The importance of personal hygiene care for older adults

Challenges for older adults in carrying out everyday personal hygiene tasks

Personal hygiene is usually a daily task that runs on autopilot for many of us, but as we get older our ability to carry out these tasks effectively and safely can start to diminish. While hygiene is an important consideration in order to maintain health and wellbeing, for older adults or those with limited mobility, undertaking daily personal hygiene tasks can go from easy to extremely challenging, or even impossible. Here, we are exploring the many physical, mental and emotional benefits of keeping up with regular personal care activities, the common challenges older adults face when managing their own personal hygiene, the essential hygienic practices everyone should consider doing, some tips for supporting an older loved one with their personal hygiene needs while encouraging their independence, and the role a professional home carer could play in this. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about personal hygiene in older adults, we can help. 

What physical health benefits are there to looking after personal hygiene?

There are a number of illnesses and issues that can arise from not taking proper, regular care of your personal hygiene, but doing so can help to avoid things like: 

• Infections – Washing hands regularly and taking care of any wounds is important to avoid the spread of infections. According to the Centers for Disease Control and Prevention, educating people on the importance of hand-washing helps to reduce diarrhoea-related illness in those with weakened immune systems by 58%, and since older adults tend to have weakened immune systems, regular bathing and hand-washing can help them avoid contracting bacterial, viral or fungal infections. 
• Skin Infections – Without regular cleansing to wash away perspiration and other impurities, skin can become dry, cracked or irritated, and when contaminated, this can lead to infections that can be painful, itchy or frustrating. Pressure sores can also occur if you are confined to one spot for a long time, and these can lead to infections if not properly cleaned. Regularly bathing skin and moisturising, particularly if you have a condition like dermatitis, is crucial to keep skin healthy and feeling fresh. 
• Dental Issues – Dental and oral issues can arise if you avoid or forget to brush and take care of your teeth on a regular basis. Twice a day, you should be brushing and flossing in order to prevent gum disease, tooth cavities, bad breath, and unpleasant infections. Good oral hygiene can prevent these issues from forming, so it is certainly worth spending some time doing this each day, or asking for help if you cannot do it alone. You can read more about this in our guide to dental care for older adults.
• Foot Care – For most of our lives, our feet may seem to take care of themselves, however in older age feet may need a little more help to stay healthy. Doing regular foot care activities, which include nail care, can help to prevent fungal infections and sores from forming, and stop ingrown toenails from becoming painful or affecting mobility. This is key for those with diabetes who have an increased risk of neuropathy and foot ulceration. You can read more about the foot issues older adults usually face in our guide to common foot problems in older adults.

One of the most vital reasons for undertaking regular personal hygiene activities is to detect any health complications that may be in the early stages of forming. These could be discovered by yourself or by a home carer if you are unable to check yourself. For example, while bathing, you may notice the beginnings of a medical condition forming, such as swollen glands, a skin condition, or a rash. Regular personal hygiene activities can help to pick up on any symptoms or health complications that would otherwise be missed. 

What are the most common challenges older adults face when taking care of their personal hygiene?

Older adults may find it more difficult than most to keep on top of their personal hygiene for a number of reasons. Studies suggest common factors affecting this include their personal health needs, their degree of independence, their motivation, and more. Some notable challenges they may face include: 

Mobility Issues and Physical Weakness 

A lack of mobility could affect a person’s ability to maintain their personal hygiene each day. Conditions like arthritis, balance problems, or symptoms like extreme fatigue can make tasks like bathing, grooming and getting dressed more difficult. Also, even without a disability, older age can lead to physical weakness such as reduced strength and endurance, which can hinder an older adult’s ability to perform hygiene tasks independently. Statistics show that in the UK, among people of state pension age with a disability, around 69% were affected by mobility impairments, and 46% were affected by issues with stamina, breathing or fatigue. If you are planning to help a disabled older loved one to bathe, get to and from the bathroom, or carry out other personal care tasks, it is extremely important to adhere to certain moving and handling practices that help to preserve their health and yours. You can read more about this in our guide tomoving and handling in home care.

Dexterity Issues 

Dexterity issues mean an older person may not have full use of their hands for personal care activities like cleaning hearing aids, or brushing their teeth. Oral hygiene is valuable for this age group, as studies suggest around 35% of older adults have not seen a dentist in the last year. It can help an older person to get the right nutrition and avoid chronic conditions, however they may require daily assistance for intricate personal care tasks such as this. You can learn more about oral health issues in our guide to dental care for older adults.

Cognitive Decline

Conditions like dementia can affect an older adult’s ability to remember or understand the importance of hygiene routines, which can lead to them missing key tasks that should be carried out to stay healthy. In this case, it may be necessary to have a loved one or a home carer take on more of a role in helping maintain their personal hygiene. According to the Alzheimer’s Society, 900,000 people currently live with dementia in the UK, so this is a fairly common condition that could lead to older adults forgetting or misunderstanding the need to carry out personal care tasks. You can read more about this condition in our guide to what dementia is. 

Vision Problems

Impaired vision can make it difficult to see clearly for activities like shaving or nail trimming, so a person with vision problems may need an extra helping hand to carry out some of these basic tasks safely and correctly. According to Age UK, compared with the general older population, those with sight loss are more likely to have other health conditions, so ensuring they are taking care of their personal care can help to prevent things like infections and skin irritation. 

Fear of Falling

Carrying out many personal care tasks often involves being in the bathroom, which can be a slipping hazard, and can make getting in and out of the shower difficult and dangerous for some older adults. Not only does this pose safety concerns, but it could also cause anxiety around falling during personal care tasks, which can lead to the person avoiding some necessary hygiene practices. A 2019 survey by Age UK found that around 4.3 million older people were worried about falling, and 36% said it was their primary concern. This is a valid worry since older adults have a much higher risk of breaking a bone or developing life-threatening injuries, however having support when undertaking personal care tasks can help to alleviate both the fear of falling, and much of the risk involved.

Incontinence

Incontinence is a common problem for older adults that can result in embarrassment, skin issues, and other infections if not cleaned properly and promptly. While it is possible to manage incontinence effectively with the help of a home carer for changes, using absorbent pads or even a catheter, accidents do happen which can lead to urine leaks on clothing. Studies suggest around 53% of homebound older adults suffer from incontinence, so this is something to be considered when planning a person’s personal care needs. Help getting to the bathroom and frequent changes may be required with some medical issues.

What essential personal hygiene practices should older people and their caregivers be aware of? 

There are many personal care tasks an older person could benefit from, but studies suggest some of the most essential include bathing, taking care of oral hygiene, using the bathroom for toileting, hair care (including shaving, brushing and styling) and nail care. Depending on their abilities, older people may find it helpful to be supported during certain personal care tasks. Below is a list of some personal care tasks that could be incorporated into their day, depending on their needs and health conditions:

• Bathing to stay clean and fresh, whether this means in a bath, sitting in a seat in the shower, self-washing in bed if confined to bed, or being given a bed bath from a carer
• Washing hands to prevent the spread of germs 
• Washing the face to ensure skin health and to feel fresh
• Moisturising to avoid dry skin or irritation 
• Brushing teeth and flossing to prevent cavities and gum disease 
• Managing false teeth (if applicable) by keeping them clean and ensuring they fit well 
• Booking and attending regular dental check-ups 
• Brushing, styling and getting regular haircuts for scalp hygiene and to improve confidence 
• Shaving where applicable for comfort and confidence  
• Trimming and cleaning nails to prevent infections and avoid ingrown nails – you can read more about the importance of this in our guide to hand, foot and nail care for older adults
• Managing incontinence (if applicable) by ensuring skin stays dry and clean 
• Bathing feet and checking for signs of fungal infections or sores – this is important for those with diabetes
• Changing clothes and bedding regularly to ensure cleanliness, skin health, and to avoid infections 
• Cleaning devices such as hearing aids and glasses

What are the best ways to help older adults with their personal hygiene needs? 

As mentioned, taking care of personal hygiene is vital, but may not always be possible for an older person. This could be due to a health condition preventing certain movements, a fear of injury, or a cognitive issue that impacts the person’s ability to understand the importance of personal hygiene. In any of these cases, having a loved one or a home caregiver remind them about personal care tasks and support them to carry these out each day can not only help to prevent potentially damaging infections, it can also alleviate discomfort and improve confidence and self-esteem. When assisting an older loved one with personal care tasks, here are a few things that can help: 

• Create a routine – Personal care tasks may take longer for older adults to ensure their safety, which means they could take up large portions of the person’s day. It can help to establish a routine that fits with their individual needs, so they can be mentally prepared. A 2022 study found that having a daily routine can be useful for older adults as it can reduce stress and anxiety, and increase feelings of safety and security. Maintaining habits and routines is also thought to be beneficial for those with a cognitive impairment who benefit from consistency to reduce confusion.
• Create a safe environment – Personal care tasks usually mean moving around the room or the home, so it is important to ensure they are always safe doing so. You may need to tidy away clutter or create spaces that are easy for your loved one to access to make the process more streamlined. For example, a chair next to the wardrobe will allow them to take their time getting dressed and sit if they need to. 
• Use adaptive aids – A number of aids can help with hygiene tasks, such as grab rails for the person to hang on to, non-slip mats in the bathroom, shower chairs so there is always a seat while washing, and frames for over the toilet to provide support for independent bathroom use. You can learn more about what might be available in our guide to home adaptations for disabled older people.
• Provide emotional support – Caregivers must remember that many personal care tasks are often of an intimate nature, and this can be difficult for an older adult to accept and be comfortable with. Showing as much respect, understanding and compassion as possible when helping with personal hygiene tasks is of the utmost importance in order to allow older adults their dignity during these intimate moments, and ensure they always feel comfortable. Try to remember that getting undressed in front of someone, particularly if it is a loved one, may feel embarrassing and cause self-consciousness for some older adults. Doing what you can to make them feel comfortable – such as only uncovering the areas you need to wash and leaving the rest covered – could help them to feel less awkward and improve their comfort. 
• Encourage independence – As much as they are able, it is valuable for older adults to take care of their own personal hygiene if possible. By doing so, they can feel more in control, have more autonomy over their daily tasks, and not feel as reliant on others, which can improve their confidence and self-esteem. To encourage this, you could also consider adaptive tools that could make this easier for them, such as a long-handled sponge for bathing, or an electric toothbrush for easy teeth brushing. When getting dressed, it is also helpful to consider what type of clothing might be easiest for the person to put on and take off by themselves. 
• Offer gentle reminders – If an older adult is able to carry out some of their personal care tasks alone, offer them gentle reminders to nudge them in the right direction if they are forgetful or have a cognitive issue causing memory loss.

What support is available for older adults who need help with personal hygiene? 

Providing adequate personal care to an older loved one is so important to ensure they remain in good health, and while these tasks may seem like the most time consuming and difficult, they are arguably some of the most pressing after providing adequate nutrition, as they not only help to support the health of an older person, but can also greatly improve their wellbeing and mental health. There are lots of resources available for anyone who is providing personal care assistance to an older loved one, and you can learn a lot about the local support groups and nearby resources from your GP if you register as a caregiver. It is important to be aware of respite care options too when looking after an older loved one. This means an alternative home carer will visit the home to take on some tasks and give you a break if you have been caring for a loved one for a long time. Whether for a couple of hours, days or weeks, respite care may be available through your local council. You could also find private respite care options, such as what we offer at Home Instead. You can read more about this in our guide to the benefits of in-home respite care.In many cases, older adults who require help with their personal hygiene duties prefer to enlist the help of a professional home carer, rather than having a loved one deal with certain intimate tasks. This could be in the form of occasional visits from a home carer, or a live-in carer if the person needs more intensive assistance. If you feel you or a loved one could benefit from support from a home care professional to help with personal care, you can get in touch with your local Home Instead office to learn more, or read our guide for everything you need to know about how to choose and arrange home care services.Our Care Professionals are the best of the best, and highly trained to deliver the services you need. No matter what type of home care you are looking for, we can provide a tailored service that suits you or your loved one. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.