Dressing someone else can be a challenge in itself. When it is coupled with a disability or impairment, it becomes a learned skill. Most adults who are parents have experience dressing their children, but dressing another adult brings a whole new set of challenges. This is especially true if the adult has a physical condition that prevents them from assisting, such as Parkinson’s Disease (PD).
The progressive state of the disease and even the time of day can impose specific challenges as well. Below are a few considerations and tips that may help simplify and speed up your loved one's daily care routine.
Adapt and Enable
- First, extend as much privacy and respect in the dressing process as possible. Promote their dignity and pick up on their cues. For example, if they say something like, "My thumbs aren’t working today," this may translate into something like, "I'm feeling confused and could use some help this morning." If they laugh, then laugh with them, or even sing the instructions. The idea is to encourage comfort and easiness in this process. It is very likely that they are as uncomfortable as you are.
- If they become confused or frustrated with a task, assist calmly with short, simple instructions.
- Be a little proactive and empty the closet of clothes that are no longer appropriate, or maybe just too frustrating to put on and take off. It can be easy for them to become overwhelmed by too many choices.
- Allow them to do as much themselves as they possibly can. Intervene at the point of oncoming frustration.
- A person in a confused or depressed state will often argue and struggle to wear the same outfit for many days. Purchase several duplicate sets to facilitate laundry and hygiene while allowing them to wear what they like.
- Buy clothing that is simple to put on and take off, including stretchable fabrics, pants with elastic waistbands, shoes with Velcro closures, a nice camisole instead of a bra, or a bra with a front closure. For women, dresses are easier to get on and off than pants. Tops that fasten in the front may be easier than pullovers depending on a loved one's flexibility and range of motion. Boxers tend to be easier for men than briefs.
- Keep in mind that what works one day may not be preferred the next in certain phases of the disease progression. It is also important to remember not to purchase clothes that you like. Rather, keep in mind that what they prefer is more important. Try not to inadvertently turn them into a "mini me" because you are trying to be too helpful. If they choose something very inappropriate, then gently try to steer them into a different decision.
- Comfortable clothing is important, not just for your ease of dressing, but for their own comfort as well. If inappropriate undressing occurs, in public places for example, calmly suggest that you need help in the restroom and guide them out of the situation. Choosing items that are easy for you to manage, but that might be more difficult for them to remove, may be a solution.
- Avoid socks with tight elastic bands. Unless therapeutic circulatory socks are required, wear loose-fitting ones. They are easier to put on, plus they are less likely to cause swelling in the feet and ankles.
- Wearing non-skid socks should replace bathroom slippers, which can easily slide off a loved one's feet. A person with Parkinson’s does not always have control of their step, in the upward lift or forward motion. This can cause their feet to come out of their slip-on shoes and result in stumbling or even a fall. Non-skid socks are comfortable and easily available in department stores. Keep in mind that falling is a great fear of someone who is unstable on his or her feet. This fear can lead to other conditions such as depression as a consequence of choosing to stay in and forfeiting social interaction.
- Wear lightweight, supportive shoes with Velcro closures or elastic shoelaces to make it easy to put on and take off shoes. Choose this type of shoe for both safety and comfort reasons. If your loved one is comfortable and secure with the fit of their shoes, they are more likely to be willing to go for a walk or participate in other types of physical therapy.
- At some point in the progression of the disease, your loved one will no longer be able to self-regulate their body temperature. You may need to monitor the appropriateness of their clothing for the current weather situation. For example, if they are still dressing themselves, they may not choose appropriate clothing items. Eventually they may reach a stage of not being able to tell you if they are hot or cold. Dressing in layers and having extra ones on hand will make it easier for you to help them stay comfortable.
- Purchase an electric razor if they do not currently use one. It is a lot easier to use and it does not necessarily have to be used in the bathroom. A loved one may be able to shave their face while sitting calmly in their living room.
- Many women feel more confident and secure with makeup, and if you are a male caregiver, you may not know how to help. Often, blush and lipstick will suffice. Assist in opening the containers, and make sure the blush is blended well so that it does not look patchy, and check to make sure lipstick is not smeared. Chances are this phase will pass, but there is nothing wrong with a little indulgence.
Create a New Routine
- Plan ahead to allow plenty of time for dressing. Rushing any activity can lead to stress and frustration, which can inadvertently slow you down.
- Create a routine of dressing and undressing at the same time each day. During progressive stages of the disease, unplanned events are generally not received well. A loved one with PD will perform and be more helpful if they are expecting the task at hand.
- Do a few stretching exercises before getting dressed to "warm up" muscles. This is particularly helpful just after waking up or if they have been sitting for a while. Their motor skills can benefit from a brief warm-up period.
- If your loved one is still able to dress themselves, lay their clothes out on the bed in the order in which they should put them on. This will lessen their confusion.
- Sit down when dressing. Choose a chair with firm support and arms. If the person cannot assist by providing a little of their own leverage or "push back," sitting in a chair will help you wield your supportive strength. A good example is putting on someone’s socks. If they are unable to hold their leg or foot firm for you to pull the sock onto their foot, then sitting allows you to place their foot in your lap. This is a much safer alternative to attempting this in a standing position.
- Do not sit on the edge of the bed to dress. It may seem like a go-to solution, but this can lead to a loss of balance and a fall. Safety is extremely important, but it is often overlooked when trying to adapt a previously simple task.
- Use a footstool to make it easier to push their foot into each shoe.
- Personal hygiene can become especially problematic. Combing hair, shaving, trimming nails, moisturizing, washing, etc. may require some adjustments in time and place. It is more important to establish a clear routine than stick to "accepted" customs. As previously mentioned, it may be easier to use an electric razor to shave a loved one's face when they are sitting in their armchair watching a favorite TV program versus getting them into the bathroom each morning to lather up.
- A loved one may be able to go through the motions while you help guide them. For instance, have your hand over theirs while brushing their hair.
- Regular visits to the hairdresser or barber will reduce hair washing at home.
- Manicures and pedicures are very calming and can be a pleasurable experience. They may look forward to such an outing as it approaches.
Try to keep in mind that the person with Parkinson’s disease needs to retain their sense of identity and feelings of self-worth. They need to feel valued as the person they have been and are now. There are many things we can do to help simply by being flexible and tolerant, making time to listen, showing affection and support, and finding things to continue to do together.