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Practical support

Personal hygiene

The person you care for may be physically or mentally unable to maintain their own personal hygiene. Keeping clean is essential for good health. Poor hygiene can cause skin complaints, unpleasant smells and bacterial or parasitic infections.

General hygiene

The daily personal hygiene of the person you care for is very important, so make sure:

  • their hands are washed after they've used the toilet
  • their genitals and anal area are washed every day
  • their face is washed daily
  • they're fully bathed or showered at least twice a week
  • their teeth are brushed twice a day. It is also important that they have regular dental checks. Find out more about dental treatment for people with special needs

Washing and bathing

For most people, washing is a very private activity. When helping someone to wash or bathe, be sensitive and help maintain their dignity. You'll both probably feel awkward and embarrassed, especially at first. To make bathing as pleasant and comfortable as possible:

  • use pleasant-smelling shampoo, bubble bath or soap
  • play music that the person you care for likes and is familiar with
  • if the person is confused, explain what's happening as you go along
  • be sensitive to the mood of the person

Carer's tip from Netbuddy

"If you are caring for someone who won't wash, get involved with activities that are followed by showers, for example swimming. It may help if they see other people showering. My son only started using the shower and wetting his head because he saw it in a film he was watching."

Visit Netbuddy to read more carers' tips like this

Personal preference and emotional state

Be aware of the emotional state of the person you care for when helping them wash. For example, some people can be anxious about deep bath water. Adaptations, such as seats or recliners, can help with anxiety. Reassure the person that you won’t let them be hurt.

Overhead showers can be frightening to some people. If you have no bath or there is a good reason for using a shower rather than a bath, use a handheld shower unit.

Ask the person how they would prefer to be helped and allow them as much independence as you think is safe. If they had a routine before you began caring for them, find out what it was and stick to it as much as you can. Find out which shampoo, shower gel or soap they prefer to make the experience more familiar to them.

Many people become self-conscious when undressed in front of others. Be sensitive to the situation and approach it in the way you think is most appropriate. The person you care for may feel isolated if you leave them alone. How you handle this depends on your relationship with them. Have clothes and towels with you so you don’t have to leave them alone in the bathroom if they don't want you to.


If the person you're looking after has limited mobility or has problems balancing, make sure that:

  • the floor is not slippery (dry it if necessary)
  • the room is a comfortable temperature
  • the water is comfortably warm (older people particularly feel the cold, so bear this in mind when adjusting the temperature)
  • the locks are removed from the door (the person you care for may want privacy, but in an emergency you will need to get into the bathroom)
  • you look out for your own safety, for example by making sure you can manage if you have to lift the person in and out of the bath


Toileting is an important part of personal hygiene, regardless of whether the person you're looking after is continent (able to control their bladder and bowels) or not. Incontinence can create feelings of shame or embarrassment for both the carer and the person being cared for. Sometimes, they may be in denial about their incontinence or refuse to accept help. Reassure them that it’s not their fault and approach the issue in a calm, reassuring way if they're in denial.

Bed baths

If the person you care for cannot move or has extremely limited mobility, you may have to give them a bed bath. You will need to be extra careful, for your own safety, when moving or lifting them. Specialist disposable baths are available if they need a proper immersive bath (to be put fully in the water).

Getting help

If you're finding it difficult to cope with toileting, washing or general hygiene, contact your local authority or a local carers organisation (see Services near you, above right).

Continence care

Caring for someone can be more difficult if they have continence problems. They might be bowel incontinent (unable to control their bowel) or urinary incontinent (they can't control their bladder) or both. People of all ages become incontinent, but it's more common in older people and women who have given birth. Incontinence may also be caused by trauma, such as spinal injury, or degenerative conditions, such as MS or MND.

Someone with dementia may also forget to use the toilet, or not remember where the toilet is. Check out Health A-Z for information on the causes of bowel incontinence and the causes of urinary incontinence.

If you care for someone who has continence problems, they should seek treatment. For more information, see treating bowel incontinence or treating urinary incontinence. You might also want to consider:

  • Waterproof bedding. This sits beneath standard bedding and protects the mattress from leaking urine and faeces. 
  • Incontinence pants or pads. These absorb any leaking urine that might otherwise come into contact with skin and clothing. There are specialist items for men and women and different absorbencies for lighter/heavier leakage. There are also products for faecal incontinence. You can speak to your GP or practice nurse about what products may best suit the person you care for. 
  • Commodes. These are portable toilets that don't use running water and so can be put anywhere. If a lack of mobility prevents the person you care for getting to the toilet in time, a commode may help. 
  • Urinary sheaths. These are suitable for male incontinence. They are penile sleeves made of latex or a non-latex alternative, which collect urine as it leaves the body. Urine is collected in a bag worn on the leg.
  • Bed moisture alarms. These consist of moisture-sensitive alarms, which will sound when moisture is detected on the area where the alarm is attached. The wearer then wakes up and can finish emptying their bladder in the toilet. They can be useful for bed-wetting in children.

You can check with your local authority and/or GP to see if these items are available on prescription or through a community care assessment.

Feelings about incontinence

Some people who are incontinent are embarrassed about it or feel that their dignity is lowered when someone has to help them use the toilet or change their clothes because of leakage. Using the toilet in private is something that most people take for granted. As a carer it’s important to understand that this might be difficult and to approach any toilet-related care sensitively. If you feel embarrassed about undertaking this type of care for someone, make sure you mention this in your Carer’s assessment and get support. For more information see complications of urinary incontinence.

There are hundreds of incontinence clinics in the UK where you can seek support and treatment for incontinence. They accept referrals from GPs but may also accept self-referrals.

Stoma care

A stoma is an opening in the abdomen, created to get rid of faecal or urinal waste when part of the bladder, bowel, rectum or anus is removed. A stoma is usually created alongside surgery to remove part of the bowel following illnesses such as bowel cancer, bladder disease or digestive complaints.

The creation of a stoma to allow urine to exit the body is called a urostomy. The operation to make a stoma opening from the bowel is called a colostomy. Some people who have a colostomy will only need to have a stoma for a few months. This could be the case if part of their bowel has been removed but they later have another operation to reconnect the bowel.

A bag to collect the waste products is attached to the stoma using an adhesive. Some bags can't be emptied without being completely removed. Some bags have a drain at the bottom, which means they can be emptied without being removed. If you're not sure which type of stoma the person you care for has, contact their stoma nurse or specialist for help. The Colostomy Association and the Urostomy Association can also provide support.

Stoma cleaning and care is important to prevent skin irritation and/or infection around the stoma and to prevent leakage from the stoma or bag. The adhesive that attaches a bag to the stoma can irritate the skin, but various powders and creams are available to protect the skin from irritation. A stoma should be cleaned using water or mild soap – if you're not sure how to clean a stoma, get medical advice.

It’s normal for someone’s stoma to be red in colour. A stoma may also bleed slightly when it’s touched or cleaned, but seek medical advice if the stoma produces a lot of blood.

Stoma supplies

When someone is discharged from hospital after a urostomy or colostomy, they'll usually be given enough stoma bags for their first few days at home. After this, they'll need to organise a regular supply. Stoma bags are available on prescription, and can be ordered from a pharmacy. It may also be possible to order supplies for home delivery. A stoma nurse should be able to advise about the options available.

People with a permanent stoma can get free prescriptions. If someone’s stoma is temporary, they may have to pay for their prescriptions. If the person you’re caring for is not eligible for free prescriptions, they may be able to save money with a Prescription Prepayment Certificate. See the page on prescription costs for more details.

It may be that the person you care for is able to change their own stoma bag and clean their stoma but needs encouragement or reminding to do so. You could work out a timetable with them, marking how often their stoma care needs to take place. If you care for someone who needs assistance in changing or cleaning their stoma bag, get training before attempting this. You may be able to get training from a specialist nurse, district nurse or health visitor.

Feelings about having a stoma

Having a stoma may affect the way that the person you care for feels about themselves. They may choose not to tell other people that they have a stoma or ostomy, or they may want to tell people in order to reduce the stigma. It’s important that you support their choice, whatever it is.

If you care for your spouse and they have a stoma or ostomy and you're worried about how it may affect your love life, encourage them to share any concerns they have about their self-esteem and attractiveness with you. Equally, if you have practical worries or concerns, make sure you're honest about them. You can discuss these concerns with their stoma nurse if you feel that you need practical and medical reassurance.


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Page last reviewed: 11/12/2013

Next review due: 11/12/2015

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