Bathing is a basic human need that results in good hygiene. However, there’s more to this activity than merely hygiene: bathing your child is a bonding experience, and you can use bath time not only as an activity but as an opportunity for a child with cerebral palsy to work on fine motor skills and relaxation techniques.
Set Out Tools First
When giving your child a bath, it’s important to start by setting out everything you’ll need before the bath. Tools that you’ll need for bath time include towels, a washcloth or sponge, soap (and possibly a soap dish), and shampoo. Make sure that all of these things are within reach so that there isn’t a single moment when you’re away from your child’s side.
Be Safe and Take Precautions
Soap and water make your child slippery, and because you’re spending so much extra effort making sure that your child is safe (not slipping, not bumping his or her head, etc.), you may end up injuring yourself either from a back injury or from slipping and holding your child up at the sacrifice of your own muscles.
To avoid these many possibilities, make sure that the bathing area has grip mats to avoid slipping. Cover any blunt edges (such as the edge of the bathtub) with rubber or with towels, and you may even consider getting kid-proof rubber coverings for the bath fixtures so that neither the child nor you have the risk of hurting yourselves on those edges.
You also may consider installing safety rails around the bathing area. Some safety rails can be drilled into the fiberglass of showers and into the drywall around bathtubs, whereas other safety rails depend on suction cups to stay up. The more permanent safety rails might be safer, but if you live in an apartment or have special circumstances, the suction cup rail is more temporary (and still safe).
Bath or Shower Chair
Part of being safe is looking out for your back as the caregiver. When you lean over so far and at such awkward angles, you can pull a muscle in your back –something that takes very long to heal and won’t heal if you’re continually re-injuring it through the same process.
Perhaps one of the best things for your back and for the child’s safety is to get a bath or a shower chair. Some special needs retailers also sell plastic bath inserts that resemble the same kind of plastic bath inserts that parents purchase for infants. This may be a great option for smaller, younger children.
No matter what bath or shower chair you select for your child, make sure that the cleaning area is elevated so that you are more comfortable and therein more safe. Also, if you’re using a bath or shower chair and bath time resembles more of a sponge bath than an immersion bath, you may want to consider having a bath sheet or extra large towel available. While you’re working on cleaning your child, he or she might experience a chill as the water evaporates, and you don’t want your child to catch a cold.
Lifting, Standing, and Sitting
Children with cerebral palsy struggle with the transition from sitting to standing (and visa versa). Because this lack of coordination is related to their disability, you can expect matching challenges when it comes to bath time. Before your child becomes too heavy to carry, you can lift your child in and out of his or her wheelchair and place him or her in the bath. But when the child is older, you and your child’s occupational therapist can work on getting your child to stand, be helped into the tub (safety rails again are very important), and to be able to sit in the shower chair or in the tub. Take this process slowly so that your child can feel relaxed, in control, and most importantly, safe.
Common in occupational therapy, children with cerebral palsy have a number of orthotic devices that help create overall strength, endurance, and eventually gait. Some of these orthotic devices can be removed for bath time, but some need to stay on. If the cast or orthotic device can’t be removed, it’s best to have a sponge bath. If the cast or orthotic device can be removed, make sure that the skin under the device is thoroughly dry before the cast goes back on.
Because bathing can be a long process, use your time wisely. Speak to your child’s occupational therapist about simple exercises that he or she can do for strength training and stretching. But if your child is sitting and merely bonding with you while you take care of him or her, try another approach: quiz your child with brain and speech exercises as well. You can test your child on information that he or she knows (this depends on what level that he or she is at, but you might quiz on what day of the week it is or what month it is), or while you’re speaking, you can get to a word that you know your child doesn’t know and you can work on practicing speech for that word and defining it.
If your child is in occupational therapy, you know that one of the reasons your therapist works so hard with your child is because you want to create independence through walking, which will eventually lead to independence in other respects. If your child is progressing in therapy and you think that he or she can manage a sponge bath alone, give it a shot. A sponge bath is safer than a full bath because there’s less of a risk of stumbling, slipping, or falling.
Additionally, a sponge bath is a form of exercise: stretching to reach around body parts and the coordination to keep up a consistent wiping movement. If you’re not sure if your child is ready for this independence, ask your child’s occupational therapist for a realistic estimate.