6 Tips to Help Manage Resistance During Dressing Tasks

Growing up, my mom and dad were the ones who instilled in me the importance of hygiene. My mom and dad always made sure I had clean clothes. They spent lots of time removing stains from my clothing and doing endless loads of laundry. It just really became engrained in me the importance of wearing clean clothes daily

Alzheimer's impact on hygiene

I was in my 20s when my dad was diagnosed with Alzheimer's disease, and then years later my mom was also diagnosed. Through those years I witnessed the subtle decline in cognitive, social, and daily functioning abilities. Those subtle changes became much more noticeable as the disease progressed. One area of both of my parents' disease that was dramatically affected was their ability to assess their hygiene status.

I am not going to lie – this was a tough one for me to accept. How could the 2 people who taught me the importance of hygiene wear the same dirty clothes every day? Did they not care, or was it a behavior? My head was flooded with many questions, and I felt so many emotions.

Understanding how Alzheimer's affects hygiene

Again, I had to step out of my daughter role and try to understand why this was happening – which was extremely hard through my physical exhaustion and sleep deprivation. It was through my healthcare training and further research that I learned about agnosia and its role in Alzheimer's disease.

Agnosia's impact in Alzheimer's

The National Institute of Health defines agnosia as a neurological disorder characterized by an inability to recognize and identify objects or persons using one or more of the senses.¹

My professional and personal experience has led me to observe that as Alzheimer's progresses, it is not uncommon for people to wear clothes that are dirty, stained, or have an odor to them.

Our loved one's vision and sense of smell may be fully intact. However, their Alzheimer's affects various parts of the brain, including their occipital, parietal, and/or temporal lobes.^1,2

This impact on our loved one's neurologic system is great. It does not allow them to use the information that they receive through their sense of vision and smell to come to the cognitive conclusion that their clothes are dirty.2

The inability to process leads to resistance

Our loved one's inability to cognitively process the information their sensory system is providing them and their memory impairments can lead to much resistance.²

This may sound very familiar to many of you reading this article. Personally, my mom would become extremely resistant when asked to change out of her dirty clothes.

Tips to help manage resistance to hygiene in people with Alzheimer's

First, it's important to understand that Alzheimer’s is a complicated neurological disease. Through my experience with both of my parents, what appears as a behavior often is linked to something else. So, understanding agnosia’s potential role in hygiene is important.

Emphasize the positive and strive to elevate mood

Entering into positive conversation with your loved one and lifting their mood can help set the tone for the rest of their day, your interactions with them, and the completion of their daily tasks.

Asking our loved ones versus telling and distraction are helpful

Instead of entering the conversation with an obvious mission, I tried to avoid stating my objective. It was helpful to not mention that my mom's clothes were dirty. Instead, I would distract her with a motivating activity.

For instance, I would talk about how perfect the outfit would be to wear outside to watch the birds. I would ask her if she thought her favorite cardigan sweater would look nice with the outfit. It was important for me to include her in the process as much as possible.

Avoid triggers

Once you have engaged your loved one and they are changing their clothes, be careful to quickly remove those soiled clothes out of your loved one’s sight. I was always careful to place my mom's dirty clothes inside the hamper and shut the lid. I would lay out her clean clothes on the bed. It helped to minimize confusion.^1,2

Remain calm, and provide reassurance and love

Unfortunately, it is common that our loved ones with Alzheimer's disease may experience delusions of paranoia, such as someone stealing from them, or that they are not wanted or loved.

Again, Alzheimer's is a neurologic disease affecting the brain. So, when entering into a conversation or activity with a loved one, it is always a good idea to address them with a happy greeting or a hug. Anything that will help to decrease any anxiety that your loved one may already be feeling.^1,2

Have duplicate sets of favorite clothes available

This helps tremendously when transitioning from a soiled outfit to a clean one. There is not much conversation that needs to occur. I personally found as the disease progressed this tip worked well.

Redirection and distraction can be a useful tool at time. When have you found yourself utilizing these techniques to assist with a task? Help others and share what you have learned from your experiences with the community!