Tips on how to be more helpful when assisting your loved one to bathe or shower. These are things that you need to think about when becoming a spousal caregiver. Understanding your own feelings and beliefs in this personal issue. Understanding your loved one’s feelings, wants and beliefs in this most personal area. It is difficult to ask for help with personal hygiene chores when you can no longer do your own self-care.
February 8, 2023
You two have been through a lot. You are a team, usually. You are both independent and self-sufficient. Then, things change and you are no longer self-sufficient. You have become a care recipient. You need help because of a stroke. You need help because of cancer. You need help because of Parkinson’s disease. You need help because of Alzheimer’s disease or other dementia. No matter the reason, your wife needs help with one of the most intimate parts of her life. It could be a temporary help because of surgery,
We don’t think about it much, but we each how our own ways of doing things. We have our own patterns and our own order of doing things. Most partners do not know their significant other’s daily routine. When you are the helper, you must be aware that your loved one has their own way of doing things. They have their own schedule and order in which to do things.
Learn Each Other’s Routine
Try this experiment. Each of you writes down exactly what you do from when you wake up to when you go to sleep that evening. I mean everything with the time of day noted. We won’t get into the getting dressed procedure. I know, some of you have this puzzled look on your face. We all have our preferred way of getting dressed and we have very specific ways we do things. For example, I place my left arm first, whether it is my shirt or jacket. It is automatic for me; if I even try to do it with my right arm first, I can’t do it easily AND I am out of sorts mentally.
Now, the next day write down your partner’s daily routine with times noted. Do this from what you have observed or what you assume they do. You will probably get the big things right, but probably not all of the little things.
Find a time to go over the information. Make it a date night. Talk about it and see how close you are to knowing each other’s routine. What are the similarities? What are the differences? This is a big-picture type of exercise. We all have our own routines.
When you are the helper or caregiver, it is best for the caree (your loved one) to be as comfortable and safe as possible. In order for that to happen, you need to know their routine and their times. We automatically do things in our routine and we don’t realize that others have other routines. Doing their routine becomes doubly important when your loved one has Alzheimer’s disease or another type of dementia.
Men don’t automatically know how to care for female anatomy
Guess what? Female anatomy is different from male anatomy. We don’t automatically know how to help the other person with bathing. We don’t automatically know how to wash and clean some private areas effectively. We don’t automatically know what to lotion and what to powder. Sometimes, we don’t know what we don’t know until we get in the big middle of it. That can be very stressful. Caregiving is hard and you want to provide the best personal care possible.
What follows are the supplies needed and the how-to tips to help you help your wife.
Bathroom
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- Grab bars installed properly and permanently. Place one above the water turn-on area, too.
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- Non-slip grips on bottom of tub
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- Portable heater to warm up the room
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- Shower seat or shower chair for tub
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- Hand-held shower head with 5–7-foot hose length
Shower Supplies
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- Pouf for bodywash – may have a handle
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- Bar soap – gentle or sensitive skin type for washing privates and underarms
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- Bodywash -for washing other body areas
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- Conditioner – apply on hair and immediately rinse off
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- Barrier cream or protectant – if needed
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- Powder or Talc – if needed
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- Gloves – nitrile seems to be the best
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- Pump supplies are easier to use
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- Cotton terry robe will help in the drying off stage, too.
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- Always have them sit on the toilet to pee first before getting into the tub. Warm water brings on the urge to pee and if it happens in the tub, no big deal move on.
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- Let the water run for 1 -2 minutes and check the temperature on the inside of your wrist before putting any water on them.
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- You may want to place a hand towel on the shower seat for warmth or comfort
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- Encourage them to wash everything that they can wash – promotes dignity and independence
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- Use a gait belt – get trained in how to use one first
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- As the helper, you need to remain calm and relaxed. It will be slower than you anticipate. If your approach is more of a loving gesture and a desire for them to feel good, it will go a lot smoother.
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- If you have the attitude of getting in, getting it done, and getting out…it is probably time to hire this job out.
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- Use the gloves – it helps to separate intimate touch from helping with a need
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- Use a hand towel over their lap to promote privacy and dignity while they are seated on the shower seat
Order of Washing -Be Gentle
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- Wash the face and neck first and dry the face
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- Have them place a washcloth over their eyes while you wash their hair and condition it. Ask them to tip their head back. Scalp massages feel really good.
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- Dry the hair with a hand towel
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- If they can, have them hold the shower handle
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- If they can wash themselves, then you soap up the washcloth or pouf
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- Wash their back in a circular motion all the way down to the buttocks
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- Wash the arms and underarms next
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- Wash the front torso and under the breasts – wash skin folds well, too
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- Rinse them off really well
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- Place a towel over the top half of the body and pat dry a little (helps keep them warm)
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- Wash the legs and have them lift up one at a time or gently lift them up. If they can stand then have them stand.
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- Wash the feet and in between the toes (while they are sitting)
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- Tell them it is time to wash private parts. Offer them the option to wash their own private parts, even if you need to help some.
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- Use a clean washcloth and clean the vulvar area – use a different clean area of the washcloth for each swipe
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- Clean from clean to dirty = front (vaginal area) to back (anal area)
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- Separate the labia with one hand and clean gently with a downward motion to the perineum area (area between vagina and anus)
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- Separate buttocks and clean from bottom to top area
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- Rinse very well
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- Talking throughout the bathing process and telling them what you are doing or will be doing next seems to help everyone calm down
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- Use a towel to pat dry and dry well
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- Areas that need extra care to be dry – vulvar area, anal area, underboob area, all skin folds and in between toes
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- Gently get them out of the tub. Dry them off again or place a terry cloth robe on them to help with that. They can either stand or sit on the commode (lid down and with a towel placed on the lit) while you lotion them, powder them, and put on deodorant. Dry and style the hair. ** Note, some want to dry and style their hair before applying lotion and anything else. Some brush their teeth either before getting into the shower or right after getting out and drying off. Ask what they want to do. **
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- Apply barrier or skin protectants to areas needed (usually incontinent folks need this)
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- Never lotion between toes (want to prevent fungal or other infections)
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- Places to put powder or talc – underboobs (skin under the breasts, and torso area where they touch), skin folds (anywhere there is skin-on-skin contact that does not get a lot of air circulation)
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- Do not put anything in or right around vagina (it is self-cleaning)
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- Help them into their clean clothes
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- They may need a nap after a bath, it is hard work
Getting clean makes all of us feel better. Change the sheets on the bed on a bath day. Some bathe every day and some bathe 2 or 3 times a week. That is fine. Find what works best for your loved one and you.
It is also fine if you hire a shower aide to come into your home to help with bathing your loved one. You will still have to do the daily cleansing needed which includes face, underarms, underboobs, skinfolds, feet, in between toes, vulva area and anal area. This is sometimes referred to as a sponge bath.
Products to Consider:
Soaps/Body Washes
CeraVe Body Wash for Dry Skin
Kiehl’s Grapefruit Bath & Shower Liquid Body Cleanser
Aveeno Restorative Skin Therapy Sulfate-Free Body Wash
Dial Clean + Gentle Body Wash, Aloe
Neutrogena Hydro Boost Fragrance-Free Hydrating Body Gel Cream
Olay Moisture Ribbons Plus
Dove Beauty Sensitive Skin Body Wash
Dove Body Wash for Dry Skin
La Roche-Posay Lipikar Wash AP+ Body & Face Wash
Lotions/Moisturizers
CeraVe Moisturizing Cream
Facial Moisturizers
CeraVe AM Facial Moisturizing Lotion
La Roche-Posay Toleriane Double Repair Face Moisturizer UV SPF 30
Aveeno Positively Radiant Daily Moisturizer SPF 30
Cetaphil Daily Facial Moisturizer SPF 35
Unscented Neutrogena Hydro Boost Water Gel Face Moisturizer with Hyaluronic Acid
Aveeno Calm and Restore Oat Gel Moisturizer Unscented
Cetaphil Gentle Clear Moisturizer
Neutrogena Oil-Free Daily Sensitive Skin Face Moisturizer
Eucerin Redness Relief Day Lotion Broad Spectrum Sunscreen
Best Body Lotions for Men
Nivea Men Maximum Hydration 3 in 1 Nourishing Lotion
Aveeno Daily Moisturizing Body Lotion
CeraVe Daily Moisturizing Lotion
Dr. Jart+ Ceramidin Body Lotion
Vaseline Intensive Care Lotion
Jack Black Cool Moisture Body Lotion
Dove Shea Butter Lotion
Men Facial Moisturizers
Neutrogena Hydro Boost Face Moisturizer
Kiehl’s Ultra Facial Moisturizing Cream with Squalane
La Roche-Posay Toleriane Ultra Soothing Repair Moisturizer
Bulldog Mens Skincare and Grooming Original Face Moisturizer
Jack Black Double-Duty Face Moisturizer SPF 20
Cetaphil Fragrance Free Daily Facial Moisturizer
Skin Care Products for Incontinence – Barriers and Protectants
BAZA Clear Skin Protectant Ointment
Sween 24 Superior Moisturizing Skin Protectant Cream
Calmoseptine Ointment
3M Cavilon Durable Barrier Cream
Boudreaux’s Butt Paste Rash Cream, Original
Incontinence Cleansers
Dementia, Surgery, or other Health Problems Require Toileting Help
Personal hygiene care is probably one of the most needed guides that no one ever talks about. It is up close and personal. Dignity is important. Good information on the differences in needs of women versus men is needed for guidance and “how-to-do.”
Let’s face it…we really only know what we need and how we do things. Someone else has no idea what you need and want. If you are helping someone of the opposite sex, some things that may be going through your mind include…
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- How do I do this hygienically?
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- Am I wiping the right way?
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- Am I helping with their dignity or do I just want to “get it done?”
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- I want to help them, but I have no idea if I am doing it right
February 1, 2023
The anatomical differences. The personal “wants” differences. The “how I do it” types of things may be different for each of us. Personal hygiene is definitely one area where very open and honest information is communicated for understanding. Never assume that you know best. Ask how you can best help them.
Tough Conversations, But Necessary Conversations
These are tough conversations but they don’t have to be awful. Maybe addressing it as a clinical need will help both of you to begin the conversation. Is it time to use adult undergarments that help with urinary or bowel incontinence? If she has hemorrhoids, how to best wipe and lessen the chance of discomfort or pain? Do any cleansers or ointments need to be applied after peeing or pooping? Do they prefer to be patted dry or wiped? After pooping, do they pat dry or wipe? Do they use a wet wipe? There are so many things to discuss.
If you are used to being in each other’s space when bathing or toileting then you will have a leg up on everyone else. If you are used to being in private when you bathe or toilet, then you will have a little more “getting used to each other” in that situation. Maybe you can pee in front of each other, but pooping is a private situation for you. That is cool, make sure your loved one is seated on the toilet comfortably, and leave the room until you are called back.
Try things and see what is more comfortable for both of you. Have gloves(nitrile) easily accessible in the bathroom and wear them. Wearing gloves seems to help each other to feel more comfortable with wiping.
Items to have on hand:
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- Disposable white washcloths
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- Personal cleansing wipes (Be careful, some of these cause a lot of irritation.)
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- Barrier cream, if needed (Calmoseptine, A&D Ointment, Boudreaux’s Butt Paste, etc.)
Niceties or Aids to help:
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- Butt Scrubber Multi-Purpose Toilet Aid
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- Bottom Wiper Self Wipe Long Reach Wiper – for larger or obese people
Cleaning with tissue paper
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- Grab more than one sheet of soft tissue paper. 4-6 squares & roll over the hand to make a roll ( I know, some people wad toilet paper.)
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- Wipe from front to back. You are cleaning the vulva area and not the vagina. The vagina is self-cleaning. Some people use toilet paper to pat the area dry and that is fine.
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- Make sure the area is completely dry.
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- Be gentle
It’s important that you wipe front to back, as wiping the opposite way — back to front — can spread bacteria.
After pooping, you will still need to wipe the vulva area as we pee when we poop.
Prepare toilet tissue as before and you will wipe from front to back from the perineal area to past the anus. Yes, you may pat the area until it is clean. Place a little pressure on the area to clean it.
Be gentle, do not wipe hard or aggressively. You may need to use a moist wipe and then pat dry.
Wiping too much or too hard will cause anal itching and that will be maddening. 2 -4 wipes should be good.
Note: The perineum is the area between the vagina and the anus.
Note: Sometimes wet wipes irritate the vulva or anal area. If it does, use warm water and a washcloth to clean the areas and then pat dry.
**Wash your hands after dealing with any bodily fluids, secretions, or stool.**
If you have wiped and still feel like you need to wipe more….it may be because of one of the following …
Dr. Sameer Islam
Feeling like you may need to wipe more may be due to one of these
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- Hemorrhoids (hangs on to feces)
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- Pelvic Floor Dysfunction (muscles are too tight)
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- Weak Rectum Muscles (leakage & soiling issues)
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- Foods can Weaken Muscles (Spicy foods, Greasy foods, Coffee)
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- Wiping Wrong
Tips to fix the problems
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- Fix your hemorrhoids
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- Get a bidet
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- Increase your fiber- slowly and drink your water to stay well hydrated
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- Pelvic Floor Therapy – see a physical therapist for too tight or too loose pelvic floor
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- Wipe correctly – front to back
Dr. Sameer Islam YouTube videos
