Each of us has things that we would be embarrassed by, and we can all understand the importance of personal privacy. Although a person with Alzheimer's disease can obviously need help, that doesn't mean that they would not be embarrassed by it. The ability to understand, and to express themselves and say "I'm embarrassed to need this help" is often lost, but that does not mean that the embarrassment is lost.
Descriptions of changes in personal care must take into account an individual's life-long standard, but most people conform to the social norm. Changes in personal care, therefore, can provide important insights into staging. In mild dementia, there are usually no changes, although sometimes, with attention to detail being impaired, subtle problems can be observed - missed spots with shaving, dirt accumulated in skin folds, a stain that does not get cleaned properly. With moderate dementia, people need prompting to do their personal care. With severe dementia, they need progressive assistance.