Anyone who has ever worked with seniors will tell you war stories about the battle of wills on bath day. When the issue gets addressed by Dear Abby you know that more than one person is writing in for her advice. Why do some older people hate to bathe? .
A psychiatrist, of course, will tell you that not wanting to bathe could very well be related to depression, low self-esteem and repressed anger, but you can’t think psychiatric care every time grandma refuses her bath. If the pattern develops in later life it could be related to organic brain disease. If you think this might be the problem a complete psychiatric examination might very well be in order.
Still, I don’t think organic brain disease is always the problem. To start with, our parents grew up in another time. Running water was not always a given and neither was a daily bath. Even I can remember when a bath once a week on Friday or Saturday night was the norm, yes a wash tub in front of the kitchen stove. Our grandparents, and maybe even our parents, grew up in a time when frequent bathing was not considered a necessity.
The real reason for less frequent bathing in the elderly could be due to a feeling of insecurity. Many older people do not feel capable of handing the rigors of a daily bath or shower. Bathing can be complicated for the elderly. There is a general weakening of muscles and their may be joint problems caused by arthritis, degenerative disease, stroke or balance issues. Not being able to use the bathroom could mean the difference in whether they can live independently or not.
Modern facilities make it possible for older people to continue bathing at home (Liz Gill: The Times (London UK) May 25, 2003). It means that the daily bath, so essential to pride and a sense of wellbeing can be done in comfort and safety. A process taken for granted when you are younger can become so difficult that a senior may face an appalling dilemma every day. Do they do something painful and hazardous in order to keep clean? Do they subject themselves to the indignity of being bathed by a stranger? Or do they allow their standards of personal hygiene to slip?
People are often reluctant to accept help with bathing because it is so connected to their private selves. Bathing can still be a wonderful experience. Help may be as simple as making sure that the tub, toilet and shower stall are all safely accessible. Remove loose rugs, install hand rails, providing special seats, and eliminating unnecessary steps into and out of the shower and tub can provide a modicum of safety. Keep a phone in the bathroom. Investigate universal design showers, toilets and sinks. You will spend more money in monthly fees at a care center than it will cost to completely redo the bathroom. Personally I can’t think of anything that sounds better than the Safe Step Walk-in tubs, such as the ones advertised by firstSTREET. I would like to have the one with both water and air jets right now. Bathing should and could become a real pleasure again.