All Dressed Up

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As I shopped for new clothes to wear to holiday parties this season, I re-lived some of the dressing dilemmas I experienced with my husband, Harvey, during his time with younger-onset Alzheimer’s disease. For example, I was flooded with memories of shopping for clothes to gift him with at Christmas that he would never have worn prior to his diagnosis.

Always a neat and conservative dresser before the diagnosis, it was hard to watch him struggle with this aspect of daily life. As with everything else associated with the ever-changing landscape of dementia, my approaches to clothing with Harvey changed as his disease advanced.

At first, there was very little need for my help or intervention when it came to clothing. The only assistance required of me was if he forget what was on our schedule and had to be reminded to dress appropriately for the occasion. I knew that he would be embarrassed if he dressed too casually for a holiday party, so he didn’t mind at all when I told him what kind of event we were headed to.

Later, I began to notice that he chose to wear the same limited number of outfits. I realized that making choices about his clothes was becoming difficult for him. First I winnowed out, surreptitiously, clothes he hadn’t worn in years, filling large garbage bags to donate. I moved off-season clothes to another closet in the house and rotated them back into his closet when it was time. I limited his shoe choices, too. Over time, I eliminated more and more clothing options.

Toward the end of the middle stage of his Alzheimer’s disease, Harvey was wearing the same outfit everyday. It didn’t matter to me that he wore the same things, even days in a row, but I did worry about hygiene, especially if he wasn’t changing his underwear. I began to offer him two choices for the day, but when even this was too overwhelming, I began to lay out clothes for him while he showered in the morning, hiding the previous day’s outfit deep in the laundry hamper. Some of his clothing choices were not matched well, but I held my tongue as I knew that criticizing him for this minor issue was not worth the damage to his self-esteem.

Eventually, he developed difficulty in knowing how to layer his clothes, putting underwear over his pants, for example. I then started laying out his clothes in order, one item on top of the other, in the order they should be donned: underwear, pants, undershirt, button-down shirt, then cardigan. Later, I learned that instead of giving an open-ended suggestion such as, “Let’s get dressed, Harvey,” I would offer more simple, direct instructions as I handed him one article, saying, for example, “Put on your pants now.”

Dressing inappropriately for the seasons was never a problem for Harvey, but it might be for other persons living with dementia. It’s ok if they wear multiple layers of clothing, but caregivers need to make sure their loved ones don’t become overheated. When headed outdoors, the caregiver must be sure that the loved is dressed appropriately for the weather—rain, snow, heat, or cold.

Next, Harvey began to have difficulty knowing how certain items of clothing were to be used. He once struggled to put his underwear on over his head, and another time, he tried stepping into the arms of a sweatshirt as if they were pants. He was very relieved for me to help him out in these instances, so I began to monitor and assist him when he got dressed and undressed.

The next phase involved moving to simpler forms of clothing: elastic waist pants, button-up shirts, and slip-on shoes. When even these items became too difficult for Harvey, and he began to put up resistance to my assistance, it was time to move him to a memory care unit. There were other factors involved of course, but he needed more help to change clothes than I and my caregivers were able to manage.

In memory care, because he was unable to manage any of his own clothing, the staff moved to dressing him in sweat pants, t-shirt, and slippers. They could expertly clothe him in seconds.

I hope my examples here will help you more easily navigate the clothing of your loved ones. Especially during the holiday season, you don’t need any added stressors. I recommend dropping the expectation that your loved one will dress and groom exactly as they have in the past for the upcoming celebrations, and just enjoy the season with whatever skills they have left.