“Doreen” is a lovely woman who enjoys her baths. She has dementia but is fairly independent and has a pleasant disposition. She’s well-known and well-loved where she lives.  Recently, Mona, a recent graduate of the CDCP™ Dementia Designation Program, and the manager of the home where Doreen lives reached out to us to let us know that Doreen has been refusing to take her bath and they needed some ideas/support.

Some Creative Solutions that Didn’t Work

Working with people living with dementia, the staff are quite aware that sudden shifts in behaviour are to be expected. Knowing that taking long baths is the highlight of Doreen’s day, they tried to understand why she now refuses to take baths, but they were at a loss.  Instead, they went ahead to try a  few solutions that worked with other residents in the past.

Solution 1 – Put Doreen in a bathing suit!

One of the residents in the care home also stopped taking baths in the past. However, when they put a bathing suit on her, it seemed to do the trick. Eager to try this approach, they put a bathing suit on Doreen, but sadly, Doreen still refused to get in the tub.

Solution 2 – Give food as an incentive. They also thought to offer a food treat that Doreen can enjoy after she takes her bath. This strategy works with kids and with another resident in the past. Unfortunately, this too did not work for Doreen.

Why did these “Best Practices” that Worked in the Past Not Work for Doreen?

It is truly commendable that the staff didn’t just give up on Doreen. They continued to support Doreen’s independence, and autonomy, respected her choices, and persevered in helping Doreen to continue to be able to do what brings her joy. They were on the right path!

But why didn’t the “proven solutions” work? What did they miss?

At Dementia Solutions, the one thing we always remind people is to always start by asking “Why?” What is the reason for the behaviour? There is always a meaning behind the behaviour. This is also why we dedicate a special section on our website to the Meaning Behind the Behaviour Stories. 

A behaviour does not appear “all of a sudden, for no reason at all.” There is a reason for your behaviour… for everyone’s behaviour. Start by asking “Why?”. 

This is what person-centred care is all about. There is no “cookie-cutter” approach to dementia care. When supporting someone living with symptoms of dementia, it is always about getting to know and understanding the person behind the dementia. Each person is different and what may work for one person may not work for another, because the reason behind the behaviour may be different.

Putting on a bathing suit did not work for Doreen because it wasn’t an issue about modesty. She had no problems taking off all her clothes and getting into the tub. Using food as an incentive was a good idea, but again, this was not the reason why Doreen refused to take a bath. She wasn’t hungry or getting food treats was not something that was particularly of interest to her when in the tub room.

The Reason Why Doreen Refused to Take a Bath and Our Simple Solution That Worked

Desperate for an answer, Mona consulted with us to find out what they can do to help Doreen return to doing what she loved most. 

Putting on our detective hats, Mona and I started asking “Why?” and investigating the reason for Doreen’s changed behaviour. 

Many questions were asked to learn more about the situation. When we inquired about the room where Doreen usually takes her baths, Mona and I realized that everything was white. The walls and floors were white. The bathtub was white. It was highly possible that Doreen was experiencing problems with depth perception due to the lack of contrast stepping into the tub!  After contemplating this possible reason, Mona shared with us that when they would go out for walks she now has troubles with stepping down from a sidewalk.  We all agreed that it may be possible that Doreen could not see the bottom of the tub and it may have looked too deep for her to get in. Therefore “fear” prevented her from getting in the tub.

Since the environment felt unsafe for Doreen, we needed to make her feel safe again. We suggested that Mona put a bright-coloured bath mat that can stick at the bottom of the tub to help with the contrast. This may help with Doreen’s depth perception and allow her to feel safe to get in the tub.

A bath mat was purchased and the first time they tried it… it worked! However, the rest of Mona’s team was not convinced that this “simple solution” was the answer. They thought that Doreen was probably just having a good day. However, Mona persisted with her team and convinced them to continue giving this a try. Since then, they never had any more issues with Doreen getting in the tub, and continued to enjoy this routine she loved most!

Some Teachings that We All Can Learn from Doreen’s Situation

• Start with believing that there is always a reason for the behaviour.  
• Ask yourself/your team the question “Why?” to get your mind into problem-solving mode.
• Be a detective to uncover the reason.
• It’s okay to ask for an outsider’s support/ideas. 
• Keep trying. Don’t give up even when you see resistance from others.
• Do whatever works!  No matter how simple or silly the solution is.

This month’s Meaning Behind the Behaviour Story was brought to our attention by Mona Morine. Mona is a Certified Dementia Care Provider. Mona is a Manager in a care home in Eastern Canada. We would like to acknowledge Mona for the love and support she gives to her clients/residents and for her determination to not give up on them. We are proud of Mona for practicing the techniques and strategies she learned from our program. The true value of training and education lies in their practice. Thanks, Mona for all you do! 

If you have concerns about a loved one or a friend and don’t know what to do, you are not alone. Reach out and ask for help. We can help by brainstorming ideas with you that will best suit your situation. Begin by contacting us through our website www.DementiaSolutions.ca to arrange your free 20-minute consultation with one of our Dementia Care Advisors.

DISCLAIMER:

The contents of this blog are provided for information purposes only. They are not intended to replace clinical diagnosis or medical advice from a health professional.