I know I should be more patient, but it takes her so long to get dressed that I end up just doing everything for her.”
I hear complaints like this all the time. Although a person with dementia may be physically capable of getting dressed with a little extra time (or just a few verbal reminders), the caregiver finds him or herself helping more than is necessary.
Is this ok? Does the extra help lead to learned dependency? Should the caregiver just let the person take as long as she needs to get dressed?
Relax, there is no right or wrong answer. It’s all relative.
First, identify if there really is a problem. Are you (caregiver) just a “get-it-done” kind of person? Does the length of time the activity takes make you late for work or other appointments? Or is your urge to help more related to the sense of normalcy and efficiency that comes with completing tasks in a timely fashion? Does it frustrate you that it takes her so long to get dressed? Ask yourself, is it just that the time required seems excessive, or do we have an actual problem?
If the answer is, “Yes, Houston, we have a problem. Mom can’t complete the task without multiple errors. She gets distracted. She takes forever to put her stockings on. She can’t decide what to wear, or chooses the wackiest outfits. She just sits there and stares. She layers her clothes. She wears yesterday’s clothes. She wears no clothes…”
…then we have an identifiable problem. We can implement some strategies that may help. Remember that although there might be some personality challenges and resistance as you try to suggest alternatives or time management strategies, there is a degenerative process going on in the brain that is causing difficulty in organizing and attending to information.
You probably wouldn’t be frustrated if Mom took longer due to an amputated leg or a paralyzed arm, so you need to view the damaged brain through the same lens. You don’t need to be patient, you just need to be informed.
Dementia is usually due to a disease process (Alzheimer’s, Parkinson’s…). There is a loss of brain cells and neural connections causing slower brain function. Problems with dressing can be related to:
- memory loss “I forget what I am doing.”
- language deficits “What is this item called?
- sequencing errors “Which item to put on first?”
- initiation problems “I don’t know how to begin.”
- problem solving difficulties “How do I get this over my head?”
- repetitive behaviors “I don’t know when I’m done.”
- Organize the environment.
- Eliminate clutter.
- Weed through and discard old clothes.
- Give only one article of clothing at a time.
- Keep verbal cues to short phrases- avoid chatter.
- Label drawers
- Lay out clothing in a left to right sequence.
- Choose your battles- or in this case, choose your body part. You can physically assist if the task is difficult or painful. But if she can get her shirt and bra on, let her. If she can pull her pants up, let her. Let him try to button his shirt and do a few of the easier ones- help with the buttons up by the neck. The physical benefits of dressing are like exercise, and carries the same “use it or lose it” potential.
- Parkinson’s- folks with Parkinson’s disease tend to move more slowly (bradykinesia) and have problems with initiation. This has nothing to do with behavior. Sometimes music with a strong beat (marching or symphonic rhythms) provide the external cues needed to move.
- Safe seating surface- make sure there is a firm seating surface for dressing. A solid chair with arms is ideal, as sitting on the edge of the bed or a low bench makes balancing and coming to stand more difficult.
What strategies have worked for you?