Bathing, Dressing, Grooming: Alzheimer's Caregiving Tips

By Jane Farrell

Expert tips from the National Institute on Aging about some of the most necessary yet difficult activities of caregiving:

At some point, people with Alzheimer’s disease will need help bathing, combing their hair, brushing their teeth, and getting dressed. Because these are private activities, people may not want help. They may feel embarrassed about being naked in front of caregivers. They also may feel angry about not being able to care for themselves. These suggestions may help with everyday care.

BATHING

Helping someone with Alzheimer’s disease take a bath or shower can be one of the hardest things you do. Planning can help make bath time better for both of you. If the person is afraid of bathing, follow his or her lifelong bathing habits, such as doing the bath or shower in the morning or before going to bed.

Safety Tips

To keep the person with Alzheimer’s safe during bath time:

• Never leave a confused or frail person alone in the tub or shower.
• Always check the water temperature before he or she gets in the tub or shower.
• Use a hand-held showerhead.
• Use a rubber bath mat and safety bars in the tub.
• Use a sturdy shower chair to support a person who is unsteady and to prevent falls. You can buy shower chairs at drug stores and medical supply stores.

Before Bathing

• Get the soap, washcloth, towels, and shampoo ready.
• Make sure the bathroom is warm and well lighted.
• Play soft music if it helps to relax the person.
• Be matter-of-fact about bathing. Say, “It’s time for a bath now.” Don’t argue about the need for a bath or shower.
• Be gentle and respectful. Tell the person what you are going to do, step by step.
• Make sure the water temperature is comfortable.
• Don’t use bath oil. It can make the tub slippery and may cause urinary tract infections.

During a Bath or Shower

Allow the person with Alzheimer’s to do as much as possible. This protects his or her dignity and helps the person feel more in control. Here are other tips:

• Put a towel over the person’s shoulders or lap. This helps him or her feel less exposed. Then use a sponge or washcloth to clean under the towel.
• Distract the person by talking about something else if he or she becomes upset.
• Give the person a washcloth to hold. This makes it less likely that he or she will try to hit you.

After Bathing

Try these suggestions:

• Prevent rashes or infections by patting the person’s skin with a towel. Make sure the person is completely dry. Be sure to dry between folds of skin.
• If the person is incontinent, use a protective ointment, such as petroleum jelly, around the rectum, vagina, or penis.
• If the person has trouble getting in and out of the bathtub, do a sponge bath instead.

Other Bathing Tips

For most people, a full bath or shower two or three times a week is enough. Between full baths, a sponge bath to clean the face, hands, feet, underarms, and genitals is all you need to do every day. Also:

• Washing the person’s hair in the sink with a hose attachment may be easier than doing it in the shower or bathtub.
• Get professional help with bathing if it becomes too hard for you to do on your own.

DRESSING

People with Alzheimer’s disease often need more time to dress. It can be hard for them to choose their clothes. They might wear the wrong clothing for the season. They also might wear colors that don’t go together or forget to put on a piece of clothing. Allow the person to dress on his or her own for as long as possible.

Other tips for dressing:

• Lay out clothes in the order the person should put them on, such as underwear first, then pants, then a shirt, and then a sweater.
• Hand the person one thing at a time, or give step-by-step dressing instructions.
• Put away some clothes in another room to reduce the number of choices. Keep only one or two outfits in the closet or dresser.
• Keep the closet locked if needed.
• Buy three or four sets of the same clothes if the person wants to wear the same clothing every day.
• Buy loose-fitting, comfortable clothing, such as sports bras, cotton socks and underwear, and sweat pants and shorts with elastic waistbands.
• Avoid girdles, control-top pantyhose, knee-high nylons, high heels, and tight socks.
• Use Velcro® tape or large zipper pulls for clothing instead of shoelaces, buttons, or buckles.
• Try slip-on shoes that won’t slide off or shoes with Velcro® straps. 

GROOMING

When people feel good about how they look, they often feel better. Helping people with Alzheimer’s disease brush their teeth, shave, put on makeup, and get dressed can help them feel more like themselves.

Mouth Care

Here are some tips to help the person with Alzheimer’s care for his or her teeth and mouth.

• Show the person how to brush his or her teeth. Go step by step. Remember to let the person do as much as possible.
• Brush your teeth at the same time.
• Help the person clean his or her dentures.
• Ask the person to rinse his or her mouth with water after each meal and use mouthwash once a day.
• Try a long-handled, angled, or electric toothbrush if you need to brush the person’s teeth.
• Take the person to see a dentist. Some dentists specialize in treating people with Alzheimer’s. Ask the dentist how often the person should be seen.

OTHER GROOMING

• Encourage a woman to wear makeup if she has always used it. If needed, help her put on powder and lipstick. Don’t use eye makeup.
• Encourage a man to shave, and help him as needed. Use an electric razor for safety.
• Take the person to the barber or beauty shop. Some barbers or hairstylists may come to your home.
• Keep the person’s nails clean and trimmed.

For more information about caregiving and activities of daily living:

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center; 1-800-438-4380 (toll-free); adear@nia.nih.gov; www.nia.nih.gov/alzheimers.

The National Institute on Aging’s ADEAR Center offers information and free print publications about Alzheimer’s disease and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimer’s Association; 1-800-272-3900 (toll-free, 24/7); 1-866-403-3073 (TTY/toll-free); info@alz.org; www.alz.org