It is not uncommon for those with dementia to struggle with matters of personal hygiene. This can be uncomfortable for caregivers to discuss, much less, address head-on, but it may be necessary to take action to help solve some of these hygiene problems.

For example, a loved one may wear the same dirty clothes repeatedly — forgetting that they need to be cleaned or simply preferring the familiarity of these clothes. It’s important not to point out that the person smells bad or looks disheveled, because this can cause them to become defensive. Instead, try to address the problem by paring down the closet to a few essentials, and by buying multiple copies of the same outfits, so the person can have that familiarity without actually wearing the same clothes every day. Also make sure to discreetly remove items that have become permanently soiled or dirty.

Another common hygiene problem: Forgetting to bathe. Sticking to a consistent bathing routine can be the best way to address this. Also, avoid falling into the trap of arguing how long it’s been since the last bath, or of whether a bath is really needed. Instead, simply begin the process of bath preparation. Once the bath or shower is ready, invite the person in, and frame it positively. Say something like, “Look, your shower is all ready for you. I know how much you look forward to a nice, relaxing shower!”

Those with dementia may also refuse help bathing, even when they need it. You might try a substitute helper; perhaps a father does not want to be bathed by his daughter, but is fine being bathed by a son or even a hired worker. Also try to minimize the time the individual spends unclothed; use some nice, comfy robes and towels to provide privacy.

Other hygiene issues may surface, too; the key is to think through the reasons they might arise, and to address the problem both pragmatically and also sensitively.

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