Dressing and Undressing for Clients Who Have Dementia

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, 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 2017).

Reasons Why Someone May Have Problems Dressing or Undressing

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

• Physical or medical issues:
• • Dementia creates physical complications, as it affects fine and gross motor skills. A resident may also have impaired vision.
  • Dementia can also cause mental illnesses, such as depression, in which a resident may lose interest in dressing and grooming.

(Dementia Australia n.d.)

• Forgetting
• • A person who has dementia may forget how to dress, forget to change their clothes, or suddenly forget they are getting dressed.

(Dementia Australia n.d.; Alzheimer’s Association 2019)

• 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.

(Dementia Australia n.d.)

• Privacy concerns
• • The 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.

(Dementia Australia n.d.)

• Decision making problems
• • Making seemingly small decisions might be difficult for someone with dementia. It is important to encourage them to make their own decisions even if it takes more time. Make the process as easy as possible for them by organising clothes beforehand.

(Dementia Australia n.d.)

• 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 n.d.)

Simple Steps to Help a Resident Dress and Undress

1. Environment

• Respect privacy by keeping doors and curtains closed.
• Keep the room warm, or to the temperature requested by the resident.
• Allocate sufficient time to the task.
• Ensure lighting is adequate.
• Remove distractions from the room such as out-of-season clothes.

(Dementia Australia n.d.; Health Net Cafe 2019)

2. Your Actions

• Encourage the resident to do 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: a person with dementia 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.

(Dementia Australia n.d.; Alzheimer’s Association 2019; Alzheimer’s Society Canada 2017; Health Vic 2017)

3. 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.

(Dementia Australia n.d.; Health Net Cafe 2019; Alzheimer’s Association 2019; Health Vic 2017)

Grooming

Similarly to forgetting how to dress, a person may also forget how to groom themselves or need help doing this. Previously simple tasks such as combing, shaving or trimming fingernails may become confusing, or a resident may forget what items such as nail clippers or combs are intended for (Alzheimer’s Association 2019).

Simple Steps to Help a Resident Groom Themselves

• Follow and maintain grooming routines.
• Buy/use the resident’s favourite toiletries.
• Perform grooming tasks on yourself in tandem with the client.
• Use safe and simple grooming tools.
• Frequent trips to the hairdressers/barbers will decrease the amount of times needed to wash hair in the facility and might be an old routine and/or enjoyable experience for the resident.

(Alzheimer’s Association 2019; Family Caregiver Alliance 2012)

Conclusion

Take the time to individualise the dressing and grooming process for each resident. Respect the resident’s 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.

Additional Resources

• Aged Care Quality Standards: https://agedcare.health.gov.au/quality/aged-care-quality-standards
• National Dementia Helpline: 1800 100 500

References

• Alzheimer’s Association 2019, Dressing and Grooming, Alzheimer’s Association, viewed 10 September 2019, https://www.alz.org/help-support/caregiving/daily-care/dressing-grooming
• Alzheimer’s Society Canada 2017, Dressing, Alzheimer’s Society Canada, viewed 10 September 2019, https://alzheimer.ca/en/Home/Living-with-dementia/Day-to-day-living/Personal-care/Dressing
• Dementia Australia n.d., Dressing, Dementia Australia, viewed 10 September, https://www.dementia.org.au/support-and-services/families-and-friends/personal-care/dressing
• Health Net Cafe 2019, Dressing and Undressing, Health Net Cafe, viewed 10 September 2019, http://www.healthnetcafe.com/content/day-to-day_care/general/dressing_and_undressing.html
• Health Vic 2017, Dressing, Health Vic, viewed 10 September 2019, https://www2.health.vic.gov.au/ageing-and-aged-care/dementia-friendly-environments/strategies-checklists-tools/dressing