Dementia and Hygiene Issues: How to Ease Fears and Frustrations

It may start with a senior wearing the same clothes every day, refusing to change them even when soiled or stained. Or, maybe you’re noticing an unclean aroma whenever you’re near your loved one. Whatever the red flags may be, you’ve now entered the realm of dementia and hygiene issues – a common and often extremely challenging hurdle to try to overcome.

Your first response may be to approach the senior and kindly suggest, “Would you like to take a shower?” Yet this is rarely an effective tactic, for several reasons:

• It can cause the senior to feel defensive or offended. “I already had a shower!” the senior may angrily exclaim. And in his or her mind, the shower from last week occurred just a few hours ago.
• “Yes or no” questions are best avoided, or you’re likely to always receive a response of “NO!” One of a child’s first learned words is “no,” and in dementia, it’s one of the last words we retain. It’s the natural, instinctive response.

Instead, try saying something like, “Let’s get you fluffed and prettied up before lunch,” or, “Let’s make you look even more handsome than you already are!”

Once you’ve gained agreement from the senior, these additional tips can help make the process as successful as possible.

• Follow the senior’s pre-dementia routine. If the person likes to take a bath at night before going to bed, and can safely still get into and out of the tub with help, adhere to that schedule. If showering is safer now, at least stick to the same time of day the person is used to.
• Keep in mind that although we may think showering every day is essential, it’s simply not true, especially for older adults with fragile skin. Bathing two or three times a week is plenty. And if the senior is especially reluctant or fearful about bathing, push it back to just once a week.
• Create a soothing atmosphere in the bathroom. Play calming music that the senior enjoys. Make sure the room is warm, or the senior won’t want to get undressed. Have plenty of towels on hand to drape over the person for modesty.
• Let the senior remain as much in control as possible. In particular, if he or she is able, allow the senior to wash private areas to reduce feelings of vulnerability. Even if the person simply holds onto a washcloth or washes the forearm, there’s a degree of independence offered.
• Always begin at the feet and work your way up. Wash the hands and work your way in. Avoid using a shower sprayer on the person’s head, which can be especially frightening for someone with dementia. If you’re washing the senior’s hair as part of bathing, do this last, and use a cup of water, gently and slowly poured over the hair while the head is tilted back. The senior may want to have a washcloth over his or her face as well to keep the water off.
• The gender of the caregiver can make a world of difference in the senior’s comfort level. The majority of seniors are more comfortable with a female handling bathing tasks, but everyone is different. Find out what works best in your case.
• Try offering a treat during the bathing process. It may seem silly, but sometimes, the senior may be distracted enough by having a cookie to enjoy that it makes things go much more smoothly.
• Ask the senior for help; “I really need your help with this shower; could you wash your arm please?” Model for the senior how to use the washcloth, and then be sure to thank the senior afterwards: “I know this wasn’t easy; I really appreciate your help.”
• If a senior is really struggling with bath time, think outside of the box. A sponge bath can be performed while the senior is on the toilet, for instance, or even in bed.

Hygiene is often a key determinant in a senior’s overall health and wellbeing, and when hygiene habits are slipping, it’s always important to explore further to find out why. Check with the senior’s physician to see if dementia is the predominant factor, or if other health concerns are at play. Whatever the cause, always be mindful and sensitive to the discomfort that may accompany bathing assistance, and seek assistance from a trained care professional if the creative approaches above aren’t effective.

Contact Right at Home for a professional caregiver to help overcome dementia and hygiene issues. Our care staff are trained, experienced, and ready to help with compassionate dementia care in Sarasota, FL and the surrounding areas.