Alzheimer’s affects not only memory but also executive functions – planning, judgement, and problem‑solving. In the shower, watch for:
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Turning the water extremely hot or cold and not recognising the danger.
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Stepping into the tub without using grab bars or mats despite having balance issues.
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Standing under running water for a long time “doing nothing,” then insisting they have already washed.
These behaviours may be early hints that the person’s ability to judge risk and sequence actions is slipping, even if their memory for recent conversations still seems fairly intact.
5. Changes in personal hygiene and awareness of smell
Forgetting to bathe or not noticing body odour
Major Alzheimer’s organisations list decline in grooming and hygiene as a common feature, particularly in the early to middle stages. Around showering, indicators include:
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Going much longer than usual between showers and insisting they already washed, when they clearly did not.
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Not noticing strong body odour or musty towels, even when it is obvious to others.
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Wearing the same clothes repeatedly despite spills or smells.
These changes stem from a mix of memory problems (“Did I shower today?”), apathy, and reduced ability to detect odours or interpret social cues – all of which can appear early in Alzheimer’s.
How smell loss and Alzheimer’s are connected
The olfactory system and memory centres
The sense of smell is closely linked to brain regions involved in memory, such as the entorhinal cortex and hippocampus, which are among the first areas affected by Alzheimer’s pathology. Research has found:
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People with mild cognitive impairment or early Alzheimer’s often perform worse on smell identification tests than healthy peers.
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Poorer smell identification is associated with greater risk of later developing dementia and faster decline in some studies.
For everyday life, the shower is one of the easiest places to notice smell changes because personal‑care products tend to be strongly scented and used close to the nose. If someone who has always commented on fragrances suddenly stops noticing them, that is meaningful context for doctors.
Important caveats: smell loss is not automatically Alzheimer’s
Many non‑dementia conditions can blunt smell:
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Viral infections (including COVID‑19).
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Chronic sinusitis, nasal polyps, allergic rhinitis.
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Smoking or long‑term environmental exposures.
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Head injury, certain medications, and normal ageing.
Because of this, professional guidelines emphasise that smell loss must be interpreted alongside other symptoms, not on its own. A single sign in the shower is not enough for a diagnosis – but it is a valuable piece of the puzzle that should prompt a thorough check‑up if it is new and persistent.
When to seek medical advice
You (or a family member) should talk to a doctor if you notice more than one of the following over several months:
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Clear, ongoing loss of smell for familiar scents in the shower or kitchen, without sinus problems or recent infection.
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Increasing difficulty or confusion with the steps of showering, dressing, or other familiar routines.
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New fear, suspicion, or resistance around bathing that is out of character.
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Declining personal hygiene, not recognising body odour, or wearing unwashed clothes regularly.
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Memory lapses affecting daily life – repeating questions, misplacing items in odd places, getting lost on familiar routes, struggling with bills or medications.
A clinician can:
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Rule out treatable causes (depression, medication side‑effects, vitamin deficiencies, thyroid disease, infections, nasal/sinus issues).
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Consider formal cognitive testing and, in some settings, smell‑identification tests.
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Refer to memory or neurology services if Alzheimer’s or another dementia is suspected.
Early diagnosis does not cure Alzheimer’s, but it allows earlier treatment, planning, safety adaptations at home (including in the bathroom), and support for both the person and their family.
Practical steps if you’re concerned
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Keep notes of what you see in the shower: missed steps, smell changes, safety issues, or new behaviours. Patterns over time are more helpful than one‑off incidents.
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Involve the person respectfully. Rather than accusing (“You never shower properly”), share observations gently (“I’ve noticed it’s harder to smell your shampoo – have you noticed that too?”).
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Ask for a comprehensive check‑up, not just a quick memory test. Mention smell changes and shower‑related difficulties specifically – many doctors find these examples very useful.
Key point
An early sign of Alzheimer’s that may show up in the shower is a marked, unexplained decline in the ability to smell familiar products, often accompanied by new confusion, fear, or mistakes in a once‑automatic bathing routine. On its own, droppped smell is not a diagnosis – but together with other subtle changes, it is a strong reason to seek medical assessment so any cognitive problems are caught and managed as early as possible.
