One of the ways in which we stand out as individuals in the world is through our appearance. As an individual’s dementia progresses, dressing and personal grooming tasks, such as caring for teeth, shaving, and brushing hair, becomes more and more challenging. The individual with dementia may even forget the function of a nail clipper, comb, or toothbrush. In addition, the person may wear inappropriate clothing, such as a sweater in the summer, or he or she may wear clothing inappropriately, such as wearing a shirt backwards. Eventually, your loved one may not know when to change clothes. You may also hear comments such as, “Which drawer are my socks in?” or “Where are my shoes?” as it becomes harder to find clothing.
Try to maintain the grooming routine established by your loved one, as the less you change the grooming routine, the more he /she will be able to do by him / herself. Also, continue to allow the individual to use the products that are his / her favorites. It’s also a good idea to use simpler, safer grooming tools. Remember to encourage and compliment your loved one in his or her efforts to groom. Problems with grooming depend upon which part of the brain is affected. For example, if the part of the brain that can follow a sequence of steps is affected, you may have to remind your loved one about each step of a grooming task. When he or she falters, demonstrate the grooming task and encourage him or her to copy you. If this fails, try the hand-under-hand technique.
Try short, simple hairstyles for men and women. Your loved one may need reminders to comb their hair in the early stage of dementia, and as the disease progresses, will require more assistance with the task. He or she may be able to take over a grooming task, for example, hair brushing, once you guide his or her hand to perform it a few times. Use minimal to no makeup for women.
In early stage Alzheimer’s or a related dementia, just a reminder to shave may be needed. If your loved one was already using an electric razor, he may be able to continue shaving relatively longer as it takes less dexterity and is safer than regular razors. If your loved one starts cutting himself with a razor, it may be time to take over shaving. If you use a safety razor, prepare by putting a towel under his chin to catch water. Use a cloth to wet the man’s beard area and apply shaving cream. Shave in the direction hair grows using short strokes, being gentle over sensitive areas. Rinse with a fresh wet cloth and dry his skin. After-shave lotion is optional.
With electric razors you may want to use a pre-shave lotion specifically for electric razors. Use firm circular motions. One way to help reduce anxiety in your loved one about your using an electric razor to shave him is to put a second electric razor in his hand and to turn it on. Feeling the vibration in his hand may help him connect with what you are doing.
People with dementia frequently misplace eyeglasses. Your loved one may eventually reach a point where he or she forgets to wear needed glasses and will need reminding. Eventually, he or she may need help putting them on. It is important the individual continue to wear glasses to help make mobility safer and to provide visual stimulation to the brain. Glaucoma and cataracts are common eye problems that need to be detected and treated to prevent blindness.
Suggestions: Be careful to always put eyeglasses in the same place when not in use. Remind your loved one to wear glasses. Remember to take your loved one to regular eye doctor checkups for as long as possible.
In the early stage of dementia, there often is no problem with mouth care. However, as the dementia progresses, your loved one may need to be reminded to brush their teeth or care for their dentures. Note: People with dementia frequently misplace dentures, but it is important they continue to wear dentures for proper digestion. Your loved one may eventually reach a point where he / she forgets to put in their dentures and will need reminding, and eventually, he / she may need help with this task, as well as brushing their teeth.
Suggestions: Be careful to always put dentures in the same place when not in use. Remind your loved one to wear dentures. Remember to take your loved one to regular dental checkups for as long as possible.
Mouth care in late dementia: Eventually you may have to take over the care for teeth and dentures, including inserting and removing dentures. As communication problems progress, your loved one may be less capable of communicating about a dental problem. Unexplained irritability or refusal to eat may indicate a dental or medical issue.
Suggestions: Brush your loved one’s teeth and/or use a moistened gauze pad to clean soft tissues in the mouth after every meal. Many caregivers find this is easiest to do from behind with your loved one’s head resting on a chair back or in their lap. A clean mouth helps reduce the risk of infection. Look for redness, sores, loose teeth, or swelling, and if you find any, seek dental treatment for your loved one.
Your loved one may lose the ability to groom his / her own nails, especially toe nails. In addition to simply forgetting how to do it, with age it also becomes harder to reach or see one’s own feet. With some forms and stages of dementia, balance and dexterity may also be a problem. Painful foot problems, such as bunions or calluses, are common in the elderly, but a person with dementia may not be able to communicate clearly what is wrong.
Suggestions: Establish a regular routine for grooming nails and assist as needed. While you are grooming the feet, check for signs of irritation that might indicate shoe problems or any enlargements, discolorations or other changes that might indicate a foot problem. It is important to catch foot problems while they are minor before they progress to serious problems.
By encouraging and complimenting a loved one with dementia in their efforts to dress and groom, you can help them to continue with the daily ritual of dressing and boost their esteem and mood at the same time. A good rule of thumb is not to let your loved one stay in their PJs all day. When having your loved one dress him / herself, allow plenty of time to avoid creating anxiety and frustration.
Try the following clothing options:
Avoid the following clothing options:
Use Organization to Support You and Your Loved One
Place pictures on closets and drawers: Pictures of what is inside closets and drawers placed on the outside provides loved ones with a visual reminder of what is inside. This can help your loved one when they are looking for their clothing.
Clean out closets and dressers: Avoid having too many choices of jackets, shoes, pants, and other clothing items. By reducing the amount of clutter and clothing, your loved one will be less confused when picking out something to wear. Also, consider removing out-of-season clothing to simplify decisions and prevent him or her from wearing inappropriate clothing.
Lay out clothes for each day: Laying out clothing choices for your loved one allows him or her to remain in control of the dressing process and it also simplifies the decision process. It may help to label each item as well. For instance, you can put a note on top of the pajamas that says “pajamas, put these on after dinner when it gets dark outside”. Eventually, you may need to hand each item of clothing to your loved one and prompt him or her as to what needs to be done to put it on.
Dressing in Late Stages of Dementia
With more advanced dementia, you may have to physically dress your loved one. As with other activities, remember to describe to them what you are doing and cue them as to what you want them to do. That said, caregivers find that it is still worthwhile to allow their loved one to maintain some sort of choice in clothing. By presenting individuals with dementia with a couple of options of tops and pants, you allow them to choose their outfit. If you find that your loved one wants to wear the same outfit all the time, consider buying duplicate outfits or similar ones.