Help with washing, showering and bathing

The information provided on this page is available to download as a printable booklet.

How often we wash, when we do it and how it is done are all very personal routines that have been developed over a lifetime. Most of us will not have needed any help with these activities since we were small children. However, these activities are often problematic for people living with dementia. The damage to the memory centres in the brain may mean that people simply forget they have not had a wash. Washing and showering involves considerable practical, visual, sensory and motivation skills, all of which can be damaged in dementia.

Individuals react in different ways to being helped with washing themselves. They may find the experience frustrating, humiliating or disorientating, or find the sensory experience unpleasant. The person may not understand why you are trying to help with something that in their mind they have already done. It’s also common for those providing care to find these activities both physically and emotionally challenging.

No one is the same, and everyone responds differently to this situation, with different experiences. While the following may not work for everyone, this booklet contains some examples of things that have helped for some.

This page covers:

• How often do you wash and how do you wash?
• Familiarity and routine
• Dignity and choice
• Equipment and adaptations
• Getting help

How often do you wash and how do you wash?

Even life-long partners and good friends will have different washing and bathing habits.

• If you are caring for someone, it is important to work from their schedule rather than your own.
• If you like a daily shower but the person you are caring for likes a weekly bath then you are unlikely to get them to change!
• Some people may go back to the sorts of washing and bathing routines they knew growing up.
• For many older people, bathing was often a once a week routine with a wash in front of the sink being the norm when they were growing up.
• Showers may be a relatively new experience over a person’s lifetime. Although they may have had a regular shower before dementia, this way of washing will be less familiar overall.
• Reflect on whether the person really needs a wash/shower/bath or whether the frequency can be relaxed.
• Reflect on whether a wash in front of a sink may work better for the person.
• Many people will respond better to a reason to wash and look their best. For example “We’re going to see David this afternoon so we’d better get spruced up!”
• Early on in a person’s dementia, it is a really good idea to record their preferred washing, showering and bathing routines in as much detail as possible.

Return to the top of the page

Familiarity and routine

• Use the products the person you care for has always used. Smells of familiar soap can prompt people to wash themselves.
• Use language or sayings that they are used to, to help put them at ease. An example might be “Friday night is bath night.”
• If the person you support needs some physical help to wash, try to do things in the way and order they have always done or show a preference for. Does the person use a flannel? Do they wash their hair and face in the bath?
• Washing, showering or bathing at the same regular time, in the same way, with regular reminders, can help assisted washing to become normal and accepted.

Return to the top of the page

Dignity and choice

• Reflect on whether you can make these activities more dignified for the person.
• Make use of 2 large towels – one to cover and one to dry.
• Special dignity gowns that cover the person in the shower work for some people.
• Encourage the person to continue doing what they can. Though it may seem quicker to do everything for someone when washing, showering or bathing, this can be disempowering.
• If they are able to help in washing themselves, this will likely feel more natural and agreeable to them, and help maintain their both their ability and dignity.
• If they are not able to help in washing themselves, consider what positions (e.g. standing or sitting) are easiest and most comfortable for them in order to wash them.
• If you are not the partner of the person living with dementia, consider someone from the same gender to help them get washed as this may feel to be more dignified for the individual. Consider what the individual would prefer.

Top tips for minimising discomfort and distress

Things to think about beforehand:

• Don’t rush – ensure you can allow adequate time and plan ahead so that you can do so.
• Before the activity, take to time to consider and think through what might work best for you both, to help with this.
• The default position for a person living with dementia may often be to say no if they cannot visualise what you are asking them to do. Suggest that you would like to ‘give them a hand’ rather than taking over the whole activity for them.
• People living with dementia can be more sensitive to temperature, so making sure the water is not too hot and the room is not too cold (including the floor, toilet seat, etc.) can help.
• Touch is also important. While some people wear gloves for hygiene, others prefer not to as gloves can feel strange and uncomfortable to the person you are helping.
• Ensuring your fingernails are kept short will minimise the risk of scratching and is more hygienic also.
• If the person is already angry or distressed at the time you planned to wash/shower/bathe then it is probably best to postpone the activity.
• Trying to force someone to wash will only reinforce negative feelings about washing and make things harder. 

During washing, bathing and showering

• Distress sometimes results from people not understanding what is happening or what to expect.
• Try explaining what you are going to do, and why, before you do it.
• Use non-verbal cues such as mime with hand gestures and show the person you care for what products or equipment you are going to use.
• Experiencing the feel, smell and appearance of products before you use them can help prepare someone for washing.
• Using humour where possible can also help keep things light, diffuse awkwardness and tension, and put people at ease.
• Sometimes the person may mistake you for someone else during these activities. It is not uncommon for the person with dementia to think the person helping them is their mum or big sister. Try not to overreact or correct the person if this happens. It maybe that childhood memories are being triggered.
• Follow the activity with something enjoyable for the person you care for, that they might look forward to. Refer to this ‘treat’ in your conversation during the activity as a focus towards completion.

Return to the top of the page

Equipment and adaptations

• Many find grab rails, a shower stool, a bathroom chair and a hand-held shower head are essential to making bathing more straightforward.
• Many also find non-slip bath mats essential, as long as they are kept clean and in good condition.
• A walk-in shower or wet room can make washing easier, but such a bathroom conversion is not always practical, affordable or even wanted by everyone.
• A wet room may feel very confusing and exposing to someone who has not previously experienced one.
• Various types of hoist seats or inflatable lifts are available to help with getting in and out of the bath.

• There are completely safe no rinse products (nilaqua) for washing and hair washing, that are excellent if the person is reluctant or averse to showering or bathing.
• There is also a product called a ‘Shower Drapon’ by Limon Attire. This product can help you to wash the person through the fabric, protecting their modesty. Search their website for more details www.limonattire.com
• Ask your pharmacist about these or look out for them in supermarkets or chemists or online.

In the following short clip, Paul shares his experiences of helping his wife in the shower and some of the equipment that he finds useful. Please note that any mention of specific products is not an endorsement, but what helps Paul and his wife in their situation.

Return to the top of the page

Getting help

Helping someone with their personal hygiene on a regular basis can be exhausting. There are many different health and care professionals that can provide practical advice, equipment and aids.

For advice and support phone any of these helplines: Alzheimer’s Society 03331 503456; Alzheimer Scotland 0808 808 3000; Dementia UK 0800 888 6678; Dementia Carers Count 0800 652 1102. Nothing that you discuss will shock or embarrass people on the other end of the phone.

Return to the top of the page