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Caregiving Challenges: Bathing and Personal Hygiene

As Alzheimer’s progresses, poor hygiene can often become more than just an unpleasant issue. It can have medical consequences, such as bacterial infections including UTIs. Gastroenteritis and other health issues can also occur, some quite serious to an immune system weakened as Alzheimer’s progresses.

Because Alzheimer’s is a steady deterioration of cognitive functions, a person with dementia will start to get confused about seemingly simple behaviors such as how to wash his or her hair. Perceptions will start to be impacted. A tub of water can become scary as the ability to perceive depth is lost. Mirrors can create a sense of strangers being present in the bathroom. A smelly shirt may be more comforting than a freshly laundered but unfamiliar replacement. A person with dementia may be overwhelmed by everyday products on the bathroom counter, perhaps using a hair product as toothpaste.

Understanding that your loved one’s perceptions are increasingly distorted by the disease’s progression and focusing on creating positive routines may help you as the caregiver deal with these difficult behaviors.

Bathing and Hygiene
Focus on “must do’s” to keep your loved one healthy while maintaining his or her dignity. A daily bath or shower really isn’t necessary as long as there is good hygiene after toileting and genitals are sponged daily. However, some caregivers do feel that an everyday bathing schedule is easier because a person with dementia can become familiar with the routine.

A bath or shower should be quick and efficient. Building positive associations, such as offering an after-bath ice cream treat, can help. Many caregivers use toileting as a starting point by removing the loved one’s clothing while they are on the toilet each day.

Be prepared for the bath prior to bringing your loved one into the bathroom. Running water may be frightening. Have it ready, along with towels and products. Cover mirrors if necessary. Use a small amount of water, and make sure to use a non-skid safety mat. If using a shower, use a hand-held showerhead so that the water isn’t falling down on your loved one, which can be disorienting. Playing some calming music can be helpful, or try singing your loved one’s favorite tunes. Give your loved one a washcloth and get him or her involved in the cleaning process. Some spouses take their shower with their loved one, enlisting the “watch me” and “do what I am doing” method. Have a comfy robe and fluffy towels nearby, and keep the room temperature warm.