How to support a person with dementia to wash, bathe and shower
Practical tips on topics including aids and equipment, skincare and nails, handwashing and dental care, washing, drying and styling hair, hair removal, and using the toilet.
- How does dementia affect washing and dressing?
- You are here: How to support a person with dementia to wash, bathe and shower
- When a person with dementia doesn’t want to change their clothes or wash
- How to support a person with dementia to get dressed or change clothes
- Personal grooming and dementia
- Supporting a person with washing and dressing - useful resources
Supporting a person with washing and dressing
By supporting a person with washing and bathing, you can help maintain their confidence, independence and sense of wellbeing. Instead of doing things for them, try to be guided by their pace and preferences. This can make washing and bathing easier for both of you.
For example, consider installing taps that are easy to use and clearly marked ‘hot’ and ‘cold’. If the person with dementia can more easily find and use taps for themselves, they may be able to continue with tasks without too much help from you.
How to make washing, bathing an showering a positive experience
Communicating clearly and calmly is essential to supporting the person. Talk through what you are doing at each step, and give the person time to understand each task. This also gives them a chance to say no to anything they are not comfortable with. Be encouraging, and don’t dwell on things that did not go well.
Some people may be unsafe or become anxious if they are left on their own. Make sure you will not be disturbed or distracted, and can stay with them if you need to.
Tips for carers supporting a person with dementia to wash, bathe or shower
These tips can help you to make washing, bathing and showering safer and easier.
- Don’t forget your own safety. If you help the person get into the bath, make sure you don’t strain your back. If this is becoming a problem, talk to an occupational therapist about equipment that can help you.
- Check the water temperature is not too hot or too cold. You can buy a heat sensor or special plug that changes colour if the bath water is too hot, which can prevent scalding. You can also buy plugs that that the bath if the water level gets too high.
- The person may feel reassured if they can feel the water with their hands before getting into the bath or stepping into the shower.
- Deep bath water can make some people feel worried. You can reassure them by making sure the bath water is shallow, or by setting up a bath seat for them to use.
- Some people find the rush of water from an overhead shower frightening or disorientating. A hand-held shower attachment may work better and will make it easier to clean all over.
- Make items such as towels and dressing gowns easy to see by choosing colours that contrast – a green towel will be easier to see than a white one if the walls are white.
- You may need to remove locks from the bathroom door, or replace them with locks that can be opened from the outside. Someone with dementia may lock themselves in and be unable to get out.
- Lock away cleaning products, medications, nail scissors and razors. The person may not be able to recognise that these are potentially harmful.
- Before washing, discuss and put out what the person will wear after they wash, either nightwear or their outfit for the day. This means they can change more quickly, so they spend less time in a damp towel.
- Visual prompts can also be helpful. For example, you could hand the person the soap at the point when they would normally wash, put the toothpaste onto the toothbrush for them or hold out a towel when it’s time for them to dry themselves.
- If they seem shy, embarrassed or reluctant, think about their personal space and privacy. Try uncovering only the part of their body that you are washing. A towel or robe can be useful for this.
- Try to use toiletries that the person is used to and avoid any that are unnecessary.
How to help the person with washing, bathing, and showering
When washing or bathing becomes difficult, the following products and equipment can help:
grab rails, to help with getting in and out of the bath
handrails, which can be attached to the wall near the shower, washbasin or toilet
non-slip mats for the bath or shower
seats to go in the bath or shower, if the person would prefer to sit or is unsteady on their feet
- bath boards and powered bath seats that can help a person get in and out of the bath.
The right equipment can help the person be more independent, and to be more relaxed when they are washing, showering or bathing.
An occupational therapist can give you more information about available products. You can contact them through your local social services,
the GP or health professional.
Larger changes, such as installing a walk-in shower or wet room, might mean the person can stay independent for longer. Involve the person with dementia as much as possible in decisions about any changes that need to be made to the bathroom.
For more information see Using equipment and making adaptations at home.
Looking after a person’s skin and nails is an important part of their personal hygiene. As a person gets older their skin becomes thinner and drier.
Dry, irritated skin may lead to discomfort in someone with dementia. While the person is undressed, check for any changes to the skin, redness or sore areas. Mention anything you’re concerned about to the GP or another health professional.
After showering or bathing:
- make sure the person is thoroughly dried, especially in the skin folds. This will prevent the skin from becoming chafed
- use the towel to pat skin dry, rather than rubbing
- take the opportunity to apply moisturiser to the person’s skin.
Keep toenails and fingernails clean and tidy. Trimming nails after a bath or shower can be easier, as nails are softer. If this isn’t possible, soak the
fingers or toes in lukewarm water for a few minutes, before trimming. This is also an opportunity to routinely check for marks or spots which might
indicate a foot problem, such as calluses.
A person with dementia may not wash their hands, or brush their teeth as often as they should. Try to work out which is the most likely reason for this.
For example, if they forget, a written reminder above the bathroom or kitchen sink might prompt them. If they are struggling with the task, talk them through handwashing or toothbrushing one step at a time.
Make handwashing easy and pleasurable, for instance by asking the person to choose their favourite soap type and scent. If they prefer a bar of soap, use one that is a different colour to the sink so they can easily see it. It can be a good idea to use a moisturising hand cream after handwashing to keep their skin in good condition.
A person with dementia may need prompting or reminding to continue brushing their teeth as part of their daily routine. Towards the later stages, you may need to help them with this task, or carry it out for them. Teeth or dentures need to be cleaned twice a day to maintain oral health.
While many people enjoy the feeling of having their hair washed, and feel better when it is done, others don’t enjoy it at all. Some people with dementia can find it distressing and confusing. If possible, try to wash the person’s hair at least once a week.
The following tips may be helpful:
- When you’re washing the person’s hair, a hand-held shower attachment or large plastic jug may work best.
- Use a shampoo that will not cause stinging if it gets into the person’s eyes. Use a hair wash shield to prevent water running onto the person’s face. Alternative options include dry shampoos. Or there are ‘no rinse’ shampoos that can clean the hair without using water – such as Towel Off Shampoo, available from Alzheimer’s Society’s online shop.
- Be mindful of the person’s post-washing routine. Respect their preference for certain haircare products (for example a particular brand, or scent of conditioner or hairspray). They may also cover their hair or wear a turban. If so, make sure you know how they like to wear these.
- Be aware that the person may begin to find hairdryers distressing due to the noise so close to their ears and the sensation of the warm air blowing. Ask them if they prefer their hair to be towel dried instead.
- If the person prefers to have their hair washed by a hairdresser, either arrange regular trips to the salon or find a hairdresser who will come to the house. This may be a time when you can have your hair cut too.
In the early stages of dementia, a person may need to be reminded to shave. As their dementia progresses, it is likely they will need more help.
If the person uses a straight edge or double edge razor, they are likely to need help much earlier than if they use a cartridge-style razor.
If they begin to cut themselves with any type of razor you will need
to supervise, or shave for them. Some razor blade manufacturers now sell razors specifically for carers to use on another person, which include a built-in safety comb and specially designed handle.
If a person uses an electric shaver then they will be able to shave independently for a longer time. If they use tweezers to remove hair, an electric trimmer can remove hair much more easily.
The person should continue using wax, hair removal creams and devices such as epilators for as long as they can safely do so, although they may need support. If using hot wax becomes too unsafe, cold wax strips can be used instead.
If the person usually goes to a salon for hair removal, then this should
continue as long as they feel comfortable and are safe to do so.
Try to make sure that the person cleans themselves properly after using the toilet, or help them to do so, if appropriate.
- be mindful that the person may prefer to use a bidet rather than toilet paper, or uses a preferred hand to clean themselves
- wipe from front to back (which helps to prevent infection), rather than back to front
- use moist toilet tissues, as they clean better than dry toilet paper. They are available from most chemists and supermarkets, and can be useful to keep around in case the person has an accident
- remind the person to wash their hands after they have used the toilet.
Incontinence is not an inevitable consequence of dementia, however if it happens, it can be a sensitive issue for both of you. If the person has an accident, they may feel ashamed. They may refuse to admit that it has happened, or to wash afterwards. Try to be reassuring. A matter-of-fact approach, or gentle humour can work well.
Talk positively and be sensitive towards the person when bathing them or helping to clean up after an accident. Reassure them that, despite it being a very personal activity, you are happy to help.
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