A person living with dementia may have difficulty dressing independently. As dementia progresses, individuals often lose the ability to carry out skilled movements, despite being motivated and having the physical ability to perform them. This is known as apraxia.
Someone with dressing apraxia may have difficulty with sequencing dressing tasks, placing their arms in sleeves, putting things on backwards/inside out, etc.
Caregivers need to be aware that the person with dementia may not understand what they need to do.
The person may also have impaired judgement and no longer knows what clothing is appropriate to wear. They may also be experiencing physical changes like pain, tremor, or decreased fine motor skills, making it difficult to bend or adjust fasteners.
Tips for caregivers providing assistance with dressing:
- Reduce distractions so the person living with dementia can concentrate on getting dressed.
- Create a sense of privacy (e.g. close doors, blinds, and curtains).
- Offer clothing options, but not too many. (Best if choosing between two items).
- Introduce yourself and explain what you are going to do. Give short, simple instructions for each step required and hand the person one item of clothing at a time.
- Demonstrate the actions required for each step if the person has difficulty understanding verbal instructions.
- Be patient and allow plenty of time so the person living with dementia does not feel rushed.
- Encourage the person to participate independently as much as possible.
- If the person seems embarrassed about accepting help due to cognitive impairment, they may be more accepting if you offer help by suggesting physical reasons (e.g. arthritis in hands or shoulders, pain, etc.)
Tips for independent dressing:
- Try posting a simple picture guide or list on the wall to help the person follow the correct order or sequence.
- Lay clothes on a flat surface— it can be on a bed or chair and place the clothes in the order they should be worn. Make sure they are not inside out.
- Ensure there is good lighting in the room and seating nearby, in case the person is tired.
- Sometimes dressing in front of a mirror helps the person put on clothes correctly. (This may not work for all people as mirrors may increase confusion for some individuals living with dementia)
- If the person has difficulty identifying the right and left side of their clothes, try sewing a small red tag, or making a red mark on the inside of the right sleeve. Remind them red is for right.
- Try to simplify the task. For example, put items away in drawers so they are easier to find. Apply labels or pictures on drawers to show what’s inside. Reduce the number of clothing choices to make the task less overwhelming (put away off-season clothing).
- Consider modified clothing (e.g. magnetic buttons or zippers, tops with wide neck openings) and avoid tight-fitting clothes. Elastic waistbands are a good choice for ease of dressing and toileting.
- Dressing aids such as a long-handled shoehorn or elastic shoelaces can help to maintain independence with dressing.
- Purchase clothing with simple patterns or solid, contrasting colours to make it easier for the person to see and distinguish between clothing items.
- If a person tends to put clothing on backwards, choose clothing (e.g. t-shirts) where the front and back look similar.
Keep in mind: If the person is getting frustrated, sometimes, it is best to set aside the task and wait to start it again at another time. Explaining or repeating the task repeatedly without a break will likely increase frustration.