Daily Care and Management
Mary M Lancaster
Nothing in life is to be feared, it is only to be
As the course of Alzheimer's disease progresses, patients begin to demonstrate a lack of attention to personal hygiene and grooming. This development may be caused by changes in memory that interfere with the patient's ability to perform tasks that require sequential steps or by simply ignoring the need for personal hygiene. Whatever the cause may be, patients with Alzheimer's disease soon experience problems with bathing, changing clothes, eating, and using the bathroom. To caregivers, these tasks seem quite simple, but to those whose memory is impaired, the tasks of daily living can be frustrating, confusing, and overwhelming.
Caregivers need to continually assess the patient's skill in performing activities of daily living (ADLs) since this skill level can change on a daily basis. Expecting the patient to perform an activity that he or she cannot do will lead to frustration for the caregiver and the patient. Catastrophic reactions occur when the patient becomes overwhelmed and frustrated by expectations. Caregivers must be attuned to the patient's general hygienic needs and to their specific areas of impairment in order to promote good personal hygiene, independent functioning, and strong self-esteem.
Maintaining set routines for all ADLs also helps to keep the patient functioning independently. For instance, every morning upon arising from bed, the patient should go through the same activities in the same sequence and at approximately the same time. The patient may use the bathroom, eat breakfast, take a bath, dress, and then brush his or her teeth. This routine should be followed every day. When routines and schedules are disrupted or changed, the patient finds the situation confusing and frustrating. A catastrophic reaction may occur that could be avoided by planning for hygienic needs in a way that is compatible with the patient's needs.