Written By: Rudi Lamy, MLS, MAS, Consultant to the Peter Lamy Center on Drug Therapy and Aging
As I write this, I am in desperate need of a long, hot, and soapy shower. If you are, as I am, the caregiver to a patient with dementia, you’ve probably found yourself in the same predicament. As caregivers, it doesn’t take us long to get so wrapped-up in the various and sundry tasks and emergencies of caring for our loved one that we leave “little” tasks, such as personal cleanliness, to go unchecked for a day or two too long.
Home Care and Personal Hygiene 101: The Basics
We as caregivers must remember that, in addition to ourselves, we are responsible for all of the personal hygiene needs of the loved ones for whom we care. During a sermon he delivered in 1778, theologian and evangelist John Wesley coined the modern version of the adage “cleanliness is next to godliness.” He wasn’t wrong. If you’ve been to a hospital or other health care facility lately, you likely have seen the many bottles of hand sanitizer perched atop counters in both waiting and treatment areas. In my home, I always keep a box of nitrile exam gloves, and I use them.
As it turns out, cleanliness just happens to be one of those small tasks that we as caregivers perform daily that is critical to the good long-term home care of a patient with dementia. We can even think of good personal hygiene — ours and theirs — as a preventative measure that we can take to help ward off some of the complications associated with this chronic illness.
Oral Health Care and Dementia
A review article published in Clinical Oral Investigations in 2018 concluded that, “The oral health and hygiene of older people with dementia is not sufficient and could be improved with oral care education of formal and informal caregivers and regular dental care to people with dementia.”
Once both my wife and I retired, we switched to a different dental practice. A few years later, insurance changes required that we make a change once again. Every caregiver will have his or her own criteria and variables to consider when choosing a new dental practice; I can only offer ours as a guide. I needed a practice near our home to help minimize travel, as well as an office that was in our insurance company’s approved network and which would accept our specific insurance plan. We also needed an office that was still accepting new patients.
However, what I thought would be the most difficult criteria to match — finding a practitioner who could work with a patient with dementia — was, interestingly, the easiest for me to find. I just asked to see the dentist once we arrived at the practice and asked “Can you work with a patient who has been diagnosed with dementia?” I was almost stunned when he confidently replied, “Yes.”
Maintaining a good relationship with our dentist has also been key to helping me keep up with my wife’s dental hygiene at home. I’ve found him to be extremely kind and helpful. In addition, I’ve found the Alzheimer’s Association’s dental care guide to be a very helpful resource. There are other reliable sources of information available online as well. For instance, Medicare provides this informative web page, which contains information specifically tailored to meet the unique needs of caregivers of patients with dementia.
Gynecological Health Care and Dementia
As my wife’s primary caregiver, I’ve had to learn how to take care of her feminine hygiene needs – knowledge that I never imagined I’d have to possess at this stage of my life. Fortunately, after asking a few simple questions and receiving some instructions from her physician, I was ready to take on this task.
My wife’s gynecologist and neuropsychiatrist recommend that all older adult women have a standard well-woman exam once every two years. But, this two-year cycle applies only to regular check-ups. Remember that you can always call your health care provider if you experience a problem, regardless of whether you have an appointment scheduled that year.
For caregivers who are caring for a female patient with dementia, it is important to remember that there is a direct link between urinary tract infections and yeast infections and delusions. There are a plethora of online sources of information available for caregivers online, including:
- The Connection Between UTIs and Dementia (net)
- Urinary Tract Infection or Dementia: Which One Do I Have? (S. News & World Report)
Additional information can be found on the American College of Obstetricians and Gynecologists (ACOG) website, including this article on urinary tract infections. You can also find information using PubMed, starting with articles such as “Beyond Urinary Tract Infections (UTIs) and Delirium: A Systematic Review of UTIs and Neuropsychiatric Disorders.”
However, while online sources can be very helpful for some topics, always be sure to check with your loved one’s gynecologist or urologist to get the most accurate diagnosis and treatment. My wife’s gynecologist even offers online communication, which can make getting an answer for a non-emergency question a lot easier.
If you discover that your loved one does have a urinary tract infection, then you will have to contend with the dreaded vicious circle that we discovered. These infections require antibiotic medication, which also kill all of the good bacteria in the body, and often lead to a yeast infection. Remember that you can always consult your pharmacist for information about prescription and over-the-counter treatment options to help address those infections.
Best Practice in Dementia Home Care Hygiene
To conclude this post, I leave you with the following tips to help you maintain good personal hygiene for both you and your loved one at home:
- Keep Clean: Wash your hands. Use gloves. Protect yourself and your loved one from cross-contamination.
- Get Help When Needed: Don’t be afraid to ask your health care professional for information or help.
Thanks for reading.
Rudi Lamy, Caregiver