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COPING STRATEGIES
PROBLEMS WITH DRESSING
As the disease progresses, complex tasks like getting dressed can become more and more of a challenge for both the person and the carer. It often takes more time to assist someone to dress themselves than it would to dress them. However, being able to dress oneself can make a person feel less dependent. Good grooming is good for the self-esteem of both carer and the Alzheimer sufferer. Here are some suggestions to help.
Establish a routine
- keep the morning routine as familiar as possible, doing things in the same order as the person was used to prior to illness
- avoid delays or interruptions which could allow the person to forget the activity they are currently engaged in
- choose one spot for the person to get dressed in the morning (getting ready for the day) and a different spot for undressing (getting ready for bed)
- it may be helpful to label drawers indicating contents
- it may help to group clothing that are the same colour and/or go together
- lay articles of clothing out in sequence on the bed, stacked in the sequence in which they are to be put on
- a poster on the wall which lists the sequence may also help; use pictures if the person can no longer read
Create a pleasant and safe environment
- make sure that the room is comfortably warm
- make sure that the room has good lighting
- respect privacy by closing the door and blinds or curtains
- keep the room free of clutter
Choose clothing carefully
- select clothing that washes easily and needs no ironing
- choose clothes that are a comfortable fit and are easy to put on and take off
- have front openings on shirts and dresses to avoid having to pull clothing over the head
- avoid clothing with buttons, zips, hooks and eyes; velcro can be very useful
- make sure that trousers or slacks and dressing gowns are not too long; this could cause accidents
- shoes should be slip on or with velcro closures
- shoes should be easily cleaned or washable and have non-skid, flat soles
- for women, a camisole or vest may replace a bra which is difficult to do up
- for men, braces may be easier than belts
- simple patterns are best; busy patterns can be distracting
- solid, contrasting colours can make it easier to distinguish one outfit from another
Use all your communication skills to try to make dressing a positive experience
- use a calm, friendly tone
- limit confusion by limiting choices; place all out of season or special outfits in another closet for storage
- show the person part of the outfit they are to put on as a introduction to the idea of getting dressed
- take into account how much assistance will be needed - for some, a process like putting on trousers may need to be broken down into steps
- simplify the task by giving one instruction at a time and gently talking the person through each step, using visual cues if necessary
- respect the need for modesty; dressing is a personal activity so shut the door for privacy
- allow the individual to do as much of the selection of outfit and dressing as is possible.
Some particular problems
Some people with dementia develop strange behaviours in relation to their clothing.
Some may choose clothes inappropriate for the temperature conditions - put on a sweater in the middle of summer. This can be avoided by reducing the number inappropriate items in the wardrobe. Some take to putting on multiple layers, regardless of weather. This habit can be frustrating and perhaps embarrassing for the carer. However, if it causes no real problem - overheating, for example - it may be something that you can choose to ignore. Gradually remove items that are favourites or problematical and replace them with more suitable items. Remember, some older people feel uncomfortable in short sleeves. Sometimes people with dementia want to wear the same outfit day after day. If you try to buy a number of similar outfits, you will at least be able to wash the clothes.
Perhaps the most difficult behaviour to cope with is the habit of undressing frequently.
It is worth trying to ask yourself a few questions to evaluate possible sources of this behaviour
- is the person too hot or too cold?
- does the person need to go to the bathroom?
- is the person tired and wanting to go to bed?
- is the person bored?
It is important to remember that the behaviour is not generally meant to provoke; it is the result of brain damage. Try putting clothing on backwards or purchase clothing with back fasteners to make it more difficult to remove.
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