Personal care with ME/CFS

Managing personal care is one of the most energy-draining parts of the day for many with ME/CFS. Washing, getting dressed and managing basic hygiene can all cause massive energy drains that you might not expect.

Heat, prolonged standing, and the sustained physical effort of routine tasks all carry a real cost. The strategies on this page are about reducing that cost, not eliminating the tasks entirely.

Showering requires many demanding elements at once: standing, heat/temperature exposure, sensory input and physical washing. Standing can be a particular problem for those who experience orthostatic intolerance, so the risk of a raised heart rate, dizziness and more fatigue are also something to consider.

Some options to limit exertion when showering:

Shower stool. Sitting down will help massively with the energy cost of the shower.

Handheld showerhead. This would reduce the movement needed during the shower, but does require holding it up.

Water temperature. Lukewarm water may be easier to manage than scalding hot, but that will depend on individual tolerance.

For a full guide to preparation, technique, alternatives, and post-shower recovery, see Showering with ME/CFS.

Washing your hair the same day as showering is often too much in one go. It’s better to treat them as separate tasks, shower one day, wash hair the next – or shower early in the day, and wash hair in the evening.

Drying your hair also needs to be considered as usually it means lifting your arms up for at least a few minutes, which is often very draining.

Options for washing hair with less exertion include:

• A handheld showerhead while seated. Tilting the head rather than repositioning the whole body.
• Over the bath or a basin. Leaning forward over a low surface while seated can work well. A plastic jug reduces the number of movements needed to rinse.
• Dry shampoo. Applied the night before and brushed out in the morning, it buys several days between washes for most people.

For a full guide, see Washing hair with ME/CFS.

Getting dressed can be a draining task, especially after a shower. It’s best to break down the task into chunks and simplify things for yourself.

• Sit down. Staying seated on a chair or your bed will make it much less draining. Standing to get dressed is surprisingly energy draining.
• Focus on low-effort items first. Begin with whatever costs you the least effort. This is usually the upper body, loose tops for example. Save socks and shoes for last if you can, as bending down is one of the more demanding movements of getting dressed.
• Choose the right clothing. Loose clothes, elastic waistbands, slip-on shoes can all help reduce the number of movements needed. Buttons, zips and shoelaces can all be costly on difficult days.
• Prepare clothes in advance. Deciding what to wear and having it within reach can reduce the energy of searching when in a rush and removes decision making when tired. Especially a good idea if you can choose what to wear the night before, to save your energy in the morning.

For a full guide, see Getting dressed with ME/CFS.

Brushing your teeth is a short task, but involves standing for the duration and sustained arm movement, which adds up.

• Electric toothbrush. This will help massively on energy cost compared to a regular toothbrush, and will be more efficient.
• Sit down while brushing. Sitting will remove the cost of standing. If you find reaching the sink difficult, you can use a small bowl on your lap.
• Split tasks up. If a full morning routine is too much for you, break tasks down throughout the day or morning with rest periods instead. Not everything has to happen at once.
• Keep things within reach. Toothbrush, toothpaste, mouthwash and a small cup could be kept on the sink or nearby instead of in a cupboard. Fewer movements, less effort.

On difficult days, the suggestions above may not be realistic. The goal on those days is not your usual standard, it is to maintain basic comfort with the least energy cost to you.

• Body wipes. A good way to stay somewhat clean without much energy use, no standing and no temperature sensitivities.
• Dry shampoo. Again, a good way to keep your hair clean when you cannot wash fully. It absorbs overnight and brushes out easily in the morning.
• A seated wash at a sink. You can wash your face, underarms, and feet while seated with a low basin. A small plastic bowl on a low surface works if the sink is not low enough.
• Lowering the standard is not failing. A day managed on wipes and dry shampoo is a day managed successfully. The goal is to preserve enough energy for what matters most.

Rest between tasks

Personal care is rarely one task, it usually combines several tasks together. Taking short rest periods between each task can make a big difference. Lying flat for two or three minutes between tasks can reduce the cumulative cost significantly.

For more on adapting daily tasks within your limits, see our living with ME/CFS guide.