Alzheimer’s Disease and Self-Care

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Logo for UNC Chapel Hill, Cecil G. Sheps Center

People with Alzheimer’s disease may stop taking care of themselves or where they live. They may just forget, or they might not be physically able to bathe, change clothes, or clean their homes. Or they might think it isn’t a problem.

This can be a challenge if your loved one lives on their own or refuses your help.

If the change in self-care happens suddenly, try to figure out if the person is sick or depressed. Look for signs of an illness, such as a runny nose, sneezing, headache or other pain, shortness of breath, cough, vomiting, diarrhea, or bleeding. Signs of depression in people with dementia include:

  • Sleeping more or less than usual
  • Eating more or less than usual
  • Having little interest in normal activities

If they haven’t been taking good care of themselves for a while, you may need to help them stay clean and healthy. Some people will be OK if you remind them or help with things like bathing and cleaning. Others might get upset and refuse your help.

If this happens, you’ll need to decide if it’s safe to let the behavior go on. If it’s not, it might be a good idea to hire someone to help or find other living arrangements. Medications can’t help with this kind of behavior.

Knowing When to Step In

If your loved one doesn’t want help but their lack of self-care causes problems, focus on changing the things that could be dangerous, like:

  • They don’t take their medicine.
  • They don’t treat ongoing medical conditions, like diabetes.
  • They’re not eating or drinking.
  • They have untreated cuts or sores.
  • Their home has bugs or rodents.
  • They keep or hide rotting food or garbage around the home.
  • They smell like pee or stool, and the smell is in their house.
  • They’re so dirty that you’re worried about them getting an infection.
  • They have more pets than they can manage.
  • They don’t wear the right clothes for the weather.
  • The heating, cooling, water, and electricity aren’t working in their home.
  • Paper or other clutter is too close to hot things in their house like radiators, stoves, or electrical appliances.
  • Clutter makes it hard to move around their home.

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Helping Your Loved Ones Take Care of Themselves

If your loved one shows signs of poor hygiene, try reminding them to bathe, change clothes, brush their teeth, and trim their nails. If that doesn’t work, offer to help them. Make sure they’re wearing the right clothes for the weather.

If they have problems taking care of their medical needs, talk with their doctor or a counselor about how you can help them remember to take their medicine or keep chronic conditions under control. If they need to be on a special diet, take away or lock up food they shouldn't eat.

If your loved one has trouble moving around or you’re worried about them falling, especially in the bathroom, put in railings and make sure that all furniture is stable so they can lean on it to get from place to place.

Check the pantry and refrigerator regularly, and toss food that’s spoiled or expired. Have any needed repairs done around the house, and make sure that working smoke detectors and carbon monoxide detectors are in place.

Be aware that taking things out of the home or making too many changes might upset your loved one. To try to keep this from happening, go slowly. Also, make sure they’re comfortable and understand what you’re doing.

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Reviewed by Melinda Ratini, DO, MS on July 18, 2018

Sources

SOURCES:

Alzheimer’s Association: “Personal Care.”

Journal of Aging and Health: “The prevalence of elder self-neglect in a community-dwelling population: hoarding, hygiene, and environmental hazards.”

International Journal of Nursing Terminologies and Classifications: “Self-neglect: a proposed new NANDA diagnosis.”

JAMA, the Journal of the American Medical Association: “Nonpharmacologic management of behavioral symptoms in dementia.”

Pain Management Nursing: “The assessment of discomfort in dementia protocol.”

Mace, N. and Rabins, P. The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer’s Disease, Related Dementias, and Memory Loss, John’s Hopkins University Press, 1981.

Journal of General Internal Medicine: “Self-neglect in Older Adults: a Primer for Clinicians.”

Journal of Elder Abuse & Neglect: “Severe self-neglect: an epidemiological and historical perspective.”

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