Which of the following approaches to hygienic care is beneficial for a patient with dementia?
a. Schedule the patient's full shower at 7 AM, three mornings every week.
b. Have a team give the bath with each member washing a different body area.
c. Wash the perineal region first to remove potentially infectious material.
d. Explain each step as you go, and keep the patient covered as much as possible while bathing.
D
A person with dementia can interpret undressing for bathing as an assault. It should be performed in a way that minimizes the intrusive and exposing aspects and maintains trust between the person and only one caregiver.
From the point of view of the well-being of the patient, bathing is rarely an emergency that it must be performed at a time when the patient is not receptive. Stimulation should be kept simple and focused, and alarming the patient should be avoided. The most sensitive and intimate areas should be washed last, after trust has been established between the patient and the nurse, which may have to be done anew at every encounter. From an infection-control standpoint, washing occurs from clean to dirty areas.
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