As a caregiver, you’ll need to learn creative ways to handle the common clothing and dressing problems experienced by people with dementia. For example, the person may no longer be able to organize and sort clothing and therefore leave piles of clothing scattered all over or mix dirty clothes with clean clothes.
At some point, dressing may require more skills than the person now possesses. For example, he or she may forget the order in which to put on various clothing items and as a result, put the sock on over the shoe. Or the person may wear too little or too many layers of clothing or refuse or forget to change clothing when needed. Often, the person may resist help and become terribly agitated when you try to intervene.
To avoid a possible fall, have your care receiver sit in a chair while dressing, especially when putting on his/her underpants, pants, pullover blouses, socks, and shoes. Some clothing management and dressing tips:
If They Can’t Find or Choose the Right Clothes
- Label drawers with words or pictures of the content (e.g., blouses, pants, underpants).
- Move most of their clothes to another location. Leave only a few items of clothing in the closest and store other clothes elsewhere. This will not work for everyone, for some individuals will become agitated if they think their clothes have been stolen.
- Get their buy-in. Ask – but limit – choices: “Would you like to wear your red or blue pants?”
- Leave out their clothes to be worn that day. You can put them on the a wall hook or on the bed. They should be placed in the order in which they are to be wor or on a pile, with the first item to be put on at the top. For example, place his/her underwear on top of their pants.
- Place their clothes directly within his/her field of vision (24 inches in front of the person).
If They Can’t Dress Independently
Choose comfortable easy-to-get-on-and-off clothing, such as pants with elastic waists (also makes toileting easier for you and the care receiver), blouses with large armholes, velcro enclosures, or large buttons. Zippers and small buttons (or any buttons) may be too difficult for the person to maneuver
If your care receiver has trouble raising her/her arms, look for special dresses, shirts, or cardigans that open from the back to simplify sliding them on without raising the arms. If your care receiver uses a wheelchair, look for pants and dresses that are designed to be put on while the person is sitting down.
When assisting do not rush! Rushing a person with dementia is a known trigger for agitation. Break dressing into simple steps as needed:
- Hand each clothing item in the order it’s to be put on.
- Demonstrate the action you want the person to do
- Give simple, step-by-step instructions. For example, “Put your left leg in the pant hole.”
- Point to the pant hole or the person’s leg.
- Gently tap the person’s leg if needed.
- Give the person plenty of time to respond.
- Physically assist, if necessary. Begin (initiate) the action (i.e. pull sleeve over hand) and allow the person to continue dressing on his/her own.
Try to have fun, but limit general conversation during dressing so that the person can attend to this activity without distraction. Smile and give praise – this can do wonders.
If They Refuse to Dress/Undress
Privacy Issues
• Hold up a towel.
• If they remark there are “people in the room,” turn any photographs over and/or the television off (people with dementia may think they’re real people).
• Draw the blinds and close the bedroom door, even if there’s no one around. It helps create a sense of boundary/privacy.
• Leave the door ajar, wait outside, and intervene only when necessary.
Other Issues
• At times, offering an inviting reason for getting dressed, such as a visit from a family member, a walk outside, or a tasty meal, is all that it takes to get to yes.
• If they refuse to undress at bedtime, allow them to sleep in their clothes.
• Buy two or three of the same clothing item. When they’re bathing, quickly swap the dirty set with the fresh.
• Make sure room temperature is warm enough for disrobing.
• Take deep breaths to reduce your stress as you help your loved one.
• If the person is resistant, stop the activity and direct his/her attention to something pleasant such as a picture of a family member or favorite item. After a period of time, try to resume dressing. If it helps, sing a favorite song together.
If They’re Constantly Undressing
•Buy special clothes that zip in back.
•Keep their hands busy. Give them a pile of colorful towels or scarves to fold, a special “rummage” box of personal treasures to sort through, or even a special activity apron made for people with dementia.
