Dementia - hygiene

Day-to-day tasks like washing, brushing our teeth and going to the toilet help keep us healthy and comfortable. But if someone you care for lives with dementia, they might find it hard to maintain their personal hygiene.

Here are some ways to help. These are intimate and sometimes embarrassing tasks, so the person living with dementia may need time to adjust. Stay calm and patient. Offer reassurance as you go.

Supporting personal care

We all have our own preferences and habits when it comes to our personal care. For example, you might like to have a shower before you go to bed each night, but dislike baths. Ask the person you care for about their routine and try to continue it, even if their habits are different to yours.

Encourage the person to do as much as they can themselves. These can be complex activities with multiple steps, so you might need to support them through the process. You can:

• break down the tasks into simple steps and go one at a time
• explain each step using simple, respectful language
• offer clear questions with limited options, like “Would you like to have a bath or a shower?” or “Would you like to have your bath now or before bed?”
• lay out the equipment for the task in the order that they’ll be used. For a shower: lay out the soap, face washer, towel and then clean clothes.

Washing, baths and showers

Bathing can be a particularly tricky task for someone with dementia. They might:

• feel embarrassed about undressing in front of someone else, particularly if they’re experiencing incontinence
• find the room too hot or cold, too bright or dark
• find reflections in mirrors confusing or disturbing
• feel water temperature and the sensation of running water differently than they used to
• feel scared: of falls, deep water, the intense physical sensations involved, or something else.

These are some things you can try:

Provide privacy

• Make sure the person with dementia is comfortable with you being there. Ask them how they’re feeling and what support they need.
• Pull down the room’s blinds or close curtains and doors.
• Cover any mirrors if they don’t recognise themselves.

Create a comfortable environment

• Ask the person with dementia whether the bathroom temperature is too warm or too cold.
• Check that the lighting is bright enough, particularly at night.
• Let the person feel the water temperature before their bath or shower. Sometimes gently pouring water over their hands or your own hands is reassuring, letting them know that it’s not too hot.
• Play soft background music, as this might be calming and relaxing.

Address any fears

• If they’re having a bath, run it ahead of time. Check the water level. Some people prefer a shallow bath, while others prefer a deep bath.
• Install handrails and a hand-held shower head to make bathing safer and easier. You could also use a shower seat or bath seat.
• If hair washing is upsetting for them, separate it from bathing. You could try visiting a hairdresser or asking a hairdresser to come to the house, if this is something they enjoy.
• Try washing from a basin, rather than a bath or shower.

Going to the toilet

If the person with dementia needs help going to the toilet, make sure they’re clean and dry, and they change their underwear when they need to.

For more on this, see Dementia Australia’s Continence page.

Shaving

If the person is used to shaving, consider encouraging them to use an electric razor, as this is safer than a traditional razor. If they use a traditional razor and start cutting themselves, you may need to help them shave.

Cleaning teeth

You might need to remind the person with dementia to clean their teeth or dentures, or you might need to brush them for them.

For more on this, see Dementia Australia’s Dental Care page.

Cutting and cleaning nails

Uncut nails can cause problems, but the person living with dementia may forget to cut them or may find it difficult. These are some things you can try:

• Ask if you can cut their nails for them.
• Make an appointment to visit a podiatrist.
• Organise a professional manicure if it’s something they enjoy.

Ear care

A build-up of earwax can be a problem for some people and can lead to unnecessary hearing impairment. Speak to the person’s doctor about the best way to deal with earwax.

Changing clothes

Clean clothes help with hygiene and freshness, but dementia can affect someone’s ability to dress and undress themselves.

For more on this, see Dementia Australia’s Getting dressed page.

It’s okay to take care of your own health and happiness. If you're struggling, contact the free, confidential National Dementia Helpline on 1800 100 500, any time of the day or night - for information, advice and support.

Equipment and support for carers

Helping people with dementia to manage their hygiene and personal care can make everyday life harder. It’s essential that carers prioritise their own well-being and develop a self-care plan. Talk to family, friends, or your doctor for ideas. You can also call the National Dementia Helpline anytime, on 1800 100 500.

As well as a listening ear and expert advice, carers can access tools, aids and technology that can make it easier to do everyday tasks. Visit Dementia Australia’s Tools and aids to help at home page.

Hold the moment podcast: How to avoid carer burnout

Caring for a person living with dementia can be all-consuming. While you’re busy caring for others, remember to care for yourself as well. Hold the moment podcast has a useful resource you can listen to on avoiding carer burnout.

Where to get help:

• Your GP
• The National Dementia Helpline: free telephone support for people living with dementia, and their families and carers – available every day, anytime, 1800 100 500
• Carer Gateway: emotional and practical services for carers.