How can I assist my loved one with Alzheimer's disease with their personal care needs?

People with Alzheimer’s disease eventually need help with activities of daily living (ADLs). Depending on his or her level of independence, a person with Alzheimer’s disease may need help with personal care activities, including eating, bathing, shaving, and using the toilet. To assist with these activities, caregivers need knowledge, skill and patience.

The following are some tips for caring for your loved one’s personal needs:

General tips

• Establish a routine. Schedule grooming activities for the same time and same place each day. For example, brush teeth after meals, or schedule baths for the mornings or evenings. Choose the most relaxed time of the day for bathing and grooming.
• Respect privacy. Close doors and blinds. Cover the person with a towel or bathrobe.
• Encourage independence as much as possible. This will help to promote a sense of accomplishment.
• Keep in mind the person’s abilities. Allow enough time to complete each task; for example, brushing his or her hair or teeth.
• Give encouragement and support as he or she completes tasks. Acknowledge his or her efforts when completed. "You did a nice job brushing your hair today."
• Tell the person what you are doing. "I am going to wash your hair now."
• Keep fingernails and toenails clean and trimmed.
• Break down all grooming tasks into simple, step-by-step instructions.

Eating

• Be sure to provide your loved one with a nutritious diet and plenty of healthy fluids, such as water or juice.
• Encourage independent eating if your loved one is able. Consider serving finger foods that are easier for the person to handle and eat.
• Adaptive equipment, such as plate guards or silverware with specially designed handles, is available for individuals who have difficulty holding or using utensils.
• Do not force feed. Try to encourage the person to eat, and try to find out why they do not want to eat. Remember to treat the person as an adult, not as a child.

Bathing

• Remove or secure throw rugs to prevent falls.
• If the person is heavy or can offer little help, special equipment may be needed. Your doctor or therapist can give you advice on how to safely bathe your loved one.
• A complete bath may not be needed every day. A sponge bath may be enough.
• Always check the temperature of the water in the bath or shower. You may want to consider setting your hot water thermostat to 120 degrees Farenheit.
• If giving a bath in the tub, try using a bath chair with handrails. Also, place rubber mats in the tub to prevent slipping.
• Use a hand-held showerhead.
• Make sure the bathroom is warm and well-lit.
• Let the person wash him/herself (if able). If needed, help guide them through each step with simple instructions. Another idea is to place your hand on top of theirs to assist with the washing action.
• Be sure that the genital areas, the area underneath any folds of skin and difficult-to-reach areas are cleaned and dried well after the shower.
• Pat the skin dry; do not rub. Apply lotion to keep the skin soft and supple.
• Never leave a frail or confused person unattended in the shower or tub.

Hair care and shaving

• Try washing the person’s hair in the sink, especially if baths are preferred to showers.
• If your loved one is able, a trip to the salon or barbershop may be a fun and positive experience.
• Try using a dry shampoo if the person is bed-bound or fearful of having his or her hair washed.
• To reduce the risk of cuts, use an electric razor for shaving, especially if the person is taking blood-thinning medicines (such as Coumadin®).

Dressing

• If the person can dress himself or herself, lay out the clothes in the order they are to be put on.
• Buy loose-fitting, comfortable clothes.
• Buy clothing that is easy to put on and take off. Garments and shoes that use Velcro closures and large zippers are preferred to belts, buckles, buttons and shoelaces.

Dental care

• If the person brushes his or her own teeth, help by putting the toothpaste on the brush.
• If the person does not brush his or her own teeth, assist them.
• If the person refuses to open his or her mouth, try brushing only the outside of the teeth.
• If the person wears dentures, clean them every day. Check that the dentures fit properly, and examine the gums for sores or areas of redness.
• Have the person rinse mouth with water after each meal.
• Ask your dentist for advice on providing good dental care.

Using the toilet

• Install safety features in the bathroom, such as grab bars and raised toilet seats.
• A bedside commode or urinal may be helpful if getting to the bathroom is a problem, especially at night.
• Schedule routine bathroom visits to prevent accidents.
• Tell the doctor about any loss of bowel or bladder control. These problems may be symptoms of conditions that can be treated with medication.