Getting Dressed: Alzheimer's and Caregiving

Your father puts on his pants one leg at a time, just as he has done since childhood. But today, there's something different. Your father has Alzheimer's disease, and this morning, unlike every other morning for the last 70 years, he's pulling on his pants on top of his pajamas.

For Alzheimer's patients and their caregivers, the seemingly simple act of getting dressed can turn into a minefield of frustration. At first, a patient may simply need extra time to pick out a pair of socks or a gentle reminder to zip up. But eventually he'll feel overwhelmed by the choices in his closet or drawers, he'll be baffled by zippers or buttons, and he'll think nothing of wearing pajamas under (or over) his pants. When his disease reaches this stage, he'll need help with his clothes for the rest of his life -- and help may not always be easy to give.

Helping someone with Alzheimer's get dressed

For one thing, many people with Alzheimer's don't see the need to change clothes every day or even every week. Even if they've worn the same outfit for a week, they'll say -- and sincerely believe -- they put on clean clothes that morning. For this reason, it's useful for caregivers to set up a routine for getting dressed at the same time every day.

But there's a more fundamental problem: Putting on clothes is a deeply personal activity, and many people with Alzheimer's become angry or confused when somebody tries to intrude in the process, even to be helpful. For this reason, caregivers must find a way to give loved ones privacy and independence along with guidance.

In her book At the Heart of Alzheimer's, author Carol Simpson recommends simplifying the task by hanging only a couple of items in the closet and by replacing snaps, buttons, or zippers with velcro fasteners. In the early stages of the disease, the more patients can do for themselves, the more relaxed and content they'll be.

And remember, even people with Alzheimer's have their own sense of style. While they are still interested, give them some say about their outfits. You could ask something like "Would you like a blue shirt or a white shirt today?" (Don't confuse them with too many options.) If your loved one prefers one type of outfit especially, you may want to buy several just like it. If she insists on wearing the same shirt every day, just launder it when she's asleep so it will be ready the next day.

Unfortunately, even this small piece of independence won't last. If they live long enough, all Alzheimer's patients eventually become incapable of dressing themselves or choosing what to wear. At this point, caregivers should take every possible opportunity to make dressing their loved ones easier. Comfortable, loose-fitting clothes that are easy to slip on and off, such as sweatsuits, can be a blessing. Loose-fitting underwear, stretchy tube socks, and slip-on shoes can also cut down on aggravation.

Here are some other tips for helping loved ones with Alzheimer's get dressed:

  • If a person needs coaching while getting dressed, give clear, simple directions. Say something like "put your leg through this hole" instead of "put on your pants."
  • Clearly label drawers and closets with signs such as "socks" or "shirts." As the disease progresses, you may need to replace words with pictures.
  • It may be helpful to lay out an outfit the night before. You can cut down on confusion by stacking clothes in order (underwear on top of pants, socks on top of shoes). Some people with Alzheimer's take to hiding the clothes, so you may want to store them out of sight.
  • If your loved one takes off her clothes in public or in front of company, she isn't trying to embarrass you. She may be too warm or may not like the feel of fabric against her skin. Try to keep your house at a comfortable temperature, help the person dress appropriately for the weather, and use soft, 100-percent cotton garments.
  • If someone with Alzheimer's tugs at her sweatpants repeatedly or takes them partly off, this may be a sign that she needs to go to the bathroom.
  • Brush her hair gently and always approach her from the front -- patients can be frightened if anyone approaches or touches them from behind.
  • A few compliments can turn a rumpled sweatsuit into a source of pride and confidence. Tell your loved one he looks sharp, and you'll start the day on an upbeat note.

References

Dressing. Alzheimer's Association. Undated.

Michael Castleman et al. There's Still a Person in There: The Complete Guide to Treating and Coping with Alzheimer's. Putnam Publishers.

Howard Gruetzner, M.Ed. A Caregiver's Guide and Sourcebook. John Wiley & Sons.

Nancy L. Mace, M.A., and Peter V. Rabins, M.D., M.P.H. The 36-Hour Day. Johns Hopkins University Press.

Lela Knox Shanks. Your Name Is Hughes Hannibal Shanks: A Caregiver's Guide to Alzheimer's. The Penguin Group.

Carol Simpson. At the Heart of Alzheimer's. Manor HealthCare Corporation.

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