Personal Care

Bathing

Personal Preference

• Some people may not feel the need to shower and/or wash their hair every day.
• Consider alternating a sponge bath with a more complete bath or shower.
• If the person is used to taking a shower in the morning or a bath at night, try to maintain that routine. Changing from day to night might distress the person.
• A person with A.D. may refuse to take a bath for an unfamiliar caregiver of the opposite sex.

Prepare the bathroom in advance

• Have the towels ready.
• Draw the water in the bathtub and test the temperature.
• Pre-measure the shampoo.
• Develop a soap pocket in the washcloth so that the person can wash herself.
• Keep the bathroom warm and comfortable.

Preparing for the Bath

• Be directive at bath time by using such phrases as, "Your bath is ready." In this way, the person will focus on each step of the task instead of whether or not she needs or wants a bath.
• If the individual continues to resist the idea of bathing, distract her for a few moments and then try again.

Make the bathroom safe.

• Always check the temperature of the water. Keep in mind that the person may not be able to judge temperature.
• Avoid using bubble bath or bath and shower oils that would make the tub or shower stall slippery
• Keep in mind that showers are often more dangerous and frightening to people with the disease than baths. If you must use a shower, install grab bars and use a tub seat.
• Never leave a person alone in the bath or shower.
• Consider using a hand-held shower.
• Use only two to three inches of water in the tub and make sure there are rubber mats or decals on the tub’s bottom.
• Use a non-slip bath mat and make sure the bathroom floor is free from puddles. Some caregivers install carpeting in the bathroom.

More Suggestions

• Gently coach the person during each step of the bath, reminding her of the areas that need washing.
• Keep in mind that you may need to complete part of the bath or shower yourself.

DRESSING

For the person with the disease, the simple act of putting on clothing can be frustrating. Keep in mind that getting dressed and looking presentable are critical to a person’s sense of well-being and self-esteem.

Making clothing selections.

• Lay out proper clothes for the person, including appropriate selections for warm and cool weather.
• If appropriate, give the person an opportunity to select favorite outfits or colors.
• If the person insists on wearing the same clothes every day, try to launder these clothes often or get duplicates of favorite outfits.
• You may need to temporarily distract the individual as you remove clothing for cleaning.
• You may want to remove excess clothing from the closet. Seeing many clothes can be overwhelming and upsetting to the person.
• Choose clothing that’s practical.
• Select fabrics that are lightweight and flexible and feel soft and comfortable on the person’s skin.
• In general, choose clothing that’s durable, washable and flame retardant.
• Many caregivers find that cardigans or tops that fasten in front are more comfortable and easier to work with than pullovers.
• To avoid tripping and falling, make sure clothing length is appropriate.
• Pressure tape or Velcro can be used as a substitute for buttons, snaps and hooks. Other devices include large-ring or loop-handled zippers or tape loops.
• Many caregivers turn to jogging suits that are washable, comfortable and have few fasteners.

Pay attention to feet.

• To give the person’s feet adequate support, encourage wearing shoes instead of slippers.
• Slip-on styles with elasticized inserts on the top are easy to put on and remove.
• Sneakers or shoes with crepe soles may help prevent falls.
• Have an extra pair of shoes on hand in case the person’s feet swell and keep the feet warm with loose fitting, easy-to-wear socks.
  

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DENTAL CARE

The person with the disease may have difficulties brushing because he forgets what to do with the toothpaste or how to rinse. As the disease progresses, the person may forget that dental care is important and neglect his teeth and gums.

You, the caregiver, may need to assume increasing responsibility for your family member’s dental care. Your efforts early in the course of the disease may help the person to avoid extensive dental procedures later.

Seek dental care for the person shortly after he/she is diagnosed with the disease.

Try to work with the dentist in the following ways throughout the progression of the disease:

• Contact your local dental society to find the names of professionals qualified to work with the elderly.
  
  Some general dentists have spent extensive time working in nursing homes and are familiar with the illness and the needs of older people.
  
• Stress maintenance.
  
  By working with a dentist to treat the person’s dental problems early in the disease, you can help to avoid having to do extensive dental work as the disease progresses.
  
• Be sure to provide the dentist with a complete listing of health-care providers who have served this family member.
  
  Also include her complete medical history and the names of all medications she has received. You may ask the dentist to arrange for the transfer of records from other offices to his/her office.
  
• Be aware of potential medication problems.
  
  Among the medications you should discuss with your dentist are Haldol, which may cause "dry mouth." Other medications you should discuss include blood thinners, anti-depressants, anti-anxiety agents, antihistamines, diuretics, and hypertensives.
  
• Be aware of the special problems of dry mouth. Saliva tends to act as a buffer against tooth decay.
  
  Some medications reduce the productions of saliva, leading to an increase in tooth decay and gum problems.
  
  If the person complains of dry mouth, offer him/her water periodically throughout the day, or buy artificial saliva (available at your pharmacy).
  
  Since alcohol can contribute to a dry mouth, some experts suggest using mouth rinses that are low in alcohol, or diluting mouth rinses containing alcohol.