Oct 12, 2013

How to Get An Alzheimer's Patient to Brush Their Teeth

I believe in you, now its time for you to start believing in yourself...

By Bob DeMarco
Alzheimer's Reading Room

Alzheimer's Patient Brush Teeth | Alzheimer's Reading Room

How many times have you heard these words: "who are you to tell me what to do"; or, "I already did that".

We have a very interesting comment from our reader Linda.

Linda wrote, under the article Dental Hygiene and Dementia.
I have tried everything to get my mom to brush or rinse. Maybe if it was a stranger relationship like in a nursing home but at home with me she refuses. Her normal response to any kind of request no matter how it is put to her is "who are you to tell me what to do" and then "I already did that" and then refusing to do it.

She is completely confused and afraid of the vibration of an electric toothbrush. That was a major disaster. She does not understand any longer how to swish something in her mouth and immediately swallows it, even toothpaste.

I've tried "helping" her by guiding the bush like one post and she hit me, got very angry at me, yelling at me "I can do it, leave me alone". "All you ever do it tell me what to do, leave me alone."

We are at a point where she refuses to brush, ever, and is having dental problems.

One person suggested to me to use oral swabs but the dentist said it was too harsh if I could not get her to rinse properly. I would love to give my mom to someone who writes these articles and see how that goes. And I have tried every tactic I can think of. I'm not a mean person and know how to try different ways of approach. But she wears me out and in the end won't do anything.

She's like this with everything. But dental care is the big issue now. I give up.

I give up? Ouch. Every said or thought those words. If only I had a nickel...

I did have the problem with getting my mother to brush her teeth. And she did say, "who are you to tell me what to do", "you are not the boss of me", "leave me alone", "kiss my butt", "I already brushed my teeth". Over and over she said soemthing of that nature.

Lets examine the responses.

Who are YOU, 

"tell ME", 

"leave ME", 

and "YOU" "ME".

My point. The dreaded word YOU is not conducive to effective Alzheimer's caregiving.

When you argue with someone did you ever notice the conversation is often dominated by the word "YOU". The word "YOU" can be combative.

What are some alternatives to engage someone with Alzheimer's, and get them to do something that is needed and necessary. Let's stick to the topic -- brushing.

Mom, WE need to brush OUR teeth.

Mom, why don't WE brush OUR teeth together.

Mom, I want to be sure that OUR teeth stay nice and healthy, why don't WE brush our teeth.

I might suggest here that you use the kitchen sink. Get out two toothbrushes and two tubes of toothpaste. I suggest you get your Alzheimer's patient strategically set, standing right in front of their toothbrush and toothpaste which is sitting strategically right next to the sink.

Turn on the water. Pick up your brush, and start brushing. You are now demonstrating what to do. And, you are doing it -- brushing your teeth.

Don't say a word. Brush. Spit. Brush.

Finally, make a short comment. This feels good. I don't want to end up in the dentist chair, this is why I am brushing.

Keep brushing, spitting, and smiling in between. Don't say a word.

Put down your brush. Pick up their brush. Put some toothpaste on the brush. Hand the brush over. Don't say a word. Do it while smiling and without talking.

Remember, some Alzheimer's patients can only do one thing at a time. They can't multi-task like you and me. This means they can't talk and brush their teeth at the same time.

If your patient doesn't brush, or if they say something negative, move the brush a little bit so they can see it, and don't say a word. Smile. Relax. Smile.

If totally frustrated, say, its up to you. Walk away.

Please consider this.

The more you talk, cajole, or push the less chance that it is going to happen. Sooner or later you'll learn, in Alzheimer's World, fewer words get you more.

Now this technique might work the very first time, or it might take 19 days. You must be patient, and you must remain positive. Please remember, if you make it like you are trying to pull teeth, you'll get what you don't want.

I doubt you will get far by pulling on the reins of a mule. Just remember, this is no mule you are working with.

Your Alzheimer's patient has been brushing their teeth for a long time. However, no one was standing around telling them what they had to do. Or, all the bad things that were going to happen if they didn't brush.

Recap. Brush with them. Demonstrate how to brush by brushing your own teeth. Do it as a team.

Use the WE approach.

If it doesn't work in the morning, try it again in the afternoon, again in the evening. Try it several times each day. Try to determine if there is a better or best time.

Relax. The world is not coming to an end. Don't worry. They'll brush. Most likely when you are not looking.

PS ... Brushing together builds team spirit and a feeling of connectedness. Don't go for perfection.

Most importantly, don't give up.

I believe in you, now its time for you to start believing in yourself.

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Bob DeMarco is the Founder and Editor of the Alzheimer's Reading Room (ARR). Bob is a recognized influencer, speaker, and expert in the Alzheimer's and Dementia Community Worldwide. The ARR Knowledge Base contains more than 4,000 articles. Bob lives in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room