Introduction
Many patients with Alzheimer’s disease have difficulty getting dressed by themselves. This may be due to confusion or short attention span as well as to cognitive dysfunction or physical disability. Dressing is a complicated series of actions which includes clothing selection, undressing, and dressing, and must be done in a correct sequence in order to successfully complete the task. Both the caregiver’s and the patient’s response to dressing activities may have an effect on subsequent behaviors and moods during the day.
Research
This study simplified dressing by separating it into two parts. Before going to sleep, eight patients selected clothing to be worn the following day. A special closet modification restricted access to only the selected set of clothing which was displayed in the order in which it was to be put on. Each morning, patients were observed by the caregiving staff to compare differences in the level of assistance and independence as measured by the amount of direct physical aid or verbal prompting required to dress.
Results
The special closet modification increased the level of independence by 19%. Instances of direct physical assistance were reduced by one-third to one-half, and the number of verbal prompts increased. This indicates that some patients became less dependent on their caregivers for physical assistance and were better able to dress independently with simple verbal directions or reminders when attention was centered on dressing.
Application
As the first challenge of the day, dressing requires sequential decision-making and focused attention. Caregivers can help minimize the confusion associated with dressing by separating the selection process (which might require complex choices involving style, color, or season appropriate outfits) from the physical act of dressing. In this way, the patient’s attention is directed to a specific article of clothing that he or she must correctly put on. Secondly, patients may be more independent in dressing when they see the article of clothing which is to be put on next. For example, clothing worn on the lower part of the body should be unfolded and placed in a pile so that the patient sees underclothing first and pants or a skirt last. Socks could be placed on top of shoes to serve as a cue that they should be put on before the shoes.
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