The majority of individuals regard daily bathing as a crucial element of personal hygiene and health. The focus of this discussion is on the “elderly bath,” a topic often met with contention within families. Adult children of aging parents frequently express concern when they discover their parents are bathing less frequently. It’s a common occurrence for older adults to reduce their bathing frequency. Interestingly, there is no official recommendation from any authoritative body regarding the frequency of baths. Despite conducting a thorough search, we found no research paper attempting to establish a correlation between bathing frequency and health outcomes. In fact, medical journals and doctor blogs often contain recommendations to bathe less frequently in certain cases. This led us to share our experiences and thoughts on the bathing frequency among older adults.

  • Roshan J Mundapallil, Sowmya Lakshmi

The source of disagreement centred around bathing. Sateesh elaborated on his mother’s usual routine, expressing concern about her reluctance to bathe while finalising the admission formalities for our skilled nursing home. “For about 30 years, my mother’s weekday mornings followed a consistent routine: shower, shampoo, dressing, makeup, feeding her pet cat, preparing breakfast, and then leaving the house. Even on weekends, she adhered to the shower, shampoo, and cat care routine,” Sateesh explained his mother’s typical schedule.

“After she retired – I can’t pinpoint the exact time, probably two or three years ago – she suddenly decided to irregularly shower one fine morning. Her bathing routine became unpredictable. It was surprising for all of us, given her typically fastidious and meticulous nature. Nowadays, she gets irritated and upset when we try to persuade her to bathe. Convincing her to take a bath has become a real challenge. Even my children complain about grandma having a noticeable odour,” Sateesh elaborated on the difficulty of getting his mother to bathe.

Sateesh found himself pondering over his mother’s changes and began questioning.
• Why is my mother showering less frequently?
• Why does my mom resist taking showers?
• Why has my mom seemingly lost interest in her appearance?

Here are five potential explanations.

Autonomy: As your parents age, they encounter a diminishing sense of control over various aspects of their lives. However, choosing to shower remains one decision they feel they can make.

Apprehension: The fear of falling in the shower and sustaining injuries can deter many elderly individuals from bathing altogether.

Diminished Sense of Smell: Aging leads to a dulled sense of smell. Your mom or dad may not detect odours, hindering their realisation that it’s time to shower.

Memory Challenges: Seniors may struggle to keep track of the days and the duration since their last bath.

Depression: A decline in interest in personal hygiene might be linked to depression. Seeking advice from a doctor is advisable.

Motivating your aging parents to take a bath can present a considerable challenge. Many family members express concerns about their loved ones developing strong body odours, urinary tract infections, or skin infections if they don’t bathe daily. Given the struggles associated with bathing your loved one, the question arises: is daily showering truly necessary? What expectations should you have for your parent and yourself? In the absence of an evidence-based answer, we can, at the very least, consider what’s considered normal and optimal based on our experiences. We would like to quote a survey, and it points that more than one out of four American’s don’t bathe daily. This varies by country. More Australians and French bathe daily than Americans. However, people of the UK, the Swedes, and the Germans bathe less than Americans. In fact, the majority of German men don’t bathe daily. What is the most bathed country? Nearly 90% of Mexicans bathe daily, making them the most bathed people. In India, except few states, there is no such thing as ‘daily bath’. This statistics, is not age-specific.

Like Sateesh’s mother, bathing is a common struggle between elders and caregivers. Getting an older adult to bathe is a struggle for many family caregivers. The biggest worry is that not bathing will cause skin or urinary infection. Seniors might also get itchy or develop strong body odour. But how often should seniors bathe to prevent health problems?

The American Academy of Dermatology says that small children and the elderly need to shower less often. The skin of small children is more delicate and elderly skin is naturally drier. The general ‘rule’, says under normal circumstances, elders are fine bathing once or twice a week. But we have a very different take on this. Our recommendation is to have daily bath, or at least alternate days. Again it depends on many factors. Before coming to these factors, we would like to list out the probable reasons for an older adult to refuse a shower.

Many reasons contribute to the reluctance for an elderly loved one not bathing. Here, we are listing few such reasons:

  1. Worried about cost – few elders may have a limited budget which simply doesn’t extend to paying for frequent baths/showers and grooming supplies
  2. Water scarcity- severe shortage of water made them feel to preserve
  3. Lethargic – may elders do have lethargic and unmotivated existence and doesn’t do much, leading to boredom, and one day will just drift into another, and they may simply forget that it has been some time since they bathed
  4. Self imposed isolation – when an older adult doesn’t get out much and see other people, they can feel that there isn’t much point in keeping up appearances
  5. Excuse as time constraints – it is natural in old age to a bit slowing down but they will still have most of the same chores time and again, and so they will have to pick and choose what the priorities are, and bathing, maybe it isn’t one
  6. Fear of catching flu – due to weak immunity, the elderly are susceptible to cold more easily than young adults, and this can be a reason for them avoid bathing
  7. Tiredness – most elders say they are too tired to take bath
  8. Fear of fall – the bathroom is the most dangerous place in the house, with the chance of 80% of falls occurring, and you loved one may be afraid of having a mishap, so may be avoiding bath
  9. Embarrassment – Many elders cannot take bath on their own, but that they feel it is demeaning to seek assistance.
  10. Pain associated with a few conditions – few conditions such as arthritis, or other knee and hip problems, can make stepping in and out of the shower, or bathtub , or even just moving around, too painful for a frequent regime of washing
  11. Depression – this is another factor contributing to avoiding their interest in bathing and other personal grooming tasks
  12. Dementia – people suffering from Dementia/Alzheimer’s not even know how to perform the what were once the easiest of tasks
  13. Impaired eye sight and hearing – loss, or partial loss, of sight or hearing can lead to a person having to move more slowly so as not to hurt themselves, and one such task is bathing which needs preparation, so elders avoid this altogether or being done less frequently

Remember, Sateesh’s daughter complaining about ‘grandma’s bad odour’. Let’s know about the ‘science’ behind this. After the age of 40 or so, our skin produces less antioxidants, and this can lead to our body odour changing. You cannot mistake this as sweat, which produces normal body odour, but rather on the skin itself. The lipid acid, which is naturally on our skin, oxidises and forms a new chemical compound called ‘Nonenal’.

Unlike, the Sweat (apocrine and eccrine) glands which secrete “sweat”, sebaceous glands which produce lipids which oxidises with oxygen in the air, and are converted into an organic compound, Nonenal, which has a unique repulsive smell. As our skin’s anti-oxident defences naturally decreases with age, Nonenal formation happens resulting in the odour. The fatty acid (lipid) properties makes it insoluble and therefore remain in the skin despite intense scrubbing. This also explains why Nonenal persists even in the cleanest environments.

We’ve compiled a list of benefits that bathing can offer to the elderly, providing compelling reasons to indulge in a soothing bath.

Brief Respite for Aching Joints:

If you experience stiff joints or conditions like arthritis or lower back pain, a warm bath can provide temporary relief. The warmth promotes improved blood circulation, facilitating better flow throughout the body, which, in turn, helps loosen joints and muscles. If stiffness is a common issue for you or cold weather affects your joints, opting for a bath can be an excellent choice. Ensure the water temperature is not too hot to avoid scalding, with the recommended bath temperature between 33 and 37 degrees Celsius. For those with arthritis or mobility concerns, a bath lift can be beneficial, offering a secure way to enter and exit the bath, ensuring a safer and enjoyable bathing experience.

Improved Sleep Quality!

Sleep disorders aren’t a typical facet of the aging process, though their frequency may increase with age. The significance of sleep for both your physical and emotional well-being remains unchanged from your younger years. A restful night’s sleep plays a vital role in enhancing concentration and memory formation, facilitating the repair of cellular damage from the day, and revitalising the immune system, contributing to disease prevention. Complaints about sleep are a common concern among older individuals.
Many of us find solace in a warm bath before bedtime, and here’s why it might be beneficial for a better night’s sleep. Achieving a good night’s sleep can often feel like a daunting task, with constant tossing and turning extending the wakefulness.. It’s a vicious cycle, isn’t it? Taking a warm bath before bedtime is suggested to aid in faster sleep onset. The warmth of the water contributes to regulating body temperature, initiating a cooling effect and enhancing blood circulation. This, in turn, triggers signals to the brain, prompting the production of the sleep hormone melatonin, facilitating a more restful sleep.
For optimal results, aim to take a bath approximately 90 minutes before bedtime to avoid heightened alertness. Give it a try and observe if your sleep quality improves!

Enhances Emotional Well-being

Indulging in a bath can serve as a mood enhancer! The warmth of the water has a calming effect on the nervous system, effectively reducing stress and anxiety levels in the body. This, in turn, contributes to an uplifted mood. It’s proven that taking a break also plays a significant role in improving one’s emotional state. Whether you’ve had a bustling day with grandchildren or errands, it’s easy to overlook the need for a break. Allocating time for yourself in the bath provides an excellent opportunity to step away, unwind, and alleviate stress.

Decrease Swelling & Inflammation

Indulging in a bath can offer temporary relief by reducing swelling and inflammation, particularly in the feet or ankles. The warmth of the bathwater encourages blood vessels to dilate, promoting improved blood circulation. A commonly employed remedy involves the use of Epsom salt. Comprising magnesium and sulfate, Epsom salt is believed to eliminate toxins responsible for inflammation in the body. Bathing with Epsom salts not only addresses swelling and inflammation but also provides additional benefits, including stress reduction, promotion of foot health, and skin soothing effects!

Even though most of us are used to showering every single day, it’s not a strict requirement for good health. At a minimum, bathing once in two days helps most seniors avoid skin breakdown and infections. We recommend to use warm washcloths to wipe armpits, groin, genitals, feet, and skin folds also helps minimise body odour in between full baths. We asked our caregivers their opinion and majority say it’s actually easier to bathe everyday. According to them, when bathing becomes part of someone’s regular daily routine, they’re much less likely to resist. Actually, the older patients who are in our care wait for bathing and don’t like to miss. Of course, it’s essential to take your older adult’s specific health conditions into consideration when choosing a bathing schedule. Some people may need to bathe more frequently than others for medical reasons.