How we choose to dress and groom can say a lot about who we are and how we want others to see us.

When a person with dementia begins to lose aspects of themselves due to a loss of memory and cognitive functions, they may express a strong desire to hold onto their identity where they can. You are in the unique position to help them achieve this.

The seemingly small task of dressing can prove to be very distressing for people with dementia, for a range of reasons. Grooming and getting dressed can be confusing and time consuming for residents and care workers as many separate steps are involved.

Helping a resident dress or undress can be challenging. Therefore, communication is crucial and care must be individualised - essentially, it’s best to avoid a one-size-fits-all approach.

This article will provide useful tips for dressing, undressing and grooming a client with dementia in a way that allows you to provide dignified, effective care. Dressing and undressing is directly tied to Standard 1 of the Aged Care Quality Standards: Consumer Dignity and Choice.

Take the time to find out what a resident’s dressing habits used to be so that you can help them to continue to dress how they would like to (Health.vic 2016).

Reasons Why Someone May Have Problems Dressing or Undressing

There are a few common reasons as to why a resident with dementia may have difficulty getting dressed. They fall under the following:

• Physical or medical issues:
  • Dementia affects fine and gross motor skills. A resident may also have impaired vision
  • Depression is common in dementia, and this may lead to a resident losing interest in dressing and grooming
• Forgetfulness:
  • A person who has dementia may forget how to dress, forget to change their clothes, or suddenly forget they are getting dressed
• Environmental issues:
  • Room elements such as lighting, noise, clutter and other people can upset a person with dementia
  • A person with dementia will be particularly sensitive to temperature and/or their senses may be impaired
• Privacy concerns:
  • Loss of independence will be particularly apparent to a person with dementia who now needs help dressing. They may resist help with dressing if adequate privacy is not provided
• Decision making problems:
  • Making seemingly small decisions might be difficult for someone with dementia. It’s important to the resident to make their own decisions even if it takes more time. Make the process as easy as possible for them by organising their clothes beforehand
• Impaired senses:
  • People with dementia may have a skewed sense of hot and cold. They might, for example, put on several layers of clothing, despite hot weather.

(Dementia Australia 2017; Alzheimer’s Association 2018)

Simple Steps to Help a Resident Dress and Undress

Environment

• Respect the client’s privacy by keeping doors and curtains closed
• Keep the room warm, or at the temperature requested by the resident
• Allocate sufficient time to the task
• Ensure lighting is adequate
• Avoid having too many clothing choices available, as this can be overwhelming. Remove distractions such as out-of-season clothes from sight.

Your Actions

• Encourage the resident to dress themselves as much as they are able to, so as to promote independence
• Place clothes on the bed in the order they are to be put on
• Make careful and gentle movements
• Plan the process beforehand and provide clear instructions
• Reassure the resident during the process
• Communicate frequently and effectively - if the client has dementia, they may not understand why they are being undressed
• Be flexible
• If possible, arrange for the same staff member to help a client dress and undress and take gender preferences into account
• Remember that being dressed and undressed can be an embarrassing experience, so preserve the client’s modesty as much as possible and be empathetic throughout the process.

Clothing Choices

• Try to dissuade the resident from picking clothing with copious buttons, hooks, zippers or buckles
• Identify a resident’s activities for the day and provide clothing options accordingly
• Keep in mind that busy and bright colours may be over-stimulating
• Slip-on shoes may be easier than shoes with laces and ties
• Loose-fitting and comfortable clothing is best
• Front-fastening bras might be easier for a client to put on.

(Dementia Australia 2017; Alzheimer’s Association 2018; Health.vic 2016; Alzheimer Society of Canada 2011; HealthNetCafe n.d.)

Grooming

Similarly to forgetting how to dress, a person with dementia may also forget how to groom themselves, or may need extra help to do so. Tasks that were once simple, such as combing their hair, shaving or trimming their fingernails, may become confusing, or a resident may forget what items such as nail clippers or combs are intended for (Alzheimer’s Association 2018).

Simple Steps to Help a Resident Groom Themselves

• Follow and maintain grooming routines
• Buy/use the resident’s favourite toiletries (e.g. perfumes)
• Perform grooming tasks on yourself in tandem with the resident
• Use safe and simple grooming tools
• Frequent trips to the hairdressers/barbers will decrease the amount of time needed to wash hair in the facility and might be an old routine and/or enjoyable experience for the resident
• Assist clients to shave or make appointments for shaving if they wish to do so. If you help a client shave, ensure you use an electric razor for safety
• Provide opportunities for beauty therapy appointments such as manicures/pedicures, gentle facials and massages if the resident would like this
• If the client wears makeup as part of their daily routine, assist them to do so - for example, by applying lipstick for them
• Ensure the client’s nails are kept clean and trimmed.

(Alzheimer’s Association 2018; Family Caregiver Alliance 2012)

Conclusion

Take the time to individualise the dressing and grooming process for each of your residents. Respect their right to dignified care and acknowledge how vulnerable their position is.

In letting you dress, undress and groom them, a resident is putting enormous trust in your care and professionalism. Your help could significantly increase their self-esteem and independence in an incredibly difficult time of their life.

References