Vivian’s husband, “Al” came to me asking for help on how best to support his wife in her new care home. He informed me that a couple of days after moving to her new home in a private long-term care complex and receiving her first bath, “Vivian” reported that she was ‘sexually assaulted‘ by her caregiver.

Was Vivian truly assaulted by her caregiver? What went wrong during Vivan’s first bath in her “new home”?

After asking many questions as a good (dementia) detective would, it was discovered that the caregiver who was supporting Vivian did everything for her during the bathing experience. She took off her clothes, put her in the bathtub washed her all over, etc.  Instead of her bath being a calming, welcoming, and relaxing experience, Vivian felt violated. She was traumatized.

According to her husband, Vivian always enjoyed her baths. She was also quite comfortable with her body and not as modest as many others would be. Therefore, modesty or feeling embarrassed was not the issue.

Even with her symptoms of dementia, Vivian still remains fairly independent and physically able to move around and perform her care tasks with minimal supervision. 

The issue was that Vivian’s caregiver, quite possibly with the best of intentions, decided to take over Vivian’s personal care which included scrubbing her private parts. Her caregiver did not give Vivian the opportunity, choice, and freedom to do this task herself.

Sometimes, care professionals can also be the trigger or the cause of agitation, aggression, and other dementia-related behaviours.

As a Dementia Consultant, Educator, and Advocate, I often remind frontline care professionals and managers of care homes that the keyword to remember is “person-centred care” and not “task-centred care.” The skills most care professionals need to be more intentional in practicing are person-centred and relationship-nurturing care. Caregiving requires trust, truly seeing the person, and supporting people living with dementia to be independent for as long as possible. 

If the person behind the dementia and their capabilities are not taken into consideration in developing their care plan (including how best to bathe the person), even the best of intentions and most caring of staff can do more harm than good. 

If you were Vivian, how do you think you would feel and how would you react?

Think for a moment if it was you or someone you love. How would you feel if you were able to bathe yourself and someone you don’t know took over this task for you without asking for your permission? 

In Vivian’s mind, she did feel like she was legitimately “assaulted” as her personal and private space was invaded without warning or permission. There was a reason and meaning behind Vivian’s behaviour. 

What can be done to best support Vivian during bath time?

As a Dementia Consultant having seen/heard of this type of situation happen to many of my clients over the years, I suggested that Al talk to the management and going forward allow Vivian who is still physically able to take care of herself. The caregivers’ role would be to supervise, assist, or cue Vivian if needed. This means just reminding Vivian what to do next, passing along the face cloth and just being within close distance to keep Vivian safe and to feel supported.

It may take longer and require a lot of patience, but individuals with dementia who are physically able should be encouraged and supported to perform activities they are still able to do on their own. This allows them to continue to experience freedom, feel independent, and maintain a sense of dignity and purpose – all essential to maintaining and boosting their overall (not just physical) well-being. 

When you practice seeing the person behind the disease, or better yet, when you see yourself or your loved one in the person you are caring for, perhaps it will remind and inspire you to slow down and be more aware, sensitive, and respectful of their personal and intimate spaces. 

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.