Odd or frustrating behaviors around clean clothes, bathing, oral care, hairstyling, and shaving seldom come “out of nowhere.” Usually there’s a trigger, and ways to work around it.

Problem 1: Wearing Dirty Clothes Over and Over

The Person May:

• Forget that the clothes are dirty after they’re removed (so they never wash)
• Have impaired ability to make judgments
• Like the familiarity
• Be overwhelmed by too many choices while dressing

What to Do

• Avoid pointing out that clothes being worn are dirty, which puts the person on the defensive and sets up an argument she doesn’t understand.
• Ask yourself if you’re bothered by the repetition of the outfit or by actual dirt or odor. (A couple of generations ago, people didn’t change clothes every day.)
• Pare down the closet to fewer options. Stock solids in favorite colors instead of patterns.
• Buy an identical replacement for favorite outfits (same color, style) so you can wash one while the other is being worn.

Problem 2: Forgetting to Bathe

The Person May:

• Have memory loss that prevents them from keeping track of or caring about bathing
• Feel confusion about the sequence of steps involved
• Feel juvenile, anxious, or defensive when asked or reminded about bathing

What to Do

• Stick to a consistent bathing routine. Make it the same time the person previously bathed (first thing in the morning, right before bed).
• Don’t remind or even mention how long it’s been since the last cleanup. Instead of arguing, proceed with bath preparations.
• Don’t ask, “Did you shower?” or “Would you like to shower now?” Get everything ready and invite the person in: “Look, your bath is ready. I know how you love your evening bath.”

Problem 3: Refusing to Bathe

The Person May:

• Have depression
• Be embarrassed being seen naked
• Have had a previous upsetting experience (slipped, the water was too hot, it took too long, she got chilled)
• Have fears (of falling or drowning)
• Dislike being told what to do

What to Do

• Build positive associations with bathing: Precede the bath with a pleasant activity (listening to a favorite radio program) and follow up with another one (a dish of ice cream).
• Build pleasant associations with the bathroom, such as hanging favorite pictures there. Keep the door closed for privacy. Buy their favorite brands or scents.
• Stick to a consistent bathing routine, which becomes soothing. When you find an approach that works, try to replicate it exactly the next time.

Problem 4: Not Wanting Help Bathing (But Needing It)

The Person May:

• Be modest
• Feel diminished by loss of independence
• Have had an unpleasant experience with someone helping

What to Do

• See if a substitute helper works better. A father may refuse a daughter’s help, for example, but accept that of a son or an aide.
• Avoid a situation where the person has to walk from changing room to bathroom naked or wrapped in a small towel. This can build embarrassment or resentment. Use an ample robe or let the person disrobe in the bathroom.
• Use a distraction while helping the person undress, such as singing or a telling a happy story unrelated to bathing.

Problem 5: Not Taking Care of One’s Teeth

The Person May:

• Suffer memory loss (a common hygiene problem)
• Dislike help because he or she feels they’re being treated like an infant or out of control
• Have dexterity problems

What to Do

• Visit a dentist twice a year to check for cavities, gum infections, dangerously cracked teeth, ill-fitting dentures, and the like. Make sure the office knows the person has dementia, to book adequate time. For tough cases, ask for a referral to a geriatric dentist who has experience working with dementia patients.
• Incorporate toothbrushing into the daily routine, such as when getting dressed or ready for bed (ideally both). If it becomes a battle, pick the person’s most cooperative time of day. Try brushing your teeth at the same time.
• Use the same brand of toothpaste the person has always used, if you can. Apply it to the brush for him or her.

Problem 6: Trouble Grooming

The Person May:

Visit a dentist twice a year to check for cavities, gum infections, dangerously cracked teeth, ill-fitting dentures, and the like. Make sure the office knows the person has dementia, to book adequate time. For tough cases, ask for a referral to a geriatric dentist who has experience working with dementia patients.

Incorporate toothbrushing into the daily routine, such as when getting dressed or ready for bed (ideally both). If it becomes a battle, pick the person’s most cooperative time of day. Try brushing your teeth at the same time.

Use the same brand of toothpaste the person has always used, if you can. Apply it to the brush for him or her.

• Forget the task entirely
• Forget the complicated steps involved
• No longer be able to identify tools involved (comb, razor)
• Be embarrassed

What to Do

• Let the stylist or barber know the person has dementia when you book the appointment, to allow for extra time.
• Don’t try to maintain an elaborate women’s hairstyle. Ask the stylist to “accidentally” cut it extra-short, so you can go longer between trimmings. Exception: If a woman has a long tradition of a weekly salon visit, she may get pleasure in continuing.
• For shaving, get the razor and lotion ready and give prompts at each step. Some men avoid shaving because they can’t remember how.

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