Introduction

A person with Alzheimer's disease will slowly become less able to take care of themselves. Caregivers will eventually become responsible for all personal care activities, such as bathing, toileting and dental care.

Here are some tips to assist the person with changing personal-care needs.

Bathing

People with Alzheimer’s may perceive bathing as unpleasant, threatening or painful. In turn, they may act in disruptive ways, like screaming, resisting and hitting.

This behavior occurs because the person doesn’t remember what bathing is for or doesn’t have the patience to endure the lack of modesty or being cold. Try the following:

• Prepare the bathroom in advance by gathering towels, washcloths, shampoo and soap. Check the room temperature to make sure it's not too cold.

• Make the bathroom safe by installing grab bars on the wall and tub edge. Use a tub bench or bath chair that can adjust to different heights.

• Help the person feel in control. Involve or coach the person through each step of bathing. Be sure the person has a role. For example, have the person hold a washcloth or shampoo bottle.

• Respect the person’s dignity. Some people may be self-conscious about being naked. Ease anxiety by letting the person hold up a large bath towel as he or she gets in and out of the shower or tub.

• Don’t worry about how often the person bathes. Try sponge baths in between showers or baths.

• Be gentle on the skin. The person’s skin may be very sensitive. Avoid scrubbing, and pat skin dry instead of rubbing.

• Be flexible when washing hair. Wash the person's hair in the sink. Use a washcloth to reduce the amount of water on the person’s face.

Using the bathroom/incontinence

Many people with dementia have loss of bladder or bowel control (incontinence). Causes include inability to recognize when they need to go to the bathroom, forgetting where the bathroom is or side effects from medicine. Have the doctor rule out medical problems as the cause.

Try the following to assist the person in using the bathroom:

• Remove obstacles. Make sure clothing is easy to remove. Clear the
  path to the bathroom by moving furniture.

• Create visible reminders. Post a sign or picture of a toilet on the bathroom door. Use colored rugs on the bathroom floor and colored toilet lids to help the toilet stand out.

• Provide reminders. Encourage the person to go regularly. Look for facial expressions or pacing that may indicate the person needs to use the bathroom.

• Monitor incontinence. Identify when accidents occur, then plan for them. If they happen every two hours, get the person to the bathroom before that time. Consider using incontinence products, such as rubber sheets on the bed or adult briefs.

• Be supportive. Help the person retain a sense of dignity. Reassure the person to reduce feelings of embarrassment.

Dental care

Proper dental care can help prevent eating difficulties, digestive problems and extensive dental procedures down the road. However, brushing is sometimes difficult because a person with dementia may forget how or why it’s important to take care of his or her teeth.

To help the individual with dental care:

• Provide short, simple instructions. Break down each step by saying: “Hold your toothbrush.” “Put paste on the brush.” Then, “Brush your teeth.”

• Use a “watch me” technique. Hold a toothbrush, and show the person how to brush his or her teeth. Or, put your hand over the person’s hand, gently guiding the brush.

• Monitor daily oral care. Brush teeth or dentures after each meal, and make sure teeth are flossed daily. Remove and clean dentures every night.

• Keep up with regular dental visits for as long as possible. Seeing a dentist regularly is essential for healthy teeth. Ask the dentist for suggestions or items that may help make dental care easier.

If you have questions about helping the person with dementia with personal care, call us at 1.800.272.3900.