If you can't lay out your toothbrush, toothpaste, a glass for rinsing, and a towel to dry your mouth, then brushing your teeth can be a very intimidating activity.
We often overlook the fact that before we
begin to brush our teeth, we make sure we have everything we need and that we plan to follow a very set sequence of steps. Because these abilities to plan and organize such daily activities are often "automatic", we often take them for granted.
These are the very skills that present problems as HD progresses. The cognitive disorder of HD presents more problems with these activities of daily living than the motor disorder does.
People who face these difficulties in bathing, dressing and grooming react
very differently. Having lost interest in themselves, some "give up" and easily let those caring for them "do everything".
Others plow ahead undaunted by the many challenges of caring for themselves, unfazed by an occasionally misbuttoned blouse or a t-shirt put on over a sweater.
Either way, needing someone else's assistance is yet another significant loss to which the individual with HD must adjust.
Many people with HD are reluctant to bathe in a tub or shower. There are many hard surfaces, protruding fixtures and close quarters to be considered. It may have been the site of previous falls.
Standing naked before an unfamiliar caregiver can be humiliating. Perhaps the feeling of water is no longer pleasing and being splashed is very unpleasant.
Maintaining both your modesty and balance while trying to help your helper to help you is certainly a tiring job!
Even though it is difficult, it is important for people with HD to bathe often.Many perspire profusely. Increased hunger and thirst require that they eat more food and drink more liquids, which leads to more frequent urination. Involuntary movements, dystonia, and problems with balance cause spills that soil both clothes and the people who wear them.
Changes in the tone and weakness of the facial muscles, as well as less effective and less frequent automatic swallowing, can cause some people to drool excessively. This frequent need for bathing means arranging times for bathing in the daily routine.
Try to keep the shower or bath as brief as possible by gathering everything
necessary before beginning.
Using a shower chair allows people with HD tofocus all their energy and attention on bathing and not on balancing in the
Hand-held shower heads allow you to aim the water stream exactlywhere it's needed, minimizing the movement required and cutting down onthe splash when it's held close to the body.
People who have difficulty holding onto soap, facecloths, and sponges may still be able to lather up with bath mitts that require no grasping and that fit right over the hand.
Extra attention needs to be given to the bathrooms used by people with chorea, dystonia, and problems with balance.
"Flopping down" onto toilet fixtures loosens the hardware that holds the seat to the bowl, as well as the wax seal and fittings that hold it firmly to the floor. Men who stand to urinate may have difficulty keeping their urine stream aimed in the bowl.
Loose seals and urine on the floor = falls. The widely available padded toilet seats may be helpful since they cushion the impact of "flopping down" onto the seat, and the padded cover may protect his back and the toilet tank as well.