Washing, bathing, personal grooming and dressing can become difficult for a person with dementia, and it is one of the most common issues raised when we talk to carers.
It can be a sensitive and personal issue for the person: as with so much related to dementia, the person has lost the ability to carry out simple tasks they used to find easy and do on their own. They may also not be comfortable with someone touching them or helping them with things that feel personal or intimate.
For you too, as a carer, it can be hard or upsetting to see the person go through outward changes in appearance and personal hygiene.
Often, reminding the person you are caring for how to wash or dress, can lead to stress, upset and arguments. So, thinking about the reasons the difficulties might be happening, can allow you to put in place practical solutions.
You should also remember that there may be other factors at play other than dementia, such as pain or tiredness.
Below are a few suggestions about what may help, but please ask for advice and support if you need it as there is no easy answer and what works one day may not work on another. It’s important that you share your concerns, so that you are not overwhelmed and can be reassured that you are doing your best.
Difficulties
Some of the difficulties the person might experience are as follows:
- Forgetting where things like clothes or shower gel are kept.
- Wearing clothes that are dirty, forgetting they have been worn before.
- Struggling to operate the shower or do up a zip.
Becoming stressed when trying to wash, dress or perform other personal hygiene jobs.
Practical ways you can help
- Lay out clothes the night before; or have a smaller collection of clothes on display.
- Take off wardrobe doors
- Collect up dirty clothes and put them in the wash.
- Lay out clean clothes.
- Put out clothes that are easier to put on, for example clothes with elasticated waists, without buttons or zips.
- Be flexible. If the person doesn’t like what you have put out for them to wear, try something else.
- Turn the shower on for them before they get in.
- Use simple instructions or demonstrate how to do something.
- Don’t rush.
If the person is having difficulty physically accessing the shower, then there may be pieces of equipment or adaptations that would help.
Some of these room adjustments are covered in our section on continence issues.
You can also read more about dealing with Everyday Challenges when caring for someone with dementia.
Making it as comfortable as possible
When dealing with personal care tasks, like helping the person wash or dress, it is important to make the experience as comforting as possible.
You can do this by using warm, soft towels, by playing music or dimming the lights and using a calm, soft voice.
Approach the conversation with care. If the person has started not wanting to wash or dress, then try telling them you’ve got them a nice new shower gel you think they’ll like, or a new shirt or tie bought especially for them.
Clothes, smells and accessories are part of our identity
It is helpful to remember the person’s identity when you are giving personal care like washing or dressing.
While it feels like nothing more than a practical daily thing, what we wear, what soap we use, whether we wear make up or jewellery is an important part of who we are.
This is no different for a person with dementia. So you can try laying out clothes they like to wear or help them put on makeup or do their hair if that is what they used to do for themselves.
Make it a joint activity. It is easier for the person to cope with the situation if they feel like they are part of it, rather than having something done to them.
This might mean giving them choices in what they wear or chatting through the steps with them.
If it becomes too much
While most of us view washing and changing our clothes each day as an essential task, for a person with dementia it may be better to take a more relaxed approach.
If the job has become very stressful one day and the person is resisting help, then maybe come back to it later or even the next day.
Equally, maybe you are having a bad day or feeling unwell, in which case, come back to the job the next day.
It’s OK if the person doesn’t wash or wears the same clothes for a day or two.
Although, there is a basic level of cleaning that we must all do to our bodies to keep us healthy, so if the job is becoming too much for you, you should ask for help from a relative or friend or from social services.
Social Services can help you to work out what the problems are for the person and come up with ways to help. They can also guide you on any equipment that might make things less difficult and how to access funding for it.
Quick look
Possible difficulty:
The person is wearing clothes again that they have taken off without realising they are dirty or have been worn before.
Things that might help:
Collect up clothes and put in the wash without making it obvious. Lay out clean clothes.
Possible difficulty:
The person realises that they can’t do the task like they used to, and are frustrated, and anxious about it.
Things that might help:
If possible make the task simpler by having clothes that are easier to put on, eg no buttons, and try elasticated waists. Be reassuring if you can and make the activity more fun by suggesting a pamper session or doing things together.
Possible difficulty:
The person needs help but won’t accept it from you.
Things that might help:
Can someone else help? Often people are more accepting of help from people they are not as close to. Do they need to do the task as often? Would they be able to have a shower every few days instead of every day?
Possible difficulty:
The person is struggling with operating the shower or co-ordinating putting on clothes, or following instructions.
Things that might help:
Gentle guidance, turn the shower on for them before they get in. Use lots of non verbal demonstrations and/or simple instructions. Allow time for someone to process each stage of the task, don’t rush.
Possible difficulty:
Physically accessing the bath or shower.
Things that might help:
Ask for an Occupational Therapy assessment from your memory team or from adult social care. There may be pieces of equipment or adaptations that would help.