How to Solve Hygiene Problems Common to People With Dementia
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 OverPossible CausesThe 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 BathePossible CausesThe person:
• 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 noisyand 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 TeethPossible CausesThe person:
• 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 ScottImage courtesy of hin255 at FreeDigitalPhotos.net