Dementia expert: Stop forcing showers, start with small tasks

Teepa Snow, a nationally recognized dementia care educator, says families must stop forcing daily routines like bathing and instead ask for help with small, specific tasks. Snow, who founded Positive Approach to Care, joined the program Aging Untold to discuss how dementia alters behavior and communication. She argues that caregivers often struggle because they view the condition as a pure decline rather than a shift in abilities.

Snow uses the term "brain change" to describe the neurological shifts in people with dementia. She notes that while some abilities fade, others transform. For instance, a person who never swore might start using strong language. Someone who was shy might begin asking strangers for directions to go home. Snow cites neuroplasticity as the reason these changes occur, stating that the brain continues to rewire itself regardless of the diagnosis.

When asked how to handle a parent who refuses to shower or take medication, Snow advised against force. She suggested asking the individual to complete a minor task first. In one example, she pointed to a spot on her cheek and told the person to look in the mirror with a washcloth to remove it. She also suggested asking the person to wash their hands before cooking dinner. If a person will not participate in these smaller steps, Snow said a full shower is unlikely to happen.

Snow explained that written reminders, such as sticky notes or labeled lists, often fail because they require complex mental processing. Following a written sequence depends on the hippocampus, which she identified as the learning and memory center. The front of the brain must also sequence the steps. Because these areas are often affected, Snow said families should recognize that the person needs more direct support to complete tasks.

Snow told gerontologist Sam Cradduck that both the person with dementia and the caregiver are doing the best they can. She stated that if a family wants to change the dynamic, one of the two parties must adjust their approach. Since the person with dementia is already experiencing brain change, the caregiver must build new awareness and skills.

Snow noted that not every family member is suited for hands-on care. She said some people are better at organizing the care than providing it. "You can be great at organizing care because not every family member is built for this," Snow said. "I mean, it’s hard work."