Nursingtimes.net is partnering with Netbuddy to help nurses care for people with learning disabilities. Here, we look at tips on bathing.
Instead of using a flannel to wash my daughter’s face, I use face wipes as the sensation is softer than a flannel, which feels rough on her face.
Sensory issues around water
If someone you are caring for has sensory issues about water and won’t wash, let them use wipes as a start, or a small damp cloth. Encourage them to tolerate water by getting them into doing dishes or washing the car, etc.
If you are caring for someone who won’t wash, get involved with activities that are followed by showers, eg swimming. It may help if they see other people showering. My son only started using the shower and wetting his head because he saw it in a film he was watching!
Fun and learning in the bath
Bath time can be a time to learn in a fun way - see www.alextoys.com. There are loads of things you can use in the bath to learn skills: rub a dub hoops in the tub; squirty balls with a net; bath books - learning words while in the bath; fashion in the tub - foam people with items of clothes that you stick onto them, to learn items of clothing and where they go.
Does it really matter where?
Sometimes someone else’s bathroom or shower can be more attractive, or a paddling pool outside in the summer can be tempting. Have you tried going swimming?
Try using bath crayons, these are coloured soap shaped like crayons, really fun for bath time and encourage reluctant kids to wash themselves! You can often find these in chemists and toy shops.
Slide sheets have been a real benefit to us. We have a two way slide sheet for our Janey’s bath seat and a one way slide sheet for her chairs. They really help to lessen back strain for the carer as you are sliding your child rather than lifting. They can be obtained through the occupational therapist.
Don’t forget the professionals
For getting in and out of the bath, contact your paediatric occupational therapist, who has many solutions for motor skills and sensory problems which help with independence.
Bathing a “floppy” baby is a nightmare and should take two people. There are also baby accessories you can buy (which I didn’t know existed) in Mothercare, etc. that can help. Failing that get an occupational therapist.
Take the flow out of hair washing
The main problem during bath time is washing hair. Donny doesn’t like the water flowing over his face. There are little “face guards” available from Boots, Mothercare and Superdrug stores which are just rings that prevent the water splashing on his face.
Timing can be key
I started bathing Donny in the afternoon when he and I are both less tired - it makes it all so much easier.
Little by little/toy by toy
Jonty simply loathed baths, so I abandoned trying it for a bit, and instead I washed and wiped the essential bits and waited. A few weeks later I started putting some warm water and toys in the bath and he leaned over the side and played with them. After some tries at this he got in….(having agreed to take his clothes off first!)
Step it out - self prompts
John was having such a good time playing in the shower he kept forgetting to wash himself. My prompts through the door to wash were wearing thin so I got him to prompt himself. He shouts out which bit of the process he is doing and I find he actually gets washed properly this way. He said he felt a bit silly doing it at first, but now he is used to it and has added some humour to it. I am hoping that once the routine is properly established it can be faded to a silent narrative to himself.
A handful of oats takes the itch out
What do you put in the water? Some easily available kiddie bath products may be too smelly or sting the skin or make the bath slippery. A handful of oats in a square of muslin, secured with an elastic band and placed under the hot tap while the bath is run, will make the water feel soft and take the itch out of eczema.
Out of your depth!
Try changing depth - it could make such a difference. I know Sally likes a really shallow bath while her twin brother Tom likes a really deep bath.
Some like it hot
The temperature of bath water really has an effect. Lots of people with special needs find it very hard to regulate their own temperatures so you need to make sure you get it right. Ask your doctor.
Pump it or flip it
We use the pump action shower gel and also the same with toothpaste as this requires minimum co-ordination skills but gives some independence and as such confidence. If I can’t get a pump action topper I’ll get something with a flip top rather than a screw top.
Put a muslin bag of sage in the bath to help relax muscles.
Tina likes us to tell her well in advance what she is doing, so I tell her in plenty of time that bath time is coming up.
Nursingtimes.net is partnering with Netbuddy to update nurses with the latest helpful tips on caring for people with learning disabilities. Over the coming months, we’ll be publishing tips on nursingtimes.net and encouraging you to share your own ideas on www.Netbuddy.org.uk.
For more on learning disability nursing, see www.nursingtimes.net/nursing-practice/clinical-specialisms/learning-disability