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She has begun layering clothes, even underpants over sweatpants. Buttons and unbuttons and just generally fusses with her clothing. I can tell she is frustrated. Wonder about activity pillows or blankets. Thanks for any suggestions.

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There are a number of activities she could do, ranging from folding clothes to helping setting the table.

Check out these:

https://www.agingcare.com/search.aspx?searchterm=activities+for+bored+elders
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Google is one of my best friends, make it yours too ;)
Try searching "keeping dementia hands busy", there should be lots of sites there for you.
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Glassgirl I feel your concern over this. My mom has a tendency to go in her bureau constantly and take out clothes. She'll change her clothes at least 5 times a day. And heaven forbid I mess up and say something like "you have a doctor's appointment tomorrow" or "tomorrow we go to church". That seems to churn up her clothing-based anxiety big time. She'll then start stacking outfits on the foot of her bed, on the sofa, etc in preparation for tomorrow's outing. Nothing wrong with that. Except she'll do it over and over changing pieces or forgetting the clothes are already there and putting them back and then putting them back out again.

It used to bother me. But I've decided it's a residual memory of how organized she used to be. She always preplanned her outfits the day before. I clearly didn't inherit THAT gene. I wake up in the mornings racing from bureau to closet to laundry room so much you'd think I was in a Benny Hill skit.

So I decided not to make an issue of it. She stops eventually. It's become a new interaction for both of us. She lays out 8-9 outfits (including shoes, undergarments, and wigs). She goes to bed. I put away 7-8 outfits, selecting the most fab of her options as The One to leave out for her to actually wear.
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Should add, I've learned not to speak of anything we have to do TOMORROW. Now I wait until the actual day and say "you have an appointment TODAY". This gives her less time to churn out outfits. As far as the 5 changes per day? I let her do her thing for now. So long as she doesn't decide to channel her inner Madonna and show up to the dinner table in nothing but a bra, booty shorts and thigh high boots (which thankfully she owns none of the last two items) I'm good with seeing which dressing gown has made the fashion show of the day.
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An activity pillow or blanket could be a very helpful item. Why don't you make or buy one and see? I don't know any other way to find out.
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Jeanne's post reminded me of others on this subject. Check out these links for a "fidget blanket."

https://www.agingcare.com/search.aspx?searchterm=fidget+blanket
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