Your approach to personal care should always take full account of the feelings and dignity of the person you are helping. People with dementia cannot always tell you if they feel embarrassed. Personal care must be given to the individual; it’s not just a matter of tasks that must be completed. Respect his/her feelings at all times.
The routine of dressing can become quite tiring, so try to make it as pleasant as possible. It is much easier to just dress the person and get it done with, than to spend time trying to persuade him to dress. It is important for the person’s physical and mental health, however, to encourage the person to do things for himself for as long as possible. As the disease progresses, he may need more help.
Help keep the person’s sense of identity by giving every opportunity for him to make a choice. Life is about choices. A danger of caring for people with dementia is that it is easier to make the choices for them, or we do so without realising it, thinking we are helping them by telling them what to do.
- Put away clothing that might cause confusion, e.g. put away winter clothes during the summer.
- The day starts with getting out of bed and changing from pyjamas into day clothes. This helps the person to realise that it is now daytime.
- Give him or her a reason for getting up and getting dressed.
- Make sure that dressing takes place in private.
- If needed, give simple instructions e.g. ‘Now put your arm through the sleeve’.
- If the person does not want to get up or get dressed, try to find out the reason and leave it for a while, rather than causing more distress.
- Ensure that there are no distractions in the room.
- Try to warm up the room before getting the person up.
- Try to keep to a dressing routine that the person is used to.
- The person may like to be left alone whilst dressing as it embarrasses him or her to dress or undress in front of someone else.
- Begin the task for the person, if necessary.
- Give people with dementia time. Give help only once they have gone as far as they can go. Avoid taking over.
- Pain may also put them off getting dressed as they might have hurt themselves, be suffering from arthritis or even feel ill.
- Do not make a big deal of behaviour that really is not a problem. It should not matter if the person puts the dress on back to front or wears three dresses at the same time, unless she’s going to be seen in public and you do not want her to be made a fool of. If family or friends are visiting, just explain the situation to them and how it is more important that she made the choice and dressed herself, than how she looks.
A possible simple routine
- Ensure that the way you present yourself is friendly, calm and relaxed, with a smile on your face, even though you might have woken up in a bad mood or are, yourself, under pressure.
- Begin the conversation with orientating information, which means identifying yourself, and calling the person by name.
- Create a relaxed atmosphere by beginning the conversation socially so as to win the person’s trust, which will make the task much easier. Spend time talking before you begin, e.g. ask how s/he slept, discuss the weather or family members, or look at photographs and talk about the people in them.
- Give the person clothes to choose from that are to his or her taste – our clothes are part of our personality. Take two suitable items out of the cupboard and ask which one s/he would like to wear. Show one item at a time. If neither is liked, take out another two. Do not give too much choice at one time as this may cause confusion. Humour or gentle teasing can also be used.
- Put the clothes out in the order that they will be put on and then leave the person to carry on, coming back now and again to see if help or encouragement is needed.
- If the person needs more help, give instructions in short steps, doing one task at a time. If an item is put on incorrectly, have a laugh while you correct it. Once the clothes are selected you can comment on how nice the outfit will look for the daughter who is coming, or for the tea party or any other function that might be looked forward to. It might just be sitting in the lounge or garden.
- Looking good helps us to feel good. Having hair styled and make-up put on, plus a dab of perfume or a piece of jewellery, plays just as important a role in dressing as do the clothes. Women who used nail varnish might enjoy having their nails done. Men may need to be reminded to shave. An electric razor would help maintain the independence of this task for longer. Beards and moustaches will also need trimming.
- Compliment the person on how nice s/he looks, to encourage her or him to be proud of her or his appearance.
Clothing tips for easy dressing
- If the person knows how to use Velcro, it is worth replacing zips with Velcro, especially the fly-zip on men’s trousers and the zips on skirts.
- Buy slip-on shoes or those that do up with Velcro, rather than lace-up shoes.
- Boxer shorts are easier for men than the conventional shorts, as are tracksuit pants rather than trousers. This will only work, however, if the items chosen are according to the person’s taste.
- Buy clothes that are easy to manage such as clothing with front fastening or without any fastening at all.
- For a woman, front-fastening bras are easier to manage. Do not let a woman who is used to wearing a bra, go without one, as she will be uncomfortable and it can also lead to soreness.
- Discourage the use of slippers whilst active during the day as they do not give enough support and the person might slop around in them, increasing the risk of falling.