How to Solve Hygiene Problems Common to People With Dementia
Odd or frustrating behaviors around clean clothes, bathing, oral care, hairstyling, and shaving seldom come “out of nowhere.” Usually, there’s a trigger, and ways to work around it. Here is some information about possible causes and strategies to overcome common problems.
Problem: Wears Same Dirty Clothes Over and Over
The person with dementia:
• Forgets the clothes are dirty after they’re removed (so they never go in the hamper or wash).
• Has impaired ability to make judgments.
• Likes the familiarity.
• Is overwhelmed by too many choices while dressing.
What to do
• Avoid pointing out that clothes being worn are dirty, which puts the person on the defensive and sets up an argument she doesn’t understand.
• Ask yourself if you’re bothered by the repetition of the outfit or by actual dirt or odor.
• Pare down the closet to fewer options. Stock solids in favorite colors instead of patterns.
• Buy an identical replacement for favorite outfits (same color, style) so you can wash one while the other is being worn.
• Remove soiled clothing from the room at night once the person is sound asleep. She’ll forget about it the next morning if there’s something else handy to put on.
Problem: Refuses to Bathe
• Has depression.
• Is embarrassed being seen naked.
• Had a previous upsetting experience (slipped, the water was too hot, it took too long, she got chilled).
• Has fears (of falling or drowning).
• Dislikes being told what to do.
• Feels rushed and out of control.
• Can’t remember the complex sequence of activities involved.
What to do
• Build positive associations with bathing: Precede the bath with a pleasant activity) and follow up with another one (a dish of ice cream).
• Stick to a consistent routine for bathing, which becomes soothing. When you find an approach that works, try to replicate it exactly the next time.
• Keep the room and water warm. Feeling chilled may be what upsets the bather. Pour a little water on her open hand to show her it feels nice before she gets in.
• Put water in the tub before the person enters the room; the loud pouring of water can cause distress and your loud voice over it can be interpreted as angry shouting. Showers are also noisy
and may be more frightening than a bath.
• Use distractions in the room to take the person’s mind off the washing: Play favorite music, install a lava lamp on a shelf opposite the tub or hang favorite pictures, keep up a conversation about a pleasant topic (antics of a dog or child, old family stories). Give the person a washcloth or wash mitt to occupy her hands.
• Act as if you have all the time in the world.
• Know when to quit trying to persuade. If you’re heading to a stand-off after five minutes of negotiations, drop the subject of bathing. Distract the person with another activity and then try again 15 or 20 minutes later. Make it sound like a fresh new idea.
Problem: Doesn’t Take Care of Teeth
• Suffers memory loss (a common hygiene problem).
• May dislike help because she feels she’s being treated like an infant or out of control.
• May have dexterity problems.
What to do
• Have professional backup: Visit a dentist twice a year to check for cavities, gum infections, dangerously cracked teeth, ill-fitting dentures, and the like. Make sure the office knows the person has dementia, to book adequate time. For tough cases, ask for a referral to a geriatric dentist who has experience working with Alzheimer’s patients.
• Incorporate tooth brushing into the daily routine, such as when getting dressed or ready for bed (ideally both). If it becomes a battle, pick the person’s most cooperative time of day. Try brushing your teeth at the same time.
• Use the same brand of toothpaste the person has always used, if you can. Apply it to the brush for him.
• Provide a thick-handled, easy-to-grip toothbrush. The noise of an electric toothbrush may cause distress.
• If the person doesn’t recognize a toothbrush, slowly insert your own toothbrush in your mouth to model how it’s done.
Written by, Paula Spencer Scott
Image courtesy of hin255 at FreeDigitalPhotos.net