for a chair plus the caregiver. Some, like mine, have a built-in bench, but it is tiled, and so slippery I rarely use it.
A tub transfer bench might be one option, but they cost around $100, and Medicare does not pay for them. Plus, they are big and bulky, and can be too big for smaller bathrooms. I have heard of people taking their loved ones to a gym or the YMCA in order to utilize those walk-in showers, and I have heard of people working out deals with nursing homes to use their shower rooms. I have even heard of people getting one of those small inflatable swimming pools to use in the bathroom or kitchen.
If getting the tub or shower is simply not an option, there are a lot of products available for bed bathing and sponge bathing that don't require getting the person in the shower or fully immersed in the tub. The University of North Carolina site listed above has links to many such products.
Whatever you do, though, think of safety, not just for the person being bathed, but for the caregiver as well. Make sure any seat used can accommodate the weight of the person, and make sure it has non-slip legs.
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Don't forget that we are always here and ready to help with your long term care planning needs.
Sincerely,
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Kim Olmedo, LCSW, CCSM, CSW-G
Elder Care Coordinator
Katten & Benson
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