Dementia can profoundly impact daily life and make routine tasks challenging. Cognitive impairments associated with dementia, such as memory loss and confusion, may disrupt a person’s ability to independently maintain proper hygiene. For example, they may forget to bathe, brush their teeth, or wash their hands. If their mobility and physical coordination are impaired, it may be difficult for them to carry out these activities by themselves, leading to feelings of frustration and further neglect of personal hygiene. Furthermore, their awareness of their hygiene may be diminished, causing them to unknowingly neglect their personal care routine. These challenges can negatively impact physical health and contribute to further emotional distress. Addressing these issues with sensitivity and respect is essential for maintaining the dignity and well-being of individuals living with dementia.
Caregiver Roles Helping Maintain Proper Hygiene
As dementia progresses, individuals often need more help with routine activities, such as bathing and dressing. It may be difficult to accept help with such intimate tasks, with some people feeling self-conscious or frustrated about needing assistance or about losing their independence. Therefore, it is important for caregivers to support those living with dementia by helping them accomplish those tasks while respecting their privacy and dignity. If the person living with dementia already has a personal care routine, it may reduce their anxiety for their caregiver to follow it to prevent confusion and allow them to maintain their autonomy. For example, if the individual likes to wear their hair a certain way or prefers showers to baths, it is best to respect their wishes.
Routine activities, such as bathing, dressing, and toileting, can cause anxiety and discomfort for both the person with dementia and their caregivers. Below are suggestions for how caregivers can care for their clients in a more comfortable and enjoyable manner.
Hand Washing
Hand washing is a crucial aspect of personal hygiene for people living with dementia, as it helps protect against infections and maintains overall health. Due to potential cognitive changes, individuals with dementia may struggle to remember the steps or the importance of hand washing, especially before meals and after using the restroom. Caregivers should remind their charges to wash thoroughly, and should watch them to ensure that it is being done properly. If the individual prefers a scented soap, that may be all that is required to entice them to use it. In general, though, a soap dispenser may be a better solution for people living with dementia who don’t remember how much soap to use. Still, they should be reminded of the necessary steps to sanitize their hands. Establish a routine that feels familiar and comfortable. Consistent hand washing helps reduce the risk of illness and cross-contamination, which is essential for the individual’s health and also helps prevent the spread of infections in their living environment.
Bathing
People living with dementia like consistency. Scheduling bathing at a fixed time of the day and developing a routine can be comforting for them. Allow the person with dementia to participate in decisions whenever possible. Many may feel sensitivity to the temperature of the water or the sensation of it against their body. Be patient, allowing them to choose the water temperature, and accommodate their preferences. If they are not able to tolerate the sensation of water hitting their body in a shower, allow them to take a bath. If they don’t like the feeling of a bath, allow them to take a sponge bath. They may not remember how to bathe properly – or completely – so talk them through the routine. If they forget where they are in the process, give them guidance. Even if the person cannot fully wash themselves, letting them have some role in the bathing process can make them feel more comfortable and in control. When washing them, it is important for caregivers to clearly explain what they’re doing, so that a sense of control and participation is maintained for the person with dementia. Mind their need for privacy, but also recognize that they may have issues with balance. Employ a chair if necessary. Remember that people living with dementia may not recognize all the signals that their body is sending them, so be mindful of the water temperature shifting, and make sure that the environment in the bathroom is comfortable.
It is recommended that individuals bathe at least two or three times a week. However, it is up to the caregiver to decide how frequently their care recipient bathes, considering how the individual responds to bathing and if more frequent bathing may cause too much emotional distress. When a full bath or shower isn’t possible, a sponge bath over the key areas of the body (e.g., face, hands, feet, and private regions) may be a good substitute.
Toileting and Incontinence
Going to the bathroom and managing incontinence can be challenging for individuals living with dementia. To reduce the occurrence of bathroom-related accidents, caregivers should remind their care recipients to use the bathroom once every two hours or before they go out. Additionally, they should look for cues that the individual needs to use the bathroom so they can guide them there in time. These nonverbal expressions may present as restlessness, changes in facial expressions, and pacing around the room. It is important that the bathroom is easy to find, well-lit, and free of obstacles to increase ease of access for the care recipient. If accidents occur, caregivers should remain patient, compassionate, and respectful throughout the process to minimize anxiety and embarrassment for those in their care. For those with incontinence, it may be useful to consider incontinence briefs and underwear, absorbent pads, and protective bedding.
Handling resistance to hygienic practices
Sometimes, individuals with dementia may be resistant to good hygienic practices. In such circumstances, handling resistance requires patience, empathy, and creativity. It may be helpful to offer the person a couple of choices, such as whether to bathe now or in fifteen minutes, or whether to use soap or hand sanitizer. These options offer a sense of control and autonomy over the individual’s routines. Additionally, breaking tasks into smaller steps and guiding the care recipient through each one, while simultaneously providing encouragement and praise, can further help. Sometimes, distractions may be necessary to make the process less stressful, such as talking about their favorite TV show or sports team. Above all, it is essential to remain calm and patient, and recognize that resistance often comes from confusion or fear. These strategies can help maintain the dignity and comfort of individuals living with dementia while ensuring their hygiene needs are met.
Takeaways
Maintaining good hygienic practices for people living with dementia is a challenging but important task. Personal hygiene is essential for both physical and emotional well-being, as good hygiene can lower risks of infections, skin irritations, and other health complications. Further, feeling clean can improve an individual’s mood and self-esteem. Establishing routines, encouraging independence, and gently guiding individuals through hygiene practices can help them go through their days with more comfort and confidence. Occasionally, individuals with dementia may have accidents or refuse to maintain their hygiene. In these instances, caregivers should remain calm and understanding, while closely working with their care recipient to ease their anxieties and provide comfort. By adopting these practices and attitudes, caregivers can create a supportive and nurturing environment that ensures proper hygiene and respect for the dignity and needs of individuals living with dementia.
Sources
The Impacts of Personal Hygiene on Your Health | InnerBody
Alzheimer’s Caregiving: Bathing, Dressing, and Grooming | NIH: National Institute of Aging
How does dementia affect washing and dressing? | Alzheimer’s Society
Daily Care: Bathing | Alzheimer’s Association
Personal Care: Toileting and Incontinence | Alzheimer Society
