The first requirement is the need to change regularly dirty or soiled clothes, and the second, washing and bathing. Some of the problems surrounding dressing have already been referred to, but the most difficult situation is a confused person who refuses to change his or her clothes. This usually happens when the suggestion is made after the person has already dressed and is most easily overcome by arranging for the provision of clean clothes and the removal of dirty ones either last thing at night or first thing in the morning.

Having a bath or a shower can also be a problem and if it provokes a catastrophic reaction it may be better to accept that there will be fewer baths if a daily routine can't be established. Do remember to make sure that someone checks the temperature of the bath water. A bedbath, although sometimes successful, is often more problematic than an ordinary bath.

It is particularly important to ensure that the skin areas around the genitalia, the patient's bottom, and the areas in skin folds, including under a woman's breasts, are thoroughly attended to. If this is not scrupulously done, superficial skin infections will take a hold, with resulting discomfort and unpleasant odours. To prevent the skin becoming chafed and sore, ensure that it is completely dry after washing or bathing. Follow towelling with talcum powder, especially in areas under skin folds.

Safety in the bathroom is paramount. As well as non-slip mats and rails in the bath and shower, make sure that the floor will not become slippery if water is spilt on it, as is the case with linoleum. Modern bathroom carpeting is very effective, but expensive. An alternative, although second best, is a substantial bath-mat fixed firmly in place with Velcro pads, attached both to the linoleum and to the underneath of the mat.

Many people believe a shower to be more unsafe than the bath. This need not be so, as many baths have high sides and it is when negotiating these that accidents can happen. A shower cubicle with a chair or stool within it and a shower head attached to a flexible hose is often easier for a relative or other carer to manage.


General Health