Washing and bathing

8. When someone is reluctant to wash

Washing is a matter of personal choice. Today, most people in the UK bathe or shower daily, but 30 years ago it was normal to have a bath only twice a week. However, washing is not just about smelling fresh and looking well-kept. It also helps prevent ill health. Not washing enough can lead to infections and skin complaints. If the person you are caring for doesn't choose to wash as often as you would wash yourself, that's not necessarily something to worry about. However, if their personal hygiene is causing problems or concerns, you will need to be a little more persuasive.

  • Make sure the person washes their hands before eating or handling food and after using the toilet.
  • The bottom and genitals should be washed every day to prevent infection. Urinary tract infections are more common in older people. 
  • The face should be washed every day to keep the skin clear.
  • The person should have a full-body wash - for example, a bath, shower or sponge bath (washing of the body with a wet sponge or cloth, but without immersion in water) - at least twice a week. This doesn't have to be done all at once though. Make use of opportunities as they arise. For example, washing different areas of the body on different days.
  • Teeth or dentures need to be cleaned twice a day to maintain oral health. 

If the person with dementia doesn't want to wash, try to remain calm and find a way around that does not involve confrontation. Think about what the person's routine was like before they had dementia and encourage them to maintain that level of cleanliness.

Encouraging someone to wash: tips for carers

  • Try giving gentle reminders about using the toilet or washing.
  • Think about the timing of your request, or the way you phrase it. A person may adamantly refuse to wash when you suggest they should, but may decide to wash themselves later in the day - try to be flexible.
  • You may find it easier to reason with the person that they should wash if they are going out, or if they are expecting visitors.
  • If bathing or showering causes the person distress, a sponge bath may be sufficient.
  • If the person is reluctant to change their clothing, try removing dirty clothes and substituting clean ones at bedtime, or after a bath. This can help prevent arguments. If they always want to wear the same clothes, it can be helpful to have a number of the same items.