Dementia care: Help with personal hygiene and dementia
Showering someone with dementia can present many challenges. Carers can spend a lot of their time attending to personal hygiene.
You can make showering easier and more relaxing by taking a few things into consideration.
In this article:
- Promoting independence
- Home care aids and equipment
- How to shower someone with dementia
- Showering alternatives
Promoting independence
Try and promote independence for as long as you can by encouraging a person with dementia to do as much as possible. People with dementia often become resistant to personal hygiene tasks. They can start screaming and abusing a carer or attempt to walk away whilst showering. This reaction can be associated with fear of overhead showers or embarrassment of nudity and incontinence.
Being naked and showered by someone else can make someone feel very vulnerable. Try and understand how a person with dementia must feel.
Whilst showering and bathing is an essential part of maintaining personal hygiene, showering every day is not always necessary. Reducing bathing can actually help protect dry ageing skin.
Try showering every second day. Between showers, you can try sponge baths or washing with non-rinse packaged towelettes.
Home care aids and equipment
The bathroom can be unsafe for someone with dementia. Be aware of slippery tiles, hot water and the risk of accidently locking a person in the bathroom. Trouble standing or transferring can also increase the risk of falls. Home care aids and lifting equipment may be necessary.
A shower chair is a useful tool for people with dementia. A carer can wash and dry someone as they remain seated. Some shower chairs have wheels for transferring from the toilet to the shower. Your bathroom may need to be modified to fit the shower chair inside the shower recess.
Shower seats or stools remain in the shower recess and are helpful for people who are unsteady on their feet, or at risk of falls. Choose one with a padded seat and adequate foot support.
Home care aids for personal hygiene include:
- Grab rails can assist with standing in the shower.
- Portable bed baths may be needed for someone who is bed or chair bound.
- Non-slip mats prevent slipping on wet tiles.
- Shower seats in the bath or shower allow a person to sit whilst showering.
- Hand-held showers promote independence.
How to shower someone with dementia
- Try and stick to a previous routine with bathing and showering. A morning shower or an afternoon bath will be familiar to someone. Try using their favourite toiletries and bath items.
- Gather all necessary equipment first, such as soap, towels, and so on, so you don't have to leave the person alone to grab something.
- Explain what you are about to do.
- Be reassuring and calm, do not rush or show frustration.
- Run the water until the temperature is comfortable and ask the person to feel the water first.
- Spraying the head first can be frightening and cause an aggressive protective response. Start by showering the legs and move upwards to the chest and back.
- Prompt a person to wash their face.
- Explain each step in simple terms and tell someone when you are about to wash their back or wash down below.
- You may need to gently prompt a person to help you.
- A hand-held shower can be helpful to promote independence and reduce fear by allowing someone to shower themselves.
- You can place a towel over the genitals and simply lift for washing if the person is uncomfortable with nudity.
- Remember to use a different washer for face and genitals.
- After washing, position towels over the person's lap and on the back of the wet shower chair for comfort and dignity.
- Pat the person dry, pay attention to areas prone to excoriation such as the groin area, abdominal skin folds, and under the breasts.
- Apply any barrier creams and moisturising lotion.
- Keep the person covered whilst you dress the top half first.
- Dress the lower half, pull pants or skirts half way up and put on shoes. Ask the person to stand, preferably using a grab rail. Dry the buttocks and genitals thoroughly before pulling up clothes.
Showering alternatives
- Give a warm sponge bath by the sink, or a wash in bed with a bowl of warm water and flannels.
- Try 'bed in the bath' products. Much like baby wipes, these towels can be used to bath an immobile person or wash genitals after incontinence episodes without the need for rinsing with water.
- If you are washing your partner, you can try showering together.
- Never force someone with dementia to shower. Try alternating times to suit them, and use other terms for bathing such as 'massage'.
Helpful resources
- Ring the National Dementia Helpline on 1800 100 500 to talk to a counsellor at Alzheimer's Australia.
- Contact The National Dementia Behaviour Advisory Service (NDBAS) on 1300 366 448. A national telephone line for carers or family concerned about the behaviour of people with dementia.
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