Clothing Issues

February 14, 2011

I remember visiting my grandparents in the mountains of Northeastern Tennessee every year over the Fourth of July. According to my grandmother, they didn’t need air conditioning, because it was cool in the mountains. However, during our summer visits, the highs would always be in the 90’s and the house was like an oven.

One of the things I remember about these times is that my grandfather, who had Alzheimer’s disease, would wear a toboggan and coat in the house, and would walk around closing all the windows, the only source of ventilation, during the heat of the day. We would go behind him opening them, but no one could convince him not to wear his toboggan and coat, so we stopped trying.

People with Alzheimer’s and other forms of dementia often have no understanding of season and temperature, much less how it should affect their choice of clothing. I heard a story once of a daughter who picked up her mother at the assisted living facility where the mother lived to take her to dinner. It was very cold outside and the mother had on her coat when the daughter picked her up, so the daughter had no idea what her mother had on under her coat. When they arrived at the restaurant and sat down, the mother had on nothing above the waist but her bra and slip.

Wearing clothing inappropriate for the season can be uncomfortable, but wearing clothing inappropriate for public view can be embarrassing. As the caregiver, what should you do?

If possible, try not to make clothing a battle. In most people with dementia, this will just make them argumentative and perhaps, combative. The best thing you can do is to prepare for this situation in advance by controlling the choices to prevent problems before they happen. Whenever possible, choose the choices, so that any choice your loved one has is appropriate.

  1. Rotate clothing in the closet seasonally, so that clothes inappropriate for the season are not available to your loved one.
  2. If your loved one allows, display two or three complete outfits as choices.
  3. If your loved one has one particular set of clothing he/she wants to wear all the time, buy 7 of this outfit, or at least something so similar that he/she can’t tell the difference.
  4. If your loved one balks at the choices, it may be that he can’t discern they’re there. Is the clothing lying on a similarly colored sheet? Those with Alzheimer’s disease lose their ability to discern the differences between similar colors. For instance, a white shirt light-colored sheets may be “invisible” to him.
  5. If your loved one balks at changing clothes, make the process more simple. Instead of saying, “Let’s change your clothes.” Go step by step, starting with, “Let’s unbutton your blouse” or whatever is appropriate for the articles of clothing she is wearing.
  6. Finally, if you don’t like the choice of clothing your loved one makes, ask yourself if it matters. If you’re staying at home, it probably doesn’t. If you’re going to your granddaughter’s wedding, it does. Don’t make something into a battle if it doesn’t matter.

Sometimes, the issue isn’t changing clothes, it’s keeping clothes on at all. Some people with dementia undress themselves in public. For ladies, you can try dresses or blouses with back zippers or buttons. Usually, these are too complicated for those with Alzheimer’s to comprehend. Pullover shirts and blouses also are a good choice. For men, it’s more difficult, since the pants are usually the issue. He may need to wear a “busy apron” or “Alzheimer’s apron” over his clothes, which has zippers, buttons, etc., but is virtually impossible for him to remove. These are also a good option for women.

When embarrassing moments happen:

  1. Take a deep breath, don’t panic and react calmly.
  2. Try to think of a way to diffuse the situation. The daughter I spoke of earlier in the blog said, “Mom, it’s really cold in here. I think I’ll put my coat back on. Let me help you with yours.” They at a lovely dinner and the daughter took her mother home. No one got upset. The mother had no idea she’d done anything wrong.
  3. Distraction is always a good idea. Usually, each individual has a distraction that will always work for them. With my father-in-law, he was very particular about his hair. When he began doing something he shouldn’t, I could always say, “Papa! Your hair is messed up! You need to go comb it!” Most people have a key “distraction phrase” if only you can find it.

What works for you? Please comment!


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2 Responses to “Clothing Issues”

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