Dec 12, 2018

Water is Invisible and Disconcerting to Dementia Patients

The simple fact is many Alzheimer's patients don't like water because they no longer perceive water in the way that you and I do.

Dementia patients don't like water because they no longer perceive water the way we do.

By Bob DeMarco
Alzheimer's Reading Room

Water is nearly invisible and often disconcerting to the typical Alzheimer's patient. 

They don't like to drink it, and they don't like to take a shower or bath in it.

We often discuss how difficult it is to get an Alzheimer's patients or a patient with a related dementia to take a bath.

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Carole Larkin estimates that bathing is one of the top three problems that Alzheimer's caregivers face.

I agree.

We have discussed the use of the smile, nonverbal communication, and a number of techniques and timings that might help the caregiver accomplish this mission -- bathing .

This time around I am going to talk about water.

Do Alzheimer's patients fear water? Is water nearly invisible to Alzheimer's patients? Does water disorient Alzheimer's patient and make them feel anxious or confused?

My observations with my mother Dotty, and discussions with other caregivers leads me to believe the answer is often yes.

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Lets start with a simple question. Do you have a problem getting an Alzheimer's patient to drink water? Do they say No or refuse to drink water? Many of you will answer yes.

Did you ever wonder why?

Article - How to Get a Dementia Patient to Cooperate

Did you ever notice that when an Alzheimer's patient gets in the shower they immediately move to the side so the water doesn't come down on them? In other words, hit them in the head.

When you go into the shower with the water on, do you willing step under the water (assuming you have it at the desired temperature), and put your head under the water? Answer? Or, do you step to the side and ease your way in?

Have you ever considered that an Alzheimer's patients can't see water, or at least they don't perceive water the way we do?

Is it possible that water is invisible, in a sense, to Alzheimer's patients?

If something you couldn't see, or perceive, started hitting you in the head would you get confused, disconcerted, or angry? If something that you couldn't see or perceive started hitting you in head, would you run from it? Answer?

Topic - How to relate to an Alzheimer's Patient

When Dotty would step into the shower she would never let the water hit her in the head; and she was clearly disconcerted until she moved out from under the shower water.

I learned how to get Dotty to accept (take) and cooperate at shower time. However, I worked diligently over time to help make that happen. This should actually read, worked with and together with Dotty to accomplish our mission.

There is an obvious alternative to having the water hit the person in the head when they enter the shower. You can use a hand held, detach it from the wall, let it hang down, and aim in at the floor, or away from the patient. Of course if you do this, you will then most likely have to assist the patient in taking the shower.

I strongly suggest you start right now in assisting the patient to take a shower. It is likely that you will have too sooner or later anyway.

Yes, my fellow men, you will likely have to give your mother a shower. It is a very rewarding if you get into the right mind set.

When my mother would go into the pool she would go into the water with great trepidation. One thing for sure. As she stepped into the water and down the steps she had no idea how far down it was to the next step. In fact, I often thought that when she looked at the water she thought it was very deep. Even though she had been entering into the same three feet of water for 40 years.

While going in, and then when in the water and walking my mother would always says, this water is making me dizzy. It clearly disconcerted her if she looked down at the water.

Here is something else we know. Many Alzheimer's patients will eat off red plates but won't eat, or eat much off white plates. Is the food invisible for some on white plates, or does it look less appetizing?

Article - 16 Ways to Get a Dementia Patient to Eat More Food

Dotty would almost always stop when she went from a colored carpet on to a white tiled floor. It was like there was some kind of magic fence. She would stop dead, and most of the time I would have to assist her for the first few steps on to the white.

She did not have any trouble by the way going from white tile onto colored carpet. She just kept on trucking.

So if white is hard to see, or scary due to depth perception, think about how scary water might be.

White a lack of color, water, no color. Invisible.

If I asked you to get in (or under) water that you couldn't see, or that made you dizzy, or worse made you feel scared, what would you do?

The simple facts are this: many Alzheimer's patients don't like water because they no longer perceive water in the way that you and I do.

However, once the AD patients gets into the water, and as long as it not too hot or cold, they will be just fine as long as stick around.

I suggest you use the hand held shower attachment. Take it down and let the water hit the ground at foot level. Gently pick it up once the patient is in the shower and shower their hand for a bit. Then arm. Then warn them well in advance that you are going to wet their hair. Be gentle. Start with the back of the head, not the top, and not the face.

If your patient is capable of washing themselves you can then hang the shower head up on its connection and let the AD patients wash themselves. In fact, if possible, I am going to encourage you to allow the AD patient to wash themselves for as long as is possible. Let them do it.

Topic - How do you live with someone who has Alzheimer's?

When Dotty wasn't sick I would give her one really good shower a week. When I was finished she looked like a finely waxed car. This included a hair wash and shave which we did first in the kitchen sink.

Now don't misunderstand me here. Dotty gave herself a shower the other 6 days of the week with some assistance from me. Like turning on the water and getting the temperature just right, by placing a nice soft towel on the floor for her feet, by making sure the bathroom was warmed up if necessary, and by cheering her own from outside the shower.

Yes, I layered on an enormous amount of positive reinforcement every step of the way at shower time. Including raving at how wonderful she looked and smelled at the end.

Water is invisible and disconcerting to the typical AD patient. They don't like to drink it, and they don't like to get in it.

So, they need some very positive assistance.

Big tip. Once you break the bad pattern, and replace it with a new pattern, you are home free and on to the solving the next problem.

Related articles

Touch and Kindness in Dementia Care

3 Ways to End the Dementia Care Blame Game

Alzheimer's Care, Don't Argue

6 Reasons Why You Might Have to Put Someone with Dementia in a Memory Care Facility or Nursing Home

Publisher Alzheimer's Reading Room
Author Bob DeMarco
February, 2016
Title: "Water is Invisible and Disconcerting to Dementia Patients"

Originally published in the Alzheimer's Reading Room