¶ Introduction
Bathing is an essential part of maintaining personal hygiene. Early ALS progression poses certain challenges that can be overcome by using adaptive equipment. Eventually, an attendant may be needed to provide assistance in the shower, or by sponge bathing in bed.
¶ Ingress, Standing and Seating
Entering and exiting a bathtub can be challenging, even for those without mobility issues. Properly positioned grab bars and transfer poles can help facilitate these movements safely, but their effectiveness is reduced if grip strength is weak.
It is advisable to maintain three points of contact at all times while entering or exiting the tub, moving only one hand or foot at a time.
Standing in the shower long enough to wash properly can become difficult once weakness develops in the lower limbs. The muscles in the feet and ankles work continuously while standing, which can lead to fatigue. Leaning against a wall may offer some temporary relief, though this should not be relied upon as there is an increased risk of falling.
Shower chairs and benches help avoid having to stand while showering. Wide benches also make transferring into and out of the tub easier, as one side remains outside of the tub.
Shower bench, with cushions
Lower limb weakness which has advanced to a point where sitting and standing from a bench becomes too difficult necessitates the use of lifts, along with this shower area that is able to receive a wheeled shower commode chair. Many individuals will resign from showering at this time, and instead resort to alternate methods of getting clean.
¶ Washing
¶ Showering
An individual that has good use of their arms and hands should have minimal difficulty showering, whether from a seated or standing position. Hand, arm, and shoulder weakness makes gripping cleaning products difficult, along with reaching the top of the head and other parts of the upper body. Further weakness will require assistance from another person. Alternative methods and adaptive equipment for such difficulties are limited.
An attendant can assist with getting clean when it is no longer possible to do so independently.
¶ Sponge Bathing
Sponge bathing, also known as bed bathing, refers to being bathed by an attendant while lying in bed or on a similar surface, typically by using wet washcloths.