When a person with dementia doesn’t want to change their clothes or wash

If the person with dementia doesn’t want to change their clothes or wash, it can be very frustrating. Try to remain calm and find a way around it. Think about what the person’s routine was like before they had dementia, and encourage them to maintain that level of cleanliness.

Not wanting to change clothes

Sometimes people with dementia are reluctant to undress, even when they go to bed, or will refuse to change their clothes.

It’s important to make sure the person changes their underwear every day and the rest of their clothes regularly, and to find ways to do this without upsetting them. Here are a few ways you could help someone:

• Remove dirty clothing and put clean clothing in its place when the person is in the bath or shower, or when they go to bed. 
• Encourage them to change for certain occasions, for example because someone is coming to visit, or they are due to go to a formal group event.
• Tell them how much you’d love to see them wearing something new.
• If they want to wear the same outfit, you could buy multiples of the same items.

Not wanting to wash

The person you are caring for may not choose to wash as often as you would wash, and you should respect their choices. However, you will need to make sure that they are washing enough to prevent ill health. To prevent infection, their bottom and genitals should be washed every day. Their face should be washed every day to keep the skin clear.

If the person you care for is reluctant to wash you could:

• try to work out why the person is refusing to wash. For example, do they think they have already had a bath or shower, or have they forgotten the steps needed to wash themselves?
• check if there may be physical problems which are making washing difficult. For more information on identifying difficulties and helping the person, see Changes in behaviour
• try a sponge bath at least twice a week, if they refuse a bath or shower. You can wash them with a wet sponge or cloth, but without them getting into a bath or under a running shower
• think about the timing of your request, or the way you phrase it. A person may refuse to wash when you suggest they should, but may decide to wash themselves later in the day – try to be flexible
• persuade the person to wash by giving them a reason – such as if they are going out or expecting visitors
• speak with the GP about any health concerns you have about the person’s hygiene
• consider arranging external carers to carry out personal care. A needs assessment with social services is a good way to see what care and support might be available.

If the person becomes aggressive when you suggest washing, change the subject or distract them and try again later.