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Dementia and personal hygiene

As a dementia progresses, many people struggle with their personal hygiene. This can lead to infections and skin damage, and can also be embarrassing for the person with dementia and those around them. Here, you can read advice on supporting a person with dementia with personal care.

It is common for people with dementia to refuse help with personal care. Some find it easier to accept help from a family member, while others prefer to be supported by a paid carer. They may be more comfortable with someone of the same sex.

Try not to feel guilty if you decide you need professional help. Paid carers are experienced in helping people with personal hygiene, and this can reduce stress for both you and the person with dementia.

If you need support with helping a person with dementia with personal hygiene, please speak to a GP or social worker. You can also speak to a dementia specialist Admiral Nurse for advice.

When supporting a person with dementia to have a bath or shower, be respectful of their usual preferences – if they have always preferred a bath, they may be reluctant to use the shower. If using a shower, they may feel more comfortable and safer using a shower seat.

These tips may help:

  • Make sure everything you need is to hand before running the bath or shower
  • Allow the person to feel the water and its depth in a bath, or run the shower over their hands before they get in, to prepare them for what to expect
  • The person may prefer to use a handheld shower rather than stand under a powerful shower stream
  • Use the person’s usual toiletries to provide familiarity
  • Offer prompts throughout the process to promote independence
  • If the person is embarrassed about showing their body or being washed, you could put a towel over their lap or shoulders to help them maintain some dignity, washing one part of their body at a time
  • If the person finds baths or showers distressing, a sponge bath may be less stressful
  • You can buy toiletries for people who find bathing and showering difficult, such as waterless shampoo and body wash
  • If the person with dementia struggles with washing their hands, they could use hand sanitiser or antibacterial wipes instead
  • You could wash, wipe or sanitise your own hands to demonstrate what to do
  • If the person is experiencing problems with hygiene due to incontinence, speak to their GP or ask for a referral to the local continence service

To make cutting and cleaning the person’s fingernails and toenails less stressful, try doing it after a bath or shower – as well as removing dirt, the water will soften the nails so they are easier to cut. Alternatively, you could encourage them to soak their hands and feet first.

Giving the person a gentle hand massage may help them relax, but if they become distressed, take a break and try again later.

If the person enjoys choosing and wearing nail varnish, try making cleaning and cutting nails part of a manicure.

You could also look for a local chiropodist or podiatrist with experience in working with people with dementia to help with nailcare.

Some people with dementia enjoy having their hair washed, cut and styled, but others find it stressful. Keep in mind that hair usually does not need washing as frequently as the body – once a week may be sufficient.

  • Encourage the person to be as independent as possible when washing their hair
  • Give step-by-step instructions if needed
  • The person may prefer to wash their hair in the bath rather than in the shower
  • If they do not like water on their face, you could use a shampoo shield or they could hold a dry flannel over their face. Using a handheld shower or a large plastic jug to rinse their hair could reduce distress
  • Go to the hairdresser’s together to make haircuts feel like a ‘treat’ or part of a special day out
  • Alternatively, a mobile hairdresser could visit the person at home – some specialise in working with people with dementia

Make sure you respect the person’s preferences with their hair. If they have long hair, for example, it may be tempting to cut it short so it needs less upkeep, but keeping their usual hairstyle is an important part of maintaining self-esteem.

These tips may make hair removal easier:

  • Encourage the person to use an electric razor – this is safer than using a traditional razor
  • If the person prefers to use a traditional razor, they may need help with this
  • Make sure you have everything prepared in advance and if necessary, talk the person through the process step by step
  • If you need to shave the person, you can buy razors that are specially designed for carers to use on the person they care for
  • People who use wax, hair removal cream or devices such as epilators can continue to use these for as long as possible, with support where necessary
  • If they go to a salon for hair removal, they can continue to do so for as long as they are comfortable

People with dementia may find it hard to accept help with dressing and cleanliness. These tips may help:

  • Try offering a choice of two outfits so the person can decide which to wear – too many choices may be overwhelming
  • Label drawers and wardrobes with pictures of what is inside to help the person find what they need
  • Try laying out the person’s clothes out in the order they would put them on
  • If the person likes to wear the same clothes all the time, you could buy several identical sets – when they are in the bath or in bed, you can swap the dirty outfit for a clean one
  • Encouraging the person to wear a particular outfit for a visit or outing could prompt them to change their clothing
  • Look for clothing that is easy to put on and take off – drawstring waists and Velcro fastenings may be easier than zips and buttons

People with young onset dementia (where symptoms develop before the age of 65) may still be having periods.

While it is important to respect their wishes around sanitary protection, you may need to rethink which products to use. For example, if you need to help them change their protection, pads may be more appropriate than tampons.

Using a smartphone app to track the person’s cycle so you and they know roughly when to expect their period can be helpful. Setting reminders to change protection may also be useful.

During perimenopause and menopause, periods often become lighter, heavier or less regular, and will eventually stop. The person may need your help to understand and manage these changes.

Children or young people who have a family member who struggles with personal hygiene may find this embarrassing or upsetting.

It is important to explain that the changes are the result of the person’s dementia and are not deliberate. You could also support the person to wash and change their clothes before they spend time with the child.

If a young person needs to help with personal care – particularly if their parent has young onset dementia – think about what tasks are and are not suitable for them to help with. For example, helping their parent use the toilet may not be appropriate, but they may like to help them choose clothes or brush their hair.

It is a good idea to request a young carer’s assessment from social services to establish what help the child or young person may need in their caring role. Your GP or social worker may also be able to suggest young carers’ support groups.

If you need advice on any aspect of dementia, please call the Dementia Helpline on 0800 888 6678 (Monday-Friday 9am-9pm, Saturday and Sunday 9am-5pm, every day except 25th December), email or you can also book a phone or virtual appointment with an Admiral Nurse.

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