Depending on the stage of dementia, you may discover that your loved one experiences some difficulties with personal hygiene (stages are better explained on a previous blog post). There can be a few reasons as to why do people with Alzheimer’s stop bathing and how to help:
- Not having any motivation to shower (this can be linked to low mood).
- They forget to have a shower.
- They no longer realise the importance of self-care and personal hygiene.
This is a very difficult stage to be in because other people stepping in (e.g. carers or even you) can be a struggle. It can be difficult for the person who has dementia because they may feel like they have completely lost their independence and it is not enjoyable, this, in turn, can then be distressing for them. It can also be an uncomfortable experience for you too. We all know that not everyone has access to carers so sometimes the responsibility falls on you, so then you may question, what can you do to help?
Before we go into this, it is important to set expectations. If the person prior to their decline only showered twice a week, it is best to maintain that rather than changing it. Showering twice a week in some cases can be sufficient if they are showered well and remain hygienic in other ways, for example changing underwear daily, wearing clean clothes. This should also be put into perspective when the worry begins about self-care. It may be that they are showering the same amount as before, so that is not alarming, but are not looking after themselves in other ways and that should become your priority. Expectations can also relate to the time of day. If you would prefer for them to have a shower in the morning but they have always been someone who has a late shower, if your schedule permits it and you want to encourage them to be a little more independent, be a little flexible.
There sometimes can be no positive outcome from trying to reason with someone who has dementia to try and encourage them to shower. If this is the case, then it is likely that what you will say will not be understood in the way you want it to be. Other than this, it can become quite a distressing experience for them and should be avoided. But, if you think reasoning will work, here are the top reasons why showering (and other self-care) adequately and at least a couple of times a week is important:
- Older people run a higher risk of urinary tract infections (UTI’s) so it is important that the genital area is kept clean.
- Washing hands before eating before handling food and after the toilet to avoid getting sick and spreading the germs to other people.
- Washing the face so that skin remains clear.
- Cleaning dentures or teeth twice a day to maintain oral hygiene.
If personal hygiene and self-care is a problem and reasoning is not an option, you should:
- Try and be more persuasive. An example of this is by trying to take advantage of the social opportunities that they have, such as if someone is coming over or if they are going out. It is good to try and use this time as it can provide some motivation for them, particularly if they are looking forward to the activity planned.
- Remain calm and try not to be confrontational as this can only make things worse (and add to your own stress levels).
- Try to give gentle reminders about using the toilet or washing, for example, you may say ‘you have drunk a lot of water today, have you been to the toilet yet’. This may be enough of a cue for them to either sense whether they need to go or maybe just to go anyway (which is not a bad thing).
- Think about what you say before you say it. By giving orders or being pushy, they can adamantly refuse to do it.
- Use a sponge bath (without a shower) if showering is especially distressing for the person. A full body clean is necessary but it does not need to be done all at once if it is too difficult. Make use of the opportunities that arise, so if it is easier to get them in the shower than keep them in the shower, you could wash different parts of the body on different days.
- Buy multiples of the items of clothing they wear often (if they refuse to wear any other clothes) so that you are able to wash those clothes and make a successful rotation. This is also good at preventing arguments because if they only want to wear a particular item and you do not allow them (because it is dirty), the situation can become hostile.
Understandably this is a difficult situation for everyone involved and you only want to do what is best for them. If this really becomes a struggle, then it is probably time to consider appointing a carer and seek some advice (see other blog posts for more information). Otherwise, hopefully, some of these tips help.