Our appearance helps express who we are, and self-maintenance is something that slips away for someone with Alzheimer’s or another form of dementia. As dementia progresses through stages, dressing and grooming (including brushing teeth, shaving, and combing hair) become harder. Someone with dementia can look at a nail clipper, comb, or toothbrush and not have any idea what it is for.
The parts of the brain that are affected by the disease will cause different grooming problems. If the part of the brain that can follow a sequence of steps is affected, you may have to remind your loved one at each step of a grooming task. If there is a moment of faltering (these moments increase as the disease advances), demonstrate how to do it yourself, and cue your loved one along to get as much participation as possible.
If you are caregiving for a loved one with dementia, pay attention to how they dress. Someone with Alzheimer’s might wear inappropriate clothing, like a sweater in summer or clothing put on backward. Eventually, your loved one may not know when or how to dress. Expect questions like “Which drawer are my socks in?” or “Where are my shoes?” Finding clothing becomes hard.
When it comes to caregiving, having an established routine makes tasks easier. Cleaning, shaving, dressing, and brushing teeth should all happen around the same time daily. The more you stick to routine, the less your help will be necessary.
Continue to allow the use of favorite products, though you may need to replace grooming tools with something easier to use and safer.
When help becomes necessary, offer reminders of what to do next. You could demonstrate the grooming task and encourage your loved one to do the same thing. If you need to physically step up and help, try the hand-under-hand technique.
– Keep hairstyles short and simple. Remind your loved one how to do something like using a comb, and if necessary, guide the hand. You may be able to let go, to see if your loved one can take over the task.
– Use products that have been used in the past so that they are familiar bottles and labels. This can also give a sense of security through routine and scent.
– Try ergonomic grips and longer handles for toothbrushes and hairbrushes. As coordination and dexterity change, these can be easier to use and give a sense of independence.
– Use minimal to no makeup for women.
– Trips to the barber or salon can be fun and empowering if your loved one can handle a change in scenery. When dementia worsens, there are barbers who will make house calls. Memory care and assisted living residences will often have a hairdresser in-house.
– Remind your loved one how to shave by breaking the process into steps and coaching them through the steps.
– Offer help as it is needed. Have your loved one participate as much as possible by using the hand-under-hand technique.
– Cuts indicate that you may need to take over shaving. Place a towel under the chin to catch water if you use a safety razor. Wet the whole beard with a wet towel, and apply shaving cream. Shave with the grain, in the direction the hair grows. Short strokes. Be gentle over sensitive spots. Rinse with a fresh wet cloth and dry the skin. After-shave is optional.
– If your loved one likes an electric razor, they can probably continue shaving longer before you step in. Consider pre-shave lotion for electric razors. Use firm circular motions. A good way to reduce anxiety about using an electric razor is to put a second one in your loved one’s hand and turn it on. They may connect with what you are doing through the vibration.
– People with dementia often misplace eyeglasses, so a good idea is to keep them in the same place when not in use.
– You will probably need to remind your loved one to put on glasses and ultimately put them on yourself. Use eyeglass holders/cords such as Croakies that allow their glasses to fall around their necks when not in use.
– Do not skip glasses; better vision makes mobility safer and delivers important stimulation to the brain and of course, reduces disorientation.
– Use easy-to-see signs if you are labeling something, use contrasting colors, and have enough lighting. As vision changes, this can let your loved one be less confused and have better mobility.
– Glaucoma and cataracts are common problems that need to be detected and treated to prevent blindness. Regular eye doctor checkups are important for as long as possible.
– In the early stage of dementia, mouth care is usually not a problem.
– Brush teeth at the same time every day and help by showing.
– Brush in the morning and night, and rinse with water after every meal.
– Maximize comfort for your loved one by having them use a toothbrush with a small head and soft bristles. Also, think about using mild or flavored kinds of toothpaste that have a more enjoyable taste.
– Eventually, reminders to brush teeth may be necessary, until you’re helping with the brushing yourself. When this happens, use a moistened gauze pad to clean the gums. This is probably easiest from behind (see the video link above). Long, angled toothbrushes are best for this.
– Look for redness, sores, loose teeth, or swelling. Alert a doctor or dentist if you find anything concerning.
– Unexplained irritability or refusal to eat may indicate a dental or medical issue.
– Help clean dentures, and don’t lose them. Like glasses, people with dementia frequently misplace dentures. Put them in the same place when they’re not in use. Keep them in when your loved one’s awake because dentures are important for proper digestion.
– Reminders eventually may not be enough, and you’ll need to help insert dentures.
– If brushing your loved one’s teeth, consider an assisted brushing toothbrush, a brush specifically designed with a grip and angles to optimize cleaning.
– Elderly people can have a difficult time reaching or seeing their own feet, and balance and dexterity become a problem.
– Establish a regular routine for trimming nails and help as needed.
– Simplify the process. Break down whatever needs to be done into easy and manageable steps.
– Offer help. Check-in with your loved one and offer assistance while promoting independence.
– When your loved one can no longer cut their own nails, help them by cutting nails straight in line with the toe, preventing ingrown nails.
– While helping, watch for swollen spots or discolorations that might indicate a problem like bunions or calluses. It is important to catch and treat foot problems early before they worsen.
– Don’t let your loved one stay in their pajamas all day.
– Encouragement and compliments can help your loved one continue with the daily ritual of dressing.
– Your job is to be like a cheerleader, so this task can boost self-esteem and elevate mood.
– Be sure to allow plenty of time, to avoid creating anxiety and frustration.
– Have a relaxing environment to prevent stress and promote focus. By having a well-lit area to dress, your loved one can be reassured.
– Organize for success. Tape pictures on closets and drawers. Pictures showing what’s inside closets and drawers provide a visual reminder of what’s inside, helping your loved one find the right item.
– Clean out closets and dressers, to avoid having too many choices of jackets, shoes, pants, and other clothes items. With less clutter and clothing, the dressing routine becomes easier. Completely remove out-of-season clothes that aren’t appropriate for the weather. Give your loved one a couple of options to choose from, because choice equals control.
– Lay out clothes for each day, in the order they should be put on (underwear first, then pants, etc.). Labeling can also help; you can put a note on top of pajamas that says “Pajamas to put on after dinner when it gets dark outside.” Eventually, you may need to hand each clothing item one at a time and prompt each step. Be specific about where the head, arms, and legs go, and use visual cues when needed.
– With advanced dementia, you may have to physically dress your loved one. Remember to describe what you are doing, and ask for help so there’s as much cooperation as possible. It is still worthwhile to present a couple of options for tops and pants. If your loved one wants to wear the same outfit all the time, consider buying more of those items.