“Momma would just die of embarrassment if she knew that we let her look like this!”
“Dad has been clean-shaven all of his life. How can the nursing home neglect him this way?”
It can certainly make us feel uncomfortable to see our loved ones not appearing like themselves, or how they used to present themselves. If the loved one has Alzheimer’s disease or another dementia, their appearance will likely change, and it is hard to witness those changes. We want to hold onto them as we remember them. And we worry that they would not want to be out in the world not looking the way that they always have in the past.
I had a patient who was the primary caregiver to her elderly mother who was living with dementia. The mother wasn’t my patient, but the daughter would bring her mother with her to her own appointments, making sure that her mother was perfectly dressed, coiffed, and made up. I marveled that the daughter could accomplish this transformation even when her mother was in the advanced stages of dementia.
I tried to keep Harvey wearing his same clothes, same haircut, same glasses, and same freshly shaved face for as long as possible. It helped me remember that he was the same person I knew before the disease, and it felt like I was respecting him by maintaining his appearance.
The first step away from this appearance was when I purchased a new pair of shoes for him. Harvey was no longer able to tie his shoes, so I thought I would buy a nice pair of slip-on loafers. I didn’t want to spend a lot of money on something he might not wear often, so I purchased a pair of “dress Croc’s.” Never would he ever… But he wore them without fuss until they were misplaced. About the time of the Croc’s, I also purchased elastic waist khakis! Again, never would he ever… Eventually, his usual attire became tee shirt, sweatpants, and slippers.
I’ve written about this before, but one Sunday, just before he was to move into memory care, Harvey just wouldn’t change out of his pajamas or shave in order to go to church. I needed my community. I HAD to go to church. I suspect most people would have decided to just stay home, but we went, with Harvey in pajamas. No one batted an eye or said a word about it. Later, someone remarked that they knew it must have been a bad day for me, but they were glad I decided to come to church anyway.
What would Harvey have thought about that? Would his prior self have been appalled that I would let him go to church in his pajamas or wear Croc’s?
I believe that keeping up the appearance of a loved one may be more for our own benefit than for the loved one. It makes us feel better to see them as they have always been. It helps keep the idea that they are worsening at bay.
And if it is not difficult to keep their appearance up, why not?
However, if you just cannot get your loved one to maintain his or her usual appearance, it is not worth a fight, or even a hassle. Their person, their essence, is not in their appearance.
And what about me writing an entire book about Harvey? And posting photos of him in the advanced stages of the disease? It gave me pause, and still does. In the end, I know that he would be very proud of the work that I am doing and the number of people who are helped by reading my words or hearing my presentations.
4 Responses
Harvey would indeed be very proud of you Renee and how much you are helping others with you honesty. At some point you must give in to your loved one with dementia and let them be comfortable and calm. That was one of the lessons I learned in taking care of my family. They are ok with their appearance even if it’s not what they used to wear. I remember when my dad wanted to go out in his underwear and my aunt “streaked” in the nursing home! Never in a million years would either have done that!
Yes, I think it’s timing. Eventually, you have to go with comfort and ease.
This is a wonderful article. It makes me think how my father really didn’t have a choice of staying in his pajamas because of where he lived. He was in several facilities before we found the perfect one, and the personal care they took of him helped define “perfect one.” Even the “Ritz Carlton” of facilities didn’t take proper care of his grooming. He lived out his life in a family-owned facility in a small town in North Carolina. I was there every single day, and dad was always freshly shaved and nicely dressed–pressed khakis, shirt tucked in, belt belted, hair combed, teeth brushed. Dad dressed well before his Alzheimer’s, and I know he was aware of how nice he looked each day. I also know there were days he wished he could stay in bed and in his pajamas, but they had a routine and stuck to it, which was actually good. Once he had to be in a rehab facility for a month, and he was a mess! I was there every day, and no matter how much I pleaded, he was left unkempt and his health constantly put in danger. One day I said, “Dad can I brush your teeth?” He said, “I’d be grateful.” Then he said, “What was that place where they took such good care of me?” He remembered, and he knew the difference. He was so happy to return there.
Rebecca, thanks for sharing your story. It sounds like the level of care your dad received was reflected in his appearance. I hadn’t thought of it that way. Thank you!