Washing, dressing and personal care

Ben Budd
November 20, 2023
November 20, 2023

Washing, bathing, personal grooming and dressing can become difficult for a person with dementia, and it is one of the most common issues raised when we talk to carers.

It can be a sensitive personal issue for the person: as with so much related to dementia, the person has lost the ability to carry out simple tasks they used to find easy. They may also think that accepting help means someone touching them or doing intimate things to them.

For you too, as a carer, it can be hard to see the person go through outward changes in appearance and personal hygiene.

While in life you are often given the advice to tackle problems ‘head on’, in the case of reminding the person you are caring for how to wash or dress, this approach can often lead to stress, upset and arguments.

Thinking about the reasons problems might be happening is a more helpful way of dealing with it and can allow you to put in place practical solutions.

You should also remember that there may be other factors at play outside of dementia, such as pain or tiredness. We explore some of these here.

Difficulties

Some of the difficulties the person might experience are as follows:

Practical ways you can help

If the person is having difficulty physically accessing the shower, then there may be pieces of equipment or adaptations that would help. 

Some of these room adjustments are covered in our section on continence issues.

You can also read more about dealing with Everyday Challenges when caring for someone with dementia.

Making it as comfortable as possible

When dealing with personal care tasks, like helping the person wash or dress, it is more important than ever to make the experience as comforting as possible. 

You can do this by using warm, soft towels, by playing music or dimming the lights and using a calm, soft voice.

Approach the conversation with care. If the person has started not wanting to wash or dress, then try telling them you’ve got them a nice new shower gel you think they’ll like, or a new shirt or tie bought especially for them.

Clothes, smells and accessories are part of our identity

It is helpful too, to remember the person’s identity when you are giving personal care like washing or dressing.

While it feels like nothing more than a practical daily thing, what we wear, what soap we use, whether we wear make up or jewellery is an important part of who we are.

This is no different for a person with dementia. So you can try laying out clothes they like to wear or help them put on makeup or do their hair if that is what they used to do for themselves.

Make it a joint activity. It is easier for the person to cope with the situation if they feel like they are part of it, rather than someone something is being done to.

This might mean giving them choices in what they wear or chatting through the steps with them.

If it becomes too much

While most of us view washing and changing our clothes each day as an essential task, for a person with dementia it may be better to take a more relaxed approach.

If the job has become very stressful one day and the person is resisting help, then maybe come back to it later or even the next day.

Equally, maybe you are having a bad day or feeling unwell, in which case, come back to the job the next day.

It’s OK if the person doesn’t wash or wears the same clothes for a day or two.

Of course, though, there is a basic level of cleaning that we must all do to our bodies to keep us healthy, so if the job is becoming too much for you, you should ask for help from a relative or friend or from social services.

They can help you work out what the actual problems are for the person and come up with ways to help. They can also guide you on any equipment that might make things less difficult and how to access funding for it.

Quick look

Possible difficulty:

The person is wearing clothes again that they have taken off without realising they are dirty or have been worn before.

Things that might help:

Collect up clothes and put in the wash without making it obvious. Lay out clean clothes.

Possible difficulty

The person realises that they can’t do the task like they used to, and are frustrated, and anxious about it.

Things that might help:

If possible make the task simpler by having clothes that are easier to put on, eg no buttons, and try elasticated waists. Be reassuring if you can and make the activity more fun by suggesting a pamper session or doing things together.

Possible difficulty

The person needs help but won’t accept it from you.

Things that might help:

Can someone else help? Often people are more accepting of help from people they are not as close to. Do they need to do the task as often? Would they be able to have a shower every few days instead of every day?

Possible difficulty:

The person is struggling with operating the shower or co-ordinating putting on clothes, or following instructions.

Things that might help:

Gentle guidance, turn the shower on for them before they get in. Use lots of non verbal demonstrations and or simple instructions. Allow time for someone to process each stage of the task, don’t rush.

Possible difficulty:

Physically accessing the bath or shower.

Things that might help:

Ask for an Occupational Therapy assessment from your memory team or from adult social care. There may be pieces of equipment or adaptations that would help.

We understand that it can be very distressing for carers to see changes in the person they care for. Changes in the persons appearance may lead to negative feelings as these changes can challenge your own moral code. Focussing too much on these changes or excessively ruminating can develop negative thinking patterns and possibly guarded interactions or excessive conflict. This will undermine any positive approach that could help you and the person that you care for and increase the risk of more stress and distress.

These are just a few suggestions about what may help, but please ask for advice and support, there is no easy answer and what works one day may not work on another. It’s important that you share your concerns so that you are not overwhelmed and can be reassured that you are doing your best.

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