Bathing and all aspects of personal hygiene, become more difficult for people living with dementia as the disease progresses.
This page looks at some of the barriers to personal hygiene, the consequences caused and what can be done to help support people to maintain a personal hygiene regime.
Obstacles to bathing & personal hygiene
- Lack of interest / awareness.
- Room to hot / cold.
- Water temperature.
- Unable to get into / out of bath.
- Fear of slipping.
- Problems with depth perception – may fear water is too deep.
- Often don’t like water on face i.e. from overhead shower.
- Unable to locate bathroom.
Consequences of poor personal hygiene
- Increase risk of skin problems and rashes.
- Increased risk of urinary infections.
- Body odor.
What can be done to support people maintain good personal hygiene?
Washing and bathing is a very personal activity and any help and support given must to be done so with tact, respect and dignity. Other ways to help are:
- Explain each step in the process.
- Make sure the room is private i.e. curtains drawn.
- Make sure room / water temperature is comfortable.
- Fit grab rails / slip mats.
- Run a shallow bath and top up later if required.
- Be organised so you don’t have to leave the room.
- Be sure not to get shampoo in eyes.
- Be sensitive to their feelings.
- Consider preferred routine i.e. bath or shower & type of toiletries used.
- Hand held showers may be better to avoid water falling on face.
- Make sure they are comfortable with the person giving support i.e. gender preferences.
- Encouraging them to bathe themselves, by showing them how, may reduce embarrassment.
- Do not rush them.
- Be ready with towels / dressing gowns to keep nakedness to a minimum.
- Make sure they are fully dried.
The problems with bathing we experienced with Mum
Before her illness Mum had liked nothing better than soaking in a hot bath but she became very reluctant to take a bath from very early in her illness. The main problems highlighted below:
- Mum struggled to get into and out of the bath.
- Even with slip mats she would often slip trying to get out and when this happened she would ‘freeze’.
- Hated it if the room was cold and would refuse to undress (quite rightly).
- Certain amount of apathy, just seemed like to much trouble.
- Had no awareness of time so wasn’t aware when she had last bathed.
- Had lost her sense of smell so wasn’t aware of body odour.
While she was living at home we never forced Mum to have a bath, but when one was due we would ask her numerous times a day hoping to catch her in the right mood. We also persuaded her to shower a couple of times (something she would never have previously have done) as it removed the problems getting in and out of the bath. We also made sure that the house was warm and that we had warm towels ready, for the times you did catch her in the right mood!!!!
In the later stages of the disease, bathing will become more and more difficult. Once this happens try to be realistic about how often bathing is required, certainly not every day. Also consider alternatives when met with resistance, like a sponge wash, rather than a bath. There are also products available such as ‘dry shampoo’ and ‘body wipes’ which can be used without water – see products & devices for daily living for more details.
For more information the Alzheimer’s Society has produced a very useful fact sheet.