Rub a Dub Dub

I expect that the posts on this blog will contain everything from the ridiculous to the sublime. This particular post, however, is likely to have far more of the ridiculous in it then the sublime. I said in my first post on this site that I hoped to both inform and learn as a result of writing each post and receive useful comments from any readers I was fortunate enough to have. While I do think there will be some useful information for readers in this post, I am counting on receiving some help myself on the subject of bathing and bathtubs. Why? Because my husband has developed a terror of bathing, a common symptom of Dementia.

I’ve included some pictures with this post. As you may be able to tell from the picture below, one of the difficulties of bathing when you suffer from dementia is that you might forget that you have already put soap on your hair, and then consequently do it again and again. And when you are using a walk-in tub with those wonderful water and air jets, this can result in a lot of bubbles. Usually, when my husband, Bill, is bathing, I stay right there with him just to prevent catastrophes like the one in the picture. The day of the picture, I decided answering the phone in the middle of Bill’s bath was a good idea. It wasn’t! By the time I returned, cell phone in hand, to check on how he was doing, bubbles were pouring out all over the floor. On the good side, since I had the cell phone camera right there, I was able to capture the moment for posterity. By the way, Bill drove a hard bargain before he signed a release agreeing to let me use the picture in this post.

Too much shampoo

Keep that shampoo away from forgetful bathers

In my very first post on this site, I mentioned that a sense of humor was extremely important when dealing with the challenges of the final fifteen percent of your life. It’s actually very helpful throughout the entire lifetime, but it’s critical in the final part. My first reaction to the bubbles rapidly filling up the floor of the bathroom was dismay at the amount of work cleaning the mess was going to take. But my upset turned to laughter the moment I caught sight of the expression on my sweetie’s face.

Bath time horror

Oh, the horror of having to take a bath

The problem I’m hoping readers of this blog can help me out with isn’t the bubbles; it’s my husband’s terror of bathing. I have already figured out how to prevent further bubble incidents; simply remove the shampoo from the vicinity of the tub once the first blob of shampoo has been delivered (or never answer the phone in the middle of the bath). I try to imagine how I would feel when confronted with a completely tricked out tub with all those controls to manage, and a memory that can’t retain the instructions on how to operate the remote control, much less a high-tech bath tub. I can see how that would be intimidating, but what my husband seems to feel when presented with the fact that it is time for a bath goes way beyond intimidation. Terror is the most accurate word I can think of to describe how Bill feels. I don’t talk to him about it ahead of time now. I just prepare the bathroom, make certain it’s nice and warm, take him by the hand and lead him to the tub, and promise him a delicious lunch as soon as we are done. I learned how to do that from the Alzheimer’s Reading Room at http://www.alzheimersreadingroom.com

Name tags on controls

Name tags on the controls help a person with dementia remember how to operate the tub.

Two years ago, we decided it was time to adapt our bathroom to help with the fact that Bill was depending on a walker to get around and that we both had some trouble climbing in and out of a regular bathtub as well as some concerns about balance in the shower. We did lots of research on walk-in tubs. I didn’t want to ruin the resale value of the house by installing a walk-in tub. No young family was likely to want that after we were gone and no parent wants to endanger the size of their children’s potential inheritance. But said children encouraged us to buy what we needed and ignore any concerns about how hard it might be for them to sell the house when we were gone. (Have I mentioned what great children we have?)

There are approximately 14 different brands of walk-in tub available; only two of the ones we found were made in the U.S. and the remainder were all made in China. The difference in quality of construction was clear. We went with a brand that was made locally. Since poor circulation is a problem for one of us, and since the other loves all those lovely jets, we decided together on a model with all the bells and whistles. The investment of money for this new tub was substantial. It isn’t the tub itself that was the major expense. It was the plumbing and electrical improvements. No one wants to have to sit in the tub for 10 minutes while it drains but opening the door before all the water is gone is not an option. We had the plumbing improved so the tub would both fill and drain quickly, added more hot water capacity and included a dedicated electrical hookup so all those jets could work their wonders without unduly taxing the power supply.

For me, all the money spent was well worth it. Half an hour of the wonderful massage and aromatherapy the tub provides can melt away an enormous amount of stress and definitely add pleasure to the final fifteen percent of my life. For my husband, not so much. He does enjoy the massage once he stops fighting about having to take a bath in the first place and he is willing to leave the operation of the controls and bubble-making substances to me so we don’t have too many “bubble” issues. But from the time the new tub was installed, he developed an enormous fear of getting into it. That fear seems to dissipate once the bath gets underway, but it comes right back the next time I announce that it is Bath Time.

Too many bubbles

Bill and his excess bubbles captured by his daughter

I told my husband’s neurologist about the fear and he said it was common for someone with dementia and prescribed a fast-acting anxiety medication to be taken half an hour before bath time. It does calm Bill down slightly, but it also leaves him feeling dopey for the rest of the day.

rubber duckies in the tub

Here are the rubber duckies our children gave us.

We tried adding some toys to the bath to make it more fun. Bill now has little rubber duckies courtesy of his children and a small fleet of boats (courtesy of me) to float in the bath. That didn’t work well either. The boats were swamped by the waves from the massaging action and the duckies fell to the bottom of the tub where they remained stuck to the intake water jet valve until the bath was over.

Poor rubber duckie

The perils of playing with a rubber duckie in your walk-in tub

I had hoped that, over time, the fear would be diminished by a long line of uneventful baths, but the memory issue seems to make that impossible. By the time I have gotten Bill successfully bathed, I need some of that massaging myself just to relieve the stress and guilt of having forced my husband to do something he fears.

I also tried blatant compliments about how great he smells after his bath, but he was unimpressed. I attempted to bribe him with his favorite meal that he can have as soon as the bath is finished, but the fear is stronger then the anticipated pleasure. I have resorted to being blunt about how badly he needs the bath, but that only results in more guilt even when it works and it gets Bill into the tub. So here is my plea: if anyone reading this post has some ideas on how to help me overcome Bill’s fear or improve the bath time experience, I would love to hear them. And in exchange, here is what I learned about getting a walk-in tub:

  • In cases where dementia is a factor and when possible, buy the tub before any dementia has progressed beyond mild so the person can adjust before the dementia becomes more severe and add instructional tags to the controls to help the person remember how to operate the tub. (They will help you too.).
  • Always stay in the room when a person who is frail or demented is bathing (I know, seems like common sense, but even 10 or 15 seconds away can lead to disaster).
  • The tubs come in different sizes. Be certain you get the right size for the users. Good tubs meet ADA standards to provide protection for users and all of them come with built-in grab bars.
  • Buy a tub that is made in America even if it costs a little more. The company we purchased from had a showroom where they displayed the mechanisms that powered their tubs as well as the ones that powered the tubs of their competitors. The difference in quality of parts and construction was huge. It didn’t take a mechanical genius to see that plastic won’t last as long as metal and that repairs could quickly eliminate our supposed cost savings.
  • Treat yourself to those lovely air and water jets and the aromatherapy feature if you can possibly afford it. There are many compelling medical reasons why the expense is justified (think stress relief and improved circulation for starters).
  • Find a great plumber and get the adjustments made that will allow quick drainage. You can keep busy while the tub is draining using the hand-held shower attachment to rinse your hair and to clean the tub. Water comes in more slowly through the showerhead and the tub will still drain quickly.
  • You may be able to get some help in paying for the tub from places like the VA or some health plans as part of adaptation for disability programs. Check into it before you buy one.

3 thoughts on “Rub a Dub Dub

  1. Is there any place that will honestly tell you what you need? My husband is 85–no dementia yet, other than having lived through 85 years of history. He has periferal neuropathy and cannot stand or walk. We are planning on a stair lift, a scooter to get to the bathroom (about six feet), and a walkin tub. He says that with grab bars he will be able to get into the tub. I am not so sure. Everything I read seems to be either a sales pitch or too contradictory to be useful. I can manage the cost (which does seem high). But I do not seem to be able to make the right decision. Thank you for your insight.

    • Jane
      I only know of one manufacturer that had a showroom where we were able to have my husband actually get into the tub from his transport chair so we could see if it was manageable for him and what size tub was a good fit. That was SafeStep in Fountain Valley, CA. That is one reason I recommend one of the American-made brands where there might be a showroom. Most of the brands are made overseas and I was unable to find a way for him to try them. However many assisted living places have walk-in tubs and, if they thought you might be considering living there some day, they might let your husband check to see if he had the strength to get over the threshold (usually it is low) and maneuver himself into the tub. After all, you would never want to move to a place where the tub wouldn’t work for you so it makes sense for them to let you try this. I looked for a hotel that might have them so they could be tried out but had no luck with that. My husband also has neuropathy and his feet are quite numb so I always stand next to him when he enters and leaves the tub. It does have a good grab bar and he has never had a fall in the two years we have had the tub. They are pricy but the massaging action is very good for the circulation problems that go with the neuropathy. And no, I would never trust the salespeople to tell the truth about what you need and the tubs are too expensive to make a mistake. If the tub doesn’t work, perhaps a roll-in shower with a wheeled transport chair to sit on in the shower would work.

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