At some point, people with Alzheimer’s disease will need help with personal hygiene — from bathing and grooming to getting dressed and following basic self-care routines. The trouble? Your loved one may not want help with these personal everyday activities. They may feel vulnerable or embarrassed about being naked in front of caregivers or frustrated and angry that they can’t perform these private activities independently. But there are ways to support them while keeping them comfortable and protecting their dignity.
The Alzheimer’s Caregivers Network asked the caregiving community to share their best tips for helping a loved one with personal hygiene activities. Read personal experiences and advice directly from caregivers and experts:
Yelena Sokolsky is the CEO and Director of Patient Services at Galaxy Home Care. She offers caregivers tips for helping a loved one maintain hygiene when they are bedridden and unable to bathe, groom, and dress on their own:
“Providing proper care and attention can help seniors (bedridden, suffering from dementia, or otherwise) maintain their hygiene and improve their quality of life. Being patient and compassionate in assisting them with these tasks is important, as they may feel embarrassed or uncomfortable. A little kindness can go a long way in making them feel clean and refreshed, which can also positively impact their physical and mental well-being.
She offers these ways to assist a loved one in staying clean and fresh:
- “One effective method is to use a sponge bath or moist towel to clean their body while in bed and use a mild and non-irritating soap to prevent skin irritation. In addition, a shower chair can be used to help them bathe.
- It is also important to moisturize their skin with lotion and body powder to keep it hydrated and healthy.
- Regularly trimming their fingernails and toenails will prevent scratches, and combing their hair will keep it neat and tidy.
- To maintain oral hygiene, caretakers should support patients as they floss and clean their teeth twice a day.
- Furthermore, changing their bed linens every 2-3 days is essential to prevent the accumulation of sweat, dead skin cells, and food crumbs.
- Another vital part of their personal hygiene routine is changing their diapers. It is recommended to have medical gloves, a pack of clean and highly absorbent adult diapers, pre-moistened wipes, a diaper rash cream, and a waterproof mattress protector on hand for this task.”
Ashley, the founder of The Dementia Guru, says creating a calm and relaxing atmosphere is helpful and that creating an inviting mood for your loved one is key. She offers these tips:
- Try warming the water ahead of time
- Try playing music that will be inviting to your person (based on their music preferences)
- Try lighting good + relaxing smelling candles/aromas
- Try offering a special snack that your person likes and might encourage them to engage
Shar offers caregivers this advice from her experience caring for her mother:
“Don’t give too many choices. Encourage them to do what they can and be ready to assist without shaming them. Find humor in the situation, like making them laugh when something gets put on backward. They know when it’s backward but can’t put the piece to the puzzle to fix it — that’s why we are here. Make light of it and just help. We have had some comical happenings; thank the Lord, my mom is a good sport. If I make her laugh, it’s a good day. Dressing and her hair are usually her biggest issues but gone are the days of her fussing about her hair — now it’s me saying, ‘Let’s do your hair, Mom.’ She fusses over the water temperature even when it’s fine. I just pull the sprayer off her head, wait a few seconds without adjusting the temperature, and ask if it’s better, and she says, ‘Yes, much better.’ I didn’t change it, but she felt in control.”
Patti LaFleur recalls helping her mom get dressed by laying out two options of what to wear each day:
I let my loved one have a choice in the process as much as possible. Deciding what to wear and being involved in the process!
Danielle Bluff says her loved one has trouble initiating bathing and grooming, so she gently suggests it:
“I will very positively suggest showering if her mood is ok. I never say, ‘You should have a shower!’ Instead, I say, ‘Let’s have a shower!’ or, ‘I was thinking we could have a nice shower before we go out.” It doesn’t sound like I’m telling her what to do and indicates that I’ll help her through it. I say how much better she’ll feel afterward, even though I know it’s so tiring. I think the whole process is very draining for her, so she is often quite resistant, and I just have to let it go if she insists.”
She offers this advice for dressing and grooming routines:
“Morning is better when energy levels are better. I will pick out clothes but involve her by saying, ‘Oh, these look nice. How about these pants for today?’ I will have to help her with the order of steps with using toiletries, but at this stage, if I squeeze the shampoo in her hand and say, ‘Here’s the shampoo for your hair,’ she can use it herself. I will gently remind her of the next step if she misses one. She loves it if I tell her the soap was a gift from my sister. She can do towel drying herself if I hand her the towel.
With dressing and undressing, I start her off by helping get her arms or legs through the right holes; then, she can do the rest by pulling over or up. I think it’s important for their dignity to be as involved as much as they can, even if it’s just a tiny little bit. It’s a much slower process, but worth it.”
Laurita shares that her mom enjoys listening to music during bath time:
“I bought a shower speaker for mom’s bath time; that has helped in getting her to get in, and she’s happy the whole time showering because she’s dancing. Definitely a mood booster!”
Heather Sosa cares for her husband with early/young onset Alzheimer’s disease. She says it’s all about having a pocket full of tried-and-tested tips, reaching for the new ones you’ve learned, and being ready to test them all based on the mood. She shares what works best for her husband:
“Learn the best times for showers and accept that they can be missed if needed. For my husband, mornings are best for the shower — it works easily because of the nightly incontinence, and he must feel uncomfortable. For the dressing, what’s worked lately is talking about changing into something clean. Letting him hold it, leaving it for many minutes, then going back and talking about changing again. I take the lead from his vibe. I let him do what he can, if he can, and walk away if it becomes difficult. Many nights, he sleeps in what he wore that day because it was just easier.”
Aging advocate Kat Verdi says that hygiene can become the most challenging task, leading to caregiver frustration and agitation for our loved ones with dementia. She shares a tactic for building a routine around bathing, grooming, and dressing:
“Something that usually works (in time) with constant consistency is starting a ‘pattern of cleaning events.’ Have your loved one help or engage to their capacity by washing one dish, cup, spoon, and fork. Then move in that same sequence to put in the laundry — one sheet, one towel — all while discussing how nice everything is when it’s clean. Have your loved one smell a fresh, clean towel from the dryer. Here is where we prompt our loved one: ‘Now it’s your turn to have everything laid out in the bathroom, including that nice warm, fresh towel.’ This sequence of events usually makes a lovely and seamless transition!”
Compassionate in Caregiving’s Stephanie Muskat, MSW, RSW, shares this tip to offer comfort during bathing, grooming, and dressing:
“My mom is deaf and needs comfort by touch. It helps her make eye contact and know she can trust you. Seeing a smile, positive, caring eye contact and a nice stroke on her head helps put her at ease.”
Frank DiMaggio, Director of Operations for the New York City and Long Island office of LifeWorx, offers a few simple tips for creating and maintaining bathing and grooming routines:
“Showering: For families thinking about elderly relatives, bathroom safety is usually a main concern. Bathing is a personal thing and your loved one may simply need help getting in and out of the bath. Whatever the care recipient needs, a caregiver is there to work around their wishes and create the most comfortable environment possible.
Brushing teeth: When it comes to oral hygiene for the elderly, consistency is key, and a caregiver is there to make sure your loved one brushes every morning and evening.
Getting ready: Caregivers are on hand to help your loved one get dressed, a task that only gets more difficult for those with joint troubles.”
DiMaggio adds that one of the most important things caregivers can do to help a loved one maintain independence and prevent potential hazards is to improve bathroom safety. He offers a few simple changes and bathroom safety equipment that can minimize the risk of falls and accidents:
“One of the most important steps to take to provide bathroom safety for elderly individuals is to install proper lighting. Poor lighting in the bathroom or any area of a loved one’s home increases the risk of falls. The ideal lighting set-up needs to be bright enough so the elderly can see what they are doing but not too bright that it blinds them which can result in dizziness or loss of balance.
Aging adults can have a difficult time bathing independently. A great addition would be the use of non-slip bathmats. They can help to prevent falls and make bathing or showering safer and more comfortable.
Grab bars are an indispensable tool for elder care bathroom safety. Grab bars come in different shapes and sizes and perform two functions. The first function is they give your loved one something to grip and anchor themselves when moving in/out of the tub or on/off the toilet. Secondly, in case of a fall, grab bars can help your loved one catch or brace themselves.”
He advises caregivers to consider these things when they are helping their loved one get dressed:
“It is important to make certain your loved ones have clean, dry clothing available to wear. Make sure the choices you have selected are in good repair and weather appropriate. Allowing your loved one to choose what to wear encourages independence ad minimizes the hassle for your loved one of choosing between too many options.”
He adds this insight about ensuring a comfortable, dignified environment for these daily living activities:
“A lack of personal hygiene is a crucial sign that your senior loved one needs assistance with activities of daily living. It’s important to have discussions with the caregiver about what your loved one is comfortable with in receiving help, which will help relieve their stress while helping the caregiver establish trust.
Providing care in this way to someone is both private and personal. It’s best to discuss these things ahead of time and know what they want help with. Also, if aging adult refuses help with certain tasks, make sure they have the knowledge and tools to handle their hygiene needs.”
Chelsea Moreau, director of business operations at AskAdveeso on Instagram advised:
“Use slow, clear, simple steps. Try visually cueing them by ‘mocking’ what you want them to do. In the later stages of Dementia, hand-over-hand guidance can be effective.”
Valarie Drown, Director of the Alzheimer’s Disease Caregiver Support Initiative, reminds caregivers that they can offer their loved ones independence while maintaining their safety:
“If the loved one wants independence, provide it as much as possible. Take away the razors that can cut and use the shower chair or built-in seat for stability. When it is time for shaving, this is an activity that can then happen under supervision by standing in front of the mirror or sitting in a chair.”
Drown says this simple purchase can help protect a loved one’s dignity and respect their privacy when help is needed with bathing:
“Consider purchasing a terry wrap for showering. It provides covering for dignity and privacy. It can be easily maneuvered for showering underneath, provides extra warmth while in the shower, and dries easily for the next use.”
She offers caregivers these things to consider when helping a loved one get dressed:
“If their loved one dresses independently, layer clothes out according to the order that you put them on. Undergarments on top etc. This can assist with the activity through planful organization.”
She also offers this advice for making a bathing/grooming routine easier and less stressful:
“Take time to listen during the process. Avoid showering when there are signs of agitation before bathing begins. Try not to rush. Make hygiene a routine rather than a rush to get it done. Behaviors are a form of communication, so watch for patterns. Maybe they do not like having water hitting their face, maybe they are frustrated with a bar of soap that is slippery. Watch and learn what works and does not work. It is often trial and error and sometimes we get it right and sometimes we do not. Maintaining hygiene is difficult so, as a caregiver, don’t beat yourself up…just keep trying.”
The director of the Alzheimer’s Disease Caregiver Support Initiative shares things that have worked for other caregivers:
“We have caregivers (spouses) who will shower with their loved one to offer support and guidance throughout the process. They have reported that this has allowed for a less stressful routine. Also, there are care receivers who end up trying to use the washcloth but do not put soap on it. There are washcloths that can be purchased with the soap already built into them. This may be helpful to consider for these individuals. Encourage caregivers to reach out to community resources and ask, even the embarrassing questions, as providers are typically familiar with what is out there and what has worked for others.”
