My brother seems to be fearful of water now that his Alzheimer’s disease is progressing. How can I make him more comfortable at bath time?

Water is clear and invisible. Many individuals with Alzheimer’s no longer perceive water the way we do. It is unknown to them and a source of great fear.

Doctors recommend older adults have a minimum of two baths weekly to reduce chances of infection, but bathing remains one of the greatest challenges of caregivers for their loved ones.

Too often, caregivers start the bath by using a hand-held shower attachment, allowing the water to hit the head of his/her loved one before getting him/her directly under the water. That can be very disconcerting to an individual with Alzheimer’s, often scaring him/her and causing much resistance.

Instead, turn the water to low and using the hand-held shower attachment let it hit the feet first and then gently trickle over the hands, then the arms. Use a calm and gentle tone of voice while you are guiding and explaining your steps to him.

Let him know in advance when you are going to wash his hair, always starting in the back of the head, not the top or around the face. Depending on his capability, allow him to do as much as possible in washing himself.

If your brother is reluctant and resistant to baths, try to make it sound like a routine, something he has done every Thursday, for example. Once he concedes, you can offer him some positive reinforcement, such as going out for a nice breakfast or the treat of a favorite dessert.

Throughout the process, continue to praise and compliment him. This positive behavior modification can become a usual practice, thus reducing your brother’s fear of water and/or bathing.

Remember to have everything ready in the bathroom — soap, shampoo, towels, washcloth. Also, check the bathroom temperature and even put on some soft music. Further, you may want to have a scented candle, such as lavender, to produce a calming environment.

And, keep to your brother’s routine. If he bathed in the morning before breakfast, then stick to that schedule. If he was a shower person, then he should be able to get into the shower, unless there are medical or physical issues.

With practice and learning your brother’s likes and dislikes at bath time, you can help ease his anxieties and apprehensions.

Questions about Alzheimer’s disease or a related dementia disorder? Contact Dana Territo, the Memory Whisperer, director of services at Alzheimer’s Services of the Capital Area, (225) 334-7494, advice@alzbr.org, or visit the organization at 3772 North Blvd., Baton Rouge.