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’re 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.
Recommended for you:
- How Often Should Seniors Bathe? 3 Essential Health Tips
- 6 Positive Ways to Approach Someone with Dementia
- Dementia and Mirrors: 10 Solutions for Challenging Behavior
By DailyCaring Editorial Team
Lucy Corey
My husband is at a point where he simply gets extremely angry about routine changes of depends. He also is dealing with hypersexuality most of his waking hours. I am his sole care giver. I am at the end of my rope, as his first stroke was 5 years ago. Is it time to think about a nursing home? He is quite strong, even with his disabilities. Thanks for any feedback, no one lives near us.
DailyCaring
We’re sorry to hear about this challenging situation.
These articles may be helpful as you make this decision:
– When to Move to Assisted Living? Advice From a Social Worker https://dailycaring.com/when-should-a-senior-move-to-assisted-living-get-advice-from-a-social-worker/
– 3 Tips to Choose Between Assisted Living vs In-Home Care https://dailycaring.com/3-tips-to-help-you-choose-between-assisted-living-vs-in-home-care/
– Memory Care: Assisted Living for Alzheimer’s and Dementia https://dailycaring.com/alzheimers-dementia-memory-care-basics/
– 3 Reasons to Stop Feeling Guilty About a Move to Assisted Living https://dailycaring.com/3-reasons-to-stop-feeling-guilty-about-putting-mom-in-assisted-living/
– 9 Ways to Handle Alzheimer’s and Sexually Inappropriate Behavior https://dailycaring.com/9-ways-to-handle-alzheimers-and-sexually-inappropriate-behavior/
Julie Faughnan
My Mom who just turned 86 and has some vascular dementia has refused to change her clothes for weeks at a time, bathe, brush her teeth, or do anything but sit on the couch and fret. My Dad took care of her for the last 10 years and had to do everything around the house. He wouldn’t argue with her about hygiene and she smelled horrible as did their house. He passed away in February and she is now living with me. I have learned a lot in the past few months and I do make her shower and wash her hair twice a week. In between, I make her clean herself with hygiene wipes in the morning and at night. She now wears Depends, but I have to make her change them in the morning and at night otherwise, she hides the clean ones and just leaves the wet ones on. I put all of her clothes in the hamper every day because if not, she would wear the same thing for months and I just say into the hamper every night and we don’t argue about it. If I make her, she brushes her teeth once a day, but if I don’t set it out and stand there, she doesn’t do it. Some times I just want to tell her that if she would just take care of herself, she could make more choices independently, but I know she thinks she can take care of herself which gets frustrating to me. At least now she is clean, not smelly and she looks better than she has in 10 years after a trip to the beauty parlor to get her hair permed and cut and a pedicure!
I have read the articles and tried some of the tips for showering and changing clothes. I really try to just change the subject and get her to shower and change clothes by talking and distracting. It takes longer, but in the end, we don’t argue every day.
DailyCaring
Thanks for sharing your experience and what’s worked for you! It’s wonderful that you’ve found a hygiene routine that helps the day go more smoothly.
Katherine
My father refuses sometimes to change his diaper even when it’s soiled. My mom will offer to help him change out of it, but he refuses. The majority of these tips seemed more to do with clothes and less with diapers, so any help would be appreciated.
DailyCaring
To encourage him to change a soiled brief, perhaps your mom could approach it as a normal part of the daily routine and not call out that he needs it.
For example, say something like “Oh look, it’s 3:30pm and time to use the toilet and change your underwear. Here’s a new pair of briefs right next to the toilet and some wet wipes to make you more comfortable.” or “Now that we’ve finished lunch, it’s time to go to the bathroom and change…”
Of course, it will likely take some experimenting to figure out what type of approach works best for him.
Generally, keeping sentences short and direct should work better (more info on that here – How to Talk to Someone with Alzheimer’s: Use Short, Direct Sentences https://dailycaring.com/how-to-talk-to-someone-with-alzheimers-use-short-direct-sentences/)
And before asking him to go to the toilet to get changed and cleaned up, lay everything out right next to the toilet so it’s all ready to go — include a fresh pair of pants when needed. Hopefully it will seem natural to him to change pants. You could also mention the pants in a positive way, like “I also put out your favorite / most comfortable pair of pants.”
Try to avoid discussing why changing briefs and pants is needed, just act like this is what’s always done at this time.
It may also help to establish a regular routine for bathroom trips. That can help reduce or prevent the need to change the brief. It can take a little experimenting to find the ideal timing for bathroom trips, but that’s a good way to help his body get used to going at certain times.
carron rackham
Sometimes my husband won’t take a bath for a week, he finally does on Sunday morn when we go to church Thank You Jesus that he loves going to church !!I’ve been doing everything wrong and telling him :You stink”” I’ll try these tips next time thanks Dixie
DailyCaring
You haven’t been doing anything wrong, that’s a natural thing someone would say to a person who hasn’t bathed. For someone with dementia, these techniques might work better than logic or reason would. For tips on getting someone with dementia to bathe, we’ve got another article that might be helpful – 7 Tips to Get Someone with Alzheimer’s to Take a Bath https://dailycaring.com/7-tips-to-get-someone-with-alzheimers-to-take-a-bath/
R. Lynn Barnett
My mom with Alzheimer’s once refused to wear a pair of striped slacks, which used to be one of her favorite outfits. She told me to give them away, but I took them, put them in my closet, and then a week or so later, when I did her laundry, I hung the slacks back in her closet, pretending that it was part of the laundry that I had just done for her. The next day she wore them and said, “I love these slacks.” Go figure. All us caregivers have learned to be, as the article says, a little sneaky, for the Alzheimer’s patient’s own good. I even wrote a book about our experiences taking care of her: “My Mother Has Alzheimer’s and My Dog Has Tapeworms: A Caregiver’s Tale.” The above anecdote is entitled, “Liar, liar, pants in dryer.”
DailyCaring
Great tip, thanks for sharing!
Gayl Weinheimer
My partner has mild to medium dementia. He also has COPD and a sacral ulcer. I need information on how to balance his physical needs with the dementia. I find redirection doesn’t work if he needs to move which is difficult. The Alzheimer’s association does not have any relevant info or services. To get medical services he is classed as housebound.
DailyCaring
I’m sorry to hear about your partner’s health issues. It’s definitely a challenge to care for someone’s physical conditions when they have dementia and aren’t able to follow important directions.
It often comes down to thinking of creative solutions that fit the specific need and situation and going through a bit of trial and error to see which approaches work better.
As an example, let’s say you needed for him to not touch anything while you change a bandage. In that case, you could give him something to hold or fiddle with, like a fidget toy (get ideas here: https://amzn.to/2RbiBM3 and https://amzn.to/2R86oba) or a stuffed animal that brings comfort. That way, he’ll have something to keep him occupied and hopefully he won’t move around while you take care of the bandage.
You may also want to consider joining some online dementia caregiver groups. They’re filled with thousands of members who are going through similar experiences and you may be able to get ideas and suggestions from them. Here are some that we recommend — https://dailycaring.com/11-caregiver-support-groups-on-facebook-youll-want-to-join/
Donna Spencer
Hi, Gayle. I found this same situation with my father. He is very resistant to changing clothes. Through trial and error, we found a couple of ideas that have extremely helped reduce his agitation during this time. One, we discovered he does well using the same order of steps each time we help him get dressed. First, we unbutton his shirt (bottom to top, for some reason that works best), then keeping all the other steps in the same pattern, including shoes and socks. This makes the dressing predictable and less confusing. We also found that he hates dressing because he gets cold. We keep a small portable heater in the dressing area and leave his undershirt on whenever possible when changing. He also has adaptive clothing (snaps in back so shirts don’t go over his head) which he hates. (You can cut a shirt down the back and use Velcro or snaps on the overlap).The less he has to move, the better changing goes. I hope this helps. I was very surprised this article did not mention the two main factors involved in changing reluctance – pain from movement and temperature changes. Most dementia clients have difficulty in regulating body temperature and get cold easily.
I hope this helps.