It is common for people living with dementia to forget about their personal hygiene or have difficulty maintaining it.
Some people will need support and help with personal hygiene. They may need time to adjust to receiving help, particularly when the support feels quite intimate or personal.
Try to calmly work out ways to help, using the tips below.
Possible causes of problems with bathing
Privacy
Washing and dressing are intimate, private activities. Undressing in front of someone may cause the person to feel embarrassed or humiliated by their need for assistance. They may feel particularly embarrassed if they are incontinent, and refuse to bathe or change their clothes to try and cover up their incontinence.
What to try:
- Be patient and offer reassurance.
- Create privacy by pulling blinds or closing curtains and doors.
- Cover mirrors if they don’t recognise themselves.
Environment
The person with dementia may feel uncomfortable. The room might be too hot or cold, or too dark.
Changes to the person’s routine, such as when and how often to wash, can be unsettling. Recognise that someone’s habits may differ from yours and do not impose your own personal values.
What to try:
• If you can, ask the person:
- What time do you like to shower or bathe? Try to be consistent with the person’s routine before they were diagnosed with dementia.
- Would you like a bath, shower or sponge bath?
- Does the room feel comfortable?
- Is the bathroom temperature too warm or too cold?
- Is the lighting bright enough, particularly at night?
• Soft background music might be calming and relaxing.
Complex tasks and changed sensations
Getting undressed, having a wash and brushing teeth can be very complex tasks for a person with dementia, because each of these tasks involves many steps.
A changed sense of perception around hot and cold water is common. This is caused by damage to the part of the brain that regulates a person’s ‘internal thermostat’.
Running water may feel different to how it used to.
What to try:
- Break down tasks into simple steps. Explain each step using simple, respectful language.
- When asking questions, offer limited choices. You could say: “Would you like to have a bath or a shower?” or “Would you like to have your bath now or before bed?”
- Let the person feel the water before a bath or shower. Sometimes gently pouring water over their hands or your own hands offers reassurance that the water isn’t too hot. You could also say “the water feels nice” or “this feels good”.
- Encourage the person to undertake as much as possible themselves.
- Lay out the soap, face washer, towel and clean clothes in sequence, so that they can be used as needed.
Fear or concerns
Consider the person may have some concerns such as:
- how deep the water is or its temperature
- fear of falling
- feeling out of control or powerless
- fear of drowning, particularly if water is running over their head.
What to try:
- Run the bath ahead of time. Check the water level. Some people prefer only a shallow bath; others prefer a deep bath.
- Separate hair washing from bathing. Some people with dementia become upset having their hair washed; it frightens them to have water poured over their head.
- Consider changes to the bathroom such as installing a hand-held shower head, bath rails, or both, to make things easier.
- Try washing from a basin, rather than a bath or shower.
Other hygiene issues
Toileting
A person with dementia may need help with toileting. Ensure they are clean and dry, and that underwear is changed as needed. If they are incontinent, make sure that they are washed carefully with warm water and dried thoroughly before putting on clean clothes.
Shaving
At first you may simply need to remind the person with dementia to shave each day. If using an electric razor, shaving may continue unsupervised for longer. If the person uses a traditional razor and is beginning to cut themselves regularly, you will need to supervise shaving or even do it for them.
Ears
A build-up of earwax can lead to hearing problems. Speak to the doctor about the best way to treat earwax.
Changing clothes
Changes of clothes are important for hygiene and personal freshness. Encourage the person to change regularly. You could try tactfully removing dirty clothes at the end of the day and substituting clean ones. To ease the workload, try to choose clothes that wash easily and need little ironing. Most people enjoy being complimented on their appearance, especially when wearing new clothes. It is important someone with dementia experiences this.
Dental care
You may need to remind the person to clean their teeth, or clean their teeth for them. You may need to remind the person to clean their teeth, or clean their teeth for them. Regular visits to the dentist are important. Advise the dentist when you make the appointment that the person has dementia and may find it difficult to cooperate.
Fingernails and toenails
Someone living with dementia may forget to cut their nails or have difficulty cutting them. Because uncut nails can lead to problems, it is important this is done regularly. It may be useful to see a podiatrist. If you can, ask the person if they would enjoy a professional nail manicure.
Hair
Washing hair can cause distress. Find a solution that is comfortable for the person. If you can, ask them what they would like. Try visiting a hairdresser or invite a hairdresser to come to the house. Many people with dementia enjoy having their hair cut and styled, and this can continue to be a pleasurable experience.
Where to get help
- National Dementia Helpline is a free telephone service that provides information, advice, counselling and carer support. Ask about support groups and programs for family and carers.
Call: 1800 100 500
Visit: dementia.org.au/helpline - Carer Gateway provides free practical information, resources, education and counselling to support carers.
Call: 1800 422 737
Visit: carergateway.gov.a