Seniors with dementia may refuse to change clothes
A common challenge for Alzheimer's and dementia caregivers is figuring out how to get someone with dementia to change clothes regularly.
The damage that dementia does to the brain can cause behavior like this that doesn’t make sense to us.
Your older adult might refuse to change even if their clothes have been worn nonstop for a week and are obviously soiled and smelly.
Or, they might insist on wearing the same outfit day and night. And sometimes they might choose clothing that completely clashes and looks strange or wear items the wrong way.
We explain 6 possible reasons for their refusal to change
and share 4 ways to get someone with dementia to change clothes more often.
6 possible causes for refusing to change clothes
Understanding what could be causing someone’s refusal to change clothes can help you find an approach that works.
It also gives some perspective on the situation and can help you realize that your older adult isn’t doing this on purpose.
1. Impaired memory or judgement
Forgets that they haven’t changed clothes in a long time or thinks that they changed recently
Is losing the ability to keep track of time
Forgets that the clothes are dirty after taking them off
Is no longer making good choices
2. Need for control
Insists on independently making their own choices even if their judgement is impaired
3. Need for comfort and security
Is comforted by the familiarity or routine of wearing the same clothing
4. Struggles with everyday tasks
Is overwhelmed by the choices and steps needed to get dressed
Has difficulty with the physical motions required to dress and undress
Has body aches and pains or being easily fatigued makes changing clothes and/or doing laundry too difficult
5. Feeling overstimulated or uncomfortable
Avoids clothing items that have distracting patterns or colors, difficult fasteners, or uncomfortable fit
6. Weakened or dulled senses
Can’t smell the odors caused by wearing soiled clothing
Doesn’t notice or see stains or dirt
Decide if a change of clothing is necessary
We’ve gotten used to changing our clothes every day and switching to pajamas for sleeping.
But neither are strictly necessary for health or hygiene.
If their clothing is not soiled, your older adult may not need to change every day.
After all, many people regularly wear their shirts and pants a couple times before putting them in the laundry.
And if your older adult is clean enough and comfortable, there’s no reason why they can’t wear the same outfit during the day as well as for sleeping at night – especially if they’re wearing comfortable loungewear.
Sometimes it’s a matter of timing. Your older adult might be tired, cranky, or not feel like changing at that moment.
Plus, if your older adult isn’t leaving the house, they may not feel that the effort to change is needed – especially if dressing is tiring or physically difficult.
Before asking a reluctant person to change clothes, consider if it’s really necessary or if it can wait until later or another day.
4 ways to get someone with dementia to change clothes
1. Avoid using logic and reason to convince them
Avoid using logic or criticism, like saying “Dad, you’ve been wearing the same clothes all week and they’re really dirty and smelly!” Hearing that would put anyone on the defensive Plus, the logic and reason is likely to confuse someone with dementia – making them even more sensitive.
Because of the damage that dementia has caused in their brain, they’ll insist on believing their own thoughts and memory over yours, no matter what the facts are.
2. Get clever or sneaky
Wait for them to fall asleep and then remove dirty clothes from their room and replace with fresh clothes.
Buy identical replacement outfits (same color and style) so you can replace them without your older adult noticing (if that’s an issue) and so you can wash one set while the other is being worn.
If they sleep in the same clothes they wear during the day, your only option may be to quietly replace with fresh clothes while they are bathing.
3. Make dressing easier
Clear out the closet so there are fewer options and less decisions to make. And if you make sure that everything already matches, that makes dressing even easier.
Choose clothing in favorite solid colors instead of potentially distracting or confusing patterns.
Remove clothing that isn’t appropriate for the season.
Choose clothes that are easy to put on and take off – consider adaptive clothing with specialized fasteners
If you lay out their clothing, do it in the same order every day.
Give them plenty of time to dress themselves so they don’t feel rushed or get flustered
4. Gain perspective on the situation
Ask yourself if you’re bothered by their choice of clothing because you don’t like it or if there’s actual soiling or odor that’s causing a problem.
Let go of embarrassment if you think an outfit isn’t appropriate, but your older adult loves it (assuming it’s clean and weather-appropriate). For example, your formerly conservative mom now only wants to wear sweatshirts with a picture of a cartoon character rather than a proper button-up cardigan. The priority is for her to be clean, comfortable, and happy.
Ask yourself if you’re more concerned about following current societal norms of changing and bathing daily rather than what's needed to maintain health.