There can be a number of reasons that older people might ‘give up’ on their personal hygiene. Sometimes older people, especially those with dementia, may fear taking a shower. The person may be afraid of falling, or they may even think their carer is trying to hurt them.
7 tips to get someone with dementia to shower or bathe
At a minimum, bathing once or twice a week helps most seniors avoid skin breakdown and infections. Using warm washcloths to wipe armpits, groin, genitals, feet, and any skin folds also helps minimize body odor in between full baths. However, some dementia caregivers say it’s actually easier to bathe every day.
It’s common for people to bathe less during stage 5 of dementia. During stage 6, they tend to stop bathing when they no longer understand the need.
People with dementia are often resistant to bathing. They will claim they just showered, or that they will do it later, or outright refuse to bathe. Unless someone is incontinent, daily bathing is not necessary.
With the aging process comes a weakening of the senses, especially one’s sense of smell. Many seniors begin showering and changing less frequently because it is harder for them to notice the tell-tale scent of body odor or see stains on their clothing that indicate it’s time for a wash-up and a load of laundry.
Ablutophobia is a specific phobia in which individuals have an irrational fear of bathing or washing. It can affect children and adults and is more common in women than men. People with specific phobias know that their fears are not realistic, but they are unable to address them.
Bathing once or twice a week is acceptable for older adults, as the purpose is to prevent the skin from breaking down and lower the risk of skin infections. Seniors also tend to be less active than younger adults, so they can get away with fewer baths. However, you don’t want your loved one to develop body odor.
Put soap on the washcloth or sponge and give it to the person. Let the person wash himself or herself. You can wash areas that he or she can’t reach. Gently remind the person you’re caring for that it’s best to start with the cleanest areas and finish with those that are less clean.
Over time, a person with dementia will have increased difficulty with memory, understanding, communication, and reasoning. Healthcare providers frequently speak about a person’s dementia in terms of stages.
They tend to get less deep or ‘slow-wave’ sleep, which helps to keep the brain healthy and refreshed. Even though a person with dementia may end up sleeping more than a typical person of their age – even as much as 14–15 hours a day – it is unlikely to all be good quality sleep.
Things you can try include:
Approach the topic in a calm, understanding manner, but try not to be patronizing. You don’t want your loved one to feel embarrassed or belittled with this conversation. Don’t be accusatory or make them feel incompetent. It is important to let them know that you have noticed some changes and that you want to help.
Set up the bathroom to make it as easy as possible for the person to get on to and off of the toilet, e.g. having a raised toilet seat and grab bars. Notice when the person gives a sign about needing to use the toilet, e.g. agitation, fidgeting, tugging on clothing, wandering, touching the genital area.
In the final stage of the disease, dementia symptoms are severe. Individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult.