Activities of Daily Living

Part 4: Personal Care and Hygiene

Although each individual is unique, dementia has a profound effect on:

  • Cognitive abilities: memory, orientation, language, judgement, concentration, and ability to sequence tasks.
  • Functional abilities: carrying out daily activities.
  • Personality, mood, and behaviour.

Some individuals find it challenging to remember to take care of their personal hygiene, such as bathing. At the same time, others may struggle with resisting showering or display complex behaviours that can be challenging for their caregivers.

Assisting with personal care and bathing is often the most difficult activity for care partners of people with dementia, and as the disease progresses, this can become increasingly challenging.

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Oral Care

Proper oral care is important to prevent tooth decay and gum disease. Poor dental health will also affect an individual's ability and willingness to eat. It is wise to have a complete dental examination early in the disease. Ask the dentist to schedule appointments at times when there will be no delay at the office.

At home, the following tips might be helpful:

  • Remind the person to brush twice a day with a soft-bristled toothbrush and fluoridated toothpaste. Give step-by-step instructions or try "hands-on" guidance or gestures.
  • Try fluoride swabs if the toothbrush is refused.
  • Remove partial dentures before cleaning natural teeth.
  • Be prepared for the person to hide their dentures; try to always keep them in a certain place.
  • Remove dentures at bedtime and clean with a firm brush. Place them in water overnight.
  • Make sure dentures are well-identified to prevent misplacement. To prevent damage when cleaning, make sure the sink is filled or the drain is closed and the toilet lid is shut.
  • If the person develops a "dry mouth," try sugarless candies or gum to increase the saliva flow.

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Hair Care

Clean, well-groomed hair will make a person living with dementia look and feel better. It will likely help their care partner feel better too.

  • Choose a hairstyle that is easy to care for.
  • Encourage the person to comb their own hair. If necessary, give step-by-step instructions or a cue, for example, place comb in person's hand or start combing your own hair.
  • Use non-stinging baby shampoo.
  • Try a dry shampoo if washing hair is difficult.
  • Try a scalp massage when washing -- it may be soothing.

A salon or barbershop can be a familiar and relaxed setting. Make the stylist aware that the person has dementia. If the person feels insecure, you may want to stay with them or try to find a stylist to come into the home to cut or style hair.

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Skin Care

As a person ages, skin becomes more delicate and needs a little extra care beyond a wash. Creams or lotions can help the skin and may be necessary in the prevention of skin breakdown for those who are inactive.  The application itself can also have a pleasantly soothing effect.

  • Use a damp cloth or a wipe for cleaning hands and face. This may be easier than a basin-soap routine.
  • Use a favourite scent for soap or lotion.
  • Massage or stroke when applying cream or lotion.
  • If applying lotion is soothing, try it at a time of day when the person is more likely to be restless.

You can also get a basin of warm water and a washcloth and sit with the person to wash their face and hands. Have a towel ready to dry them as well.

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Foot Care

As people age, foot care is often neglected because they can no longer comfortably reach their feet and can no longer see to provide proper nail care. This task can be more of a challenge if the person has dementia.

The following suggestions may assist you:

  • Check the person's feet on a regular basis. Look for discoloration that might be a sign of circulatory problems. Check for calluses, bunions or nail problems that might cause foot pain. Report any findings to the doctor.
  • Check nail length. Be careful with nail clippers and scissors. If you are uncomfortable trimming nails, arrange to have this done at a foot clinic or have a professional come to the house.
  • After bathing, make sure the skin between the toes is clean and dry.
  • While checking the person's feet, you can provide comfort by giving them a foot massage with scented lotions.
  • Make sure care providers know that toe spacers can prevent foot pain.

And a little nail polish always brings about a smile!

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Getting Dressed

  • Whenever possible, allow the person to choose the clothing to be worn that day. Limit the number of choices to make the decision easier. 
  • Lay out clothing in the order that it should be put on.
  • Remove extra clothing from the closet. Seeing a lot of clothing can be confusing.
  • If the person insists on wearing the same clothes every day, try to launder these clothes often or get duplicates of favourite outfits.
  • Choose clothing that is easy to wear and care for. Zippers and Velcro are easier to fasten than buttons. Skirts and pants with elastic bands are easier to put on.
  • Label (or use pictures from magazines) to describe the contents of dresser drawers.
  • For some people, it may be helpful to group items of the same colour or ones that are worn together.
  • Hang ties, belts or other accessories on a hanger with the matching shirt, dress or pants.
  • Have a basket to put soiled laundry to avoid confusion with clean clothes.

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More Learning Resources

Personal Care

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