Bathing and Post-Bath Hydration for People with Dementia🍵

[Creative Awards 2025 All-Category Entry]

1. Introduction

Hello everyone! Thank you for reading.😊

As a home helper, I visit the homes of my clients every day.
I learn something new from my clients through my daily services. It is always full of surprises and inspiration.

2. Stories from Bathing

People with dementia. How can we help them bathe at home? Due to various circumstances, they cannot use visiting bath services or day care. The bathing procedure was discussed by the service manager, the nurse, and myself, the assigned helper.
Once the service began, naturally, we adjusted the procedure based on their condition.
Even though they are usually emotionally unstable, they seem to enjoy bathing—I don't know their true feelings, but just by saying, "Let's take a bath," they would smile or stand up immediately. Because of this, we were able to try various forms of independence support (support where they think or act for themselves).

Even if I hand them a towel, they don't start washing themselves, so...

• I move my hands with them and hand them the towel again. They move their hands, but then stop.

• I pretend to wash myself for them to see. They move their hands, but then stop.

• Maybe they are cold. I let the shower run on them for a bit longer. They move their hands, but then stop.

• Maybe they don't like being watched. I'll turn my back. They move their hands, but then stop.

• ...I lather up a lot of soap to let them feel the texture!? Here goes!
  ...They move their hands, but then stop.

And other things...

It wasn't all at once, but I repeated these things. Their expression remained a smile as always. However, I don't know their true feelings, and they shouldn't get tired. Keeping an eye on the time, I finished up by washing them myself.

3. Post-Bath Hydration

[1]Don't give too many choices
In this person's case, even when I asked, "What would you like to drink?", they seemed to have difficulty judging and choosing a drink by comparing it with the situation and their body's sensations. Therefore, I thought that instead of presenting multiple options, narrowing it down to two types—"room temperature drink" and "warm drink"—was a way to be considerate of their feelings and physical condition. This time, I first offered them
a hot sports drink diluted 2 to 3 times.

• Reason: Commercially available sports drinks have a lot of sugar and can sometimes be refused because the flavor is too strong, so I diluted it before serving. In addition to replenishing electrolytes like sodium and potassium, serving it warm allows for hydration without cooling the body down. The aroma and sweetness become milder, making it easier to accept.

Also, to ensure they can reach for a drink whenever they feel like it, I arranged the following drinks on the table so they are within their line of sight.

• Room temperature water: This efficiently replenishes fluids lost through sweat and is gentle on the stomach, so it can be consumed with peace of mind.

• Hot barley tea: It contains no caffeine, so there is no concern about it affecting nighttime sleep. It has a fragrant aroma and a pleasant taste, which can also have a relaxing effect. It also helps with mineral replenishment.

[2]Be mindful of the timing

• Reason: Since physical strength is depleted after bathing, offering a drink immediately may result in a lack of focus, which can actually lead to refusal. In particular, when they are still in the middle of changing clothes or their mood has not yet shifted, they tend to react by saying things like, "I don't want to drink right now."
  

• Countermeasure: First, I waited until they finished changing, sat in a chair, and confirmed that their breathing and expression had calmed down before speaking to them with reassuring words such as, "Here is a warm drink" or "This will help you relax." By offering it naturally when their gaze turned toward the drink, they accepted it.

• [3] Do not make them drink all at once

• Reason: People with dementia may have dulled swallowing reflexes or sensitivity to choking. Trying to make them drink too much at once can cause them to choke or lead to discomfort.
  

• Countermeasure: I made sure to offer it one sip at a time, matching their own pace. I watched over them while offering reassuring words like, "Just a little bit first" or "It's okay to take it slowly." The use of items like straws is also something that can be considered depending on the individual's condition.

[4]Some people are sensitive to the temperature of drinks

• Reason: There are cases where people react hypersensitively to the temperature of a drink, such as being startled and refusing if it is too hot, or finding it too stimulating to their teeth or stomach if it is too cold. Since people with dementia may find it difficult to explain the reason in words, it is important not to miss signs in their expressions or gestures.
  

• Countermeasure: This time, I adjusted it to a lukewarm temperature similar to skin temperature before serving. Since I saw an expression where they let out a small sigh of relief after drinking, I felt it was a comfortable temperature. I will continue to adjust the temperature according to their reactions at the time. [5]
  
  Do not forget the perspective of dehydration prevention
  People with dementia may find it difficult to realize the sensation of being thirsty, and it may also be difficult for them to convey that in words. Since they may already be in a state of mild dehydration by the time it is noticed, creating an environment that consciously encourages fluid intake is important. This time, in addition to the timing after bathing, I put effort into
  how to choose, place, and offer the drinks so that they could reach for them naturally. I will continue to consciously maintain the "habit of drinking fluids" in our daily interactions to help prevent heatstroke and dehydration.

4. Reflection

The user may not know what they are doing, or may not understand, but they are doing things for themselves little by little. They are a very hardworking person. Their dedicated demeanor is wonderful, and I was moved by it. When I feel like giving up, or when I am about to forget something, remembering the user encourages me. Is this what you call a motivation boost? For me, it is the best medicine.

How do you all feel about this?

5. Conclusion

Thank you for reading until the end. Once again, I look forward to working with you in the future! Your likes and comments are encouraging. I look forward to them😆