Urging Mom to get dressed every day

[rosarugosa]

My mother has never been much for strong routines like I am, and I feel like this is making the Alzheimer's challenge a little more challenging. Lately we've been having a little bit of friction on the subject of getting up and dressed every day. She really hates the winter and the cold, and would really just as soon stay in bed reading all day. She understands that she should not do this because it causes issues for her, primarily constipation if she isn't up and moving about. So she does get up and about within her house, but is inclined to stay in her bathrobe and pajamas all day if she isn't going anywhere. I've been pushing her to get dressed because this is what heathy adults do (at least most of the time), and I feel that the more these healthy routines/ADLs are "muscle memory" for her, the longer she will retain these abilities. She keeps her house at a toasty 78 degrees, and the house is well-insulated and very warm.
I would like some input as to whether it is appropriate to urge her to get dressed each day, or if I am just being needlessly annoying to my poor confused old mother.
She is still early AD, and it is possible to have reasonable conversations with her. She still lives alone, and it is in the best interests of my mother and those of us who love her to keep her as independent as possible for as long as possible.

[catherine]

Uh oh. I'm still in my pajamas (11:26am on the East Coast).

I am not an expert in Alzheimer's by a long shot, and I can certainly understand the value of keeping to daily routines. If the argument/discussion is causing her stress, maybe that's not a good thing. OTOH, it would probably be better for her to get dressed. Can you find out why she doesn't want to get dressed? Are her day clothes uncomfortable? Is it a struggle to decide what to wear? Maybe if you arrange a comfortable "uniform" for her to wear every day, she'll be more motivated to dress.

I'm off to get myself dressed now! :)

[iris lilies]

This is why loungewear exists. Sleep in it. Walk out to get mail in it. Go to the grocery store in it.

I think you have two separate issues. What she’s wearing, and getting up and moving.

I wouldn’t argue with the first one, I would see if she is open to abandoning “pajamas and robe” to wear loungewear to wear all the time.

The second one is important. moving, getting circulation going. That may be worth a fight. But in the end you have to ask yourself how much minutia of her life you can/will manage. Maybe this is not worth your life energy.

[Alan]

Uh oh. I'm still in my pajamas (11:26am on the East Coast).

12:54 Eastern time here and I'm still in pajama bottoms and a tee shirt. I guess I'd better get dressed too before going out to check the mail.

[JaneV2.0]

I'm with Iris Lily on this--completely. There are days I don't want to struggle to put on more "formal" clothes--thank heavens for loungewear.

[Teacher Terry]

Once my dad had a massive stroke he decided he was done with getting dressed. He wore pajamas for 14 years until he died. No one waited on him so he was forced to move around.

[Tradd]

Definitely agree on getting your mom some different clothes if needed.

Heck, my boss (work from home and his own company) told me he often works in his bathrobe in the winter. :D

[Simplemind]

You're lucky you can still have reasonable conversations. My mom got to the point where she wasn't changing her clothes and she had previously been quite the clothes horse. She had never been one for jammies so she was actually sleeping on the couch in her clothes. I was going out on the pretense of helping out with the laundry and in the beginning could talk her out of her clothes and set new ones out. It became tense in trying to talk her into a shower between clothing changes.
Changing or stopping daily routines were always a way to tell when the level of cognitive ability had dropped off with both of my parents. My dad always got up to build a fire in the morning and wind the clocks. I knew we were in new territory when I would come into a cold quiet house. The clothing was a biggie with him too. He would tell me he didn't need to change them because they weren't getting dirty.

[herbgeek]

My mom gets dressed every day, but sometimes its the same thing 5 days in a row - according to my sister. I see her once a week. I don't think she's taking a shower that frequently though and certainly not washing her hair because her dry hair is greasy when I see it at least 80% of the time. I struggle with saying something- my sister will tell her to take a shower before doctor visits, but it is worth the hassle of reminding her when there really isn't any place she has to be? She is in huge denial that she has any problems whatsoever, and will often start crying and lashing out when reminded of her [incontinence, lack of shower, needs to brush her teeth], so I tend not to say much. What's the point? Its not like she is going to change. She no longer cares about her appearance for the few friends left, and they know she has dementia anyways. Its really me who's embarrassed- to see a formerly really proud woman not be able to care anymore. What's funny is that she still notices OTHER old people and will comment on their lack of grooming but doesn't see it in herself/doesn't care herself.

[frugal-one]

My mom gets dressed every day, but sometimes its the same thing 5 days in a row - according to my sister. I see her once a week. I don't think she's taking a shower that frequently though and certainly not washing her hair because her dry hair is greasy when I see it at least 80% of the time. I struggle with saying something- my sister will tell her to take a shower before doctor visits, but it is worth the hassle of reminding her when there really isn't any place she has to be? She is in huge denial that she has any problems whatsoever, and will often start crying and lashing out when reminded of her [incontinence, lack of shower, needs to brush her teeth], so I tend not to say much. What's the point? Its not like she is going to change. She no longer cares about her appearance for the few friends left, and they know she has dementia anyways. Its really me who's embarrassed- to see a formerly really proud woman not be able to care anymore. What's funny is that she still notices OTHER old people and will comment on their lack of grooming but doesn't see it in herself/doesn't care herself.



Depression too?

[Teacher Terry]

Unfortunately hygiene completely leaves when people have dementia. They will not shower and change clothes to the point that they stink. They often will fight if someone insists. My friend was like that even though she taught classes on hygiene at one point. Another sad part of the illness.

[iris lilies]

From what I can remember of my mothers Alzheimer’s life before she entered a nursing home, I guess she got dressed regularly. She might have been wearing the same clothes dailey. I don’t know. But I know she did get dressed in streetwear.


In her later years in the nursing home they chose her clothes and some of the choices were pretty awful. I remember one event where She wore a Christmas sweater in April. I don’t know where the sweater came from but it was kind of funny. Her personal care attendant was an eastern European women and maybe that kind of stuff doesn’t matter to that culture? Or maybe that sweater was just the handiest thing that day. Another time she was wearing leopard print tops. Oh my God, that was not her style at all. My mother is an LL Bean type dresser. Again, I don’t know where the leopard tops came from.

But I never said anything because it did not matter. If my mom didnt care, I didn’t care. There was the idea that nursing home patients needed to retain as much as possible of who they really are, but I didn’t ever bring up the clothing problem. I thought they had enough to do and they did nit need to be worrying about the fashion of her clothes. On the other hand, this is exactly the kind of thing my sister-in-law would’ve taken them to task for. So that’s why I stayed out of it.


That reminds me of our discussion about what to dress our deceased parents in for a funeral. I’m sure my sister-in-law made the choice of clothing for my deceased mother, and that’s fine. Because my sister-in-law has very strong ideas about what must take place, fine with me. To me, this is where the person who cares the most gets to make the decision.

[razz]

Don't these residents get a complete immersion bath once a week in nursing homes? From what I saw, the residents loved being lifted into the warm water and soaking there weekly.

[Teacher Terry]

Razz, nothing but showers where my friend was.

[beckyliz]

I'm on a private FB support group for caregivers of dementia spouses. This is a common topic - clean clothes, showering, etc. I can see my DH is on this road. I have to remind him to shower and I've noticed when I do laundry, there may only be 1 or 2 pairs of underwear in there (eww). It can be a struggle and you have to choose your battles. What works one week or one day won't work the next. I guess I fall on the side of maintaining a level of cleanliness so their skin stays healthy. I've seen suggestions about making sure the bathroom is really warm. A lot of dementia patients don't like the feeling of the shower on their skin and it's scary in a closed space. May have to do sink baths or bed baths.

[Yppej]

I wore pajamas all weekend.

I have seen people wear pajamas in public, even to court.

This reminds me of the book Don't Sweat the Small Stuff (and it's all small stuff).

[herbgeek]

Depression too?

I think so. Since my Dad died, she says she doesn't care how she looks. But sometimes she does make an effort.

[Tybee]

Rosa, it kind of sounds like it might be too late for your mom to be living alone? My mom has dementia, and I know for years my dad was watching out for her at home, but it got really bad for the both of them at the end, and he was no longer able to watch out for her, and her skin broke down.

Is there any way she could move to assisted living? Not because she's wearing pyjamas, but because she sounds disregulated, and she can't do a routine anymore--my mom could not remember to eat, for example, and needed the structure and supervision of assisted living.

[rosarugosa]

Wow, what a bunch of slouches hanging around in your PJs all day, lol. In all seriousness, I acknowledge that I am on the far end of the spectrum for extreme structure in my days and habits. The only day I can remember not getting dressed in my adult life, I was an inpatient at the hospital, and it was just for one day. That's actually one of the reasons I asked. Mom certainly has the right to do things differently from the way I do them.
I'm going to probe a little more into the why of this. I think it might be a matter of her feeling cold when she undresses, so maybe setting up a heater in her bedroom so she could change in front of it would help. She sponge bathes rather than showers, so I wonder how thoroughly this is happening in the colder months, hmm. I realized some months ago that she was no longer washing her hair. We have a friend/caregiver who goes over twice a week and has taken on the responsibility of a weekly shampoo.
Tybee, I think we're getting nearer to the time when she won't be able to live alone, but we're not quite there yet. She can't really afford assisted living, at least not for more than a couple of years. None of our homes can comfortably accommodate multigenerational living either, so next steps aren't going to be easy. I have a tiny house that doesn't even have a second bedroom. I really wish we had a home with an "in-law" so we could move her in with us. That would be ideal. My sister was planning to move in with her when it became necessary, but she has a boyfriend now which somewhat changes things.
This will probably sound terrible, but I didn't have children for a reason. I've never had any interest in taking total responsibility for another human being. So I'm realizing that despite having fairly decent intentions, I don't have the degree of selflessness required to go the whole distance in taking care of Mom as this disease progresses.
Herbgeek: I'm so sorry for the nightmare situation with your mother.
Beckyliz: I'm so sorry for the challenges you are facing with your husband.
These sure are difficult situations to navigate and I appreciate everyone's input.

[catherine]

This is an off-topic sidebar, but kind of related. One of the reasons I lounge around all morning in my pjs is because I was the sole dog walker in the house for 20 years. Every single day, rain or shine, when my feet hit the floor I HAD to get dressed and walk the dog. I'm not saying "poor me"--I know that tons of people get up and walk their dogs. And the exercise I'm sure did me good.

But when my last dog died, I was THRILLED to be able to do whatever I want in the morning, and frankly, the novelty still hasn't worn off. I won't get a dog again until my DH agrees on a fence so that I can walk the dog when I want to and simply let it out when I don't.

So, when I get to the afternoon and I still have my robe on, I smile, raise my eyes heavenward and thank the Lord, with all due love and respect to my dearly departed Laddie and Nessie.

So rosa, maybe get your mom a dog (just kidding!!!)

[Teacher Terry]

Rosa, I wouldn’t force a move for your mom until you have no choice. My friend went downhill so fast it was heartbreaking. If her husband hadn’t died she would have been home longer although eventually her care would have become too much.

[rosarugosa]

Catherine: That is funny, my mother would LOVE nothing more in the world than a dog, but as she loses her abilities, it would fall on us to take care of the dog in addition to Mom.
TT: I agree. Right now, Mom is happiest in her own home. If she is living a less-than-perfect, somewhat chaotic life, that is still better than the alternative (and she was always a bit disorganized). I do think I need to work a bit more on downsizing and streamlining her possessions. That would make life a bit easier for all of us.

[Tybee]

Catherine: That is funny, my mother would LOVE nothing more in the world than a dog, but as she loses her abilities, it would fall on us to take care of the dog in addition to Mom.
TT: I agree. Right now, Mom is happiest in her own home. If she is living a less-than-perfect, somewhat chaotic life, that is still better than the alternative (and she was always a bit disorganized). I do think I need to work a bit more on downsizing and streamlining her possessions. That would make life a bit easier for all of us.

Good point about streamlining--that is a great thing you can do right now.

If I were you and your sister, knowing what I know now about dementia and social services, I would tour some places now in your area to try to get a better picture of what kind of places are out there, should the need arise in the future. I say this because I think my parents were pretty typical in that they so wanted to stay in their home that when my dad fell, and the EMt'S saw Mom and ordered a second ambulance, that it was all a giant mess, as they had delayed way too long, and the hospital got involved with mental competency testing, and there was no way they would be allowed back home without 24 hour care-- that was what happened to my folks. Plus the social worker would have never allowed them to return to their home in the state it was in. So once the fall lands someone in the hospital, then you're off to the races, and no longer have much choice in the matter.

If we had toured some places, and had a better idea of what was out there, then the emergency situation would have been a lot easier to navigate. I wish I had talked to an elder care social worker much, much sooner.

We so wanted them to stay in their home and it broke our hearts. On the other hand, we were given absolutely no choice in the end, and there we were, trying to say, yes, this place, no, not that place, which place would meet their needs--last minute is not good.

[pinkytoe]

My 96 yo neighbor died this morning at home as I imagine she wished. I doubt she worried about getting dressed for many years since she never left the house but I don't know about her mental status. After several hospital visits, social service people were showing up every day to take care of her. Perhaps the familiarity of home helps some older folks maneuver when they would be much safer elsewhere. I guess you could say that having her dress in regular clothes once in while makes you happy. Do Alzheimer's patients still show empathy?

[Teacher Terry]

The only thing about scoping things out in advance is that you don’t know if they will have a opening when needed but still a great idea. People with dementia eventually end up in homes because their needs become overwhelming and frequently they only sleep during the day. My mom decided being in her apartment was more important than safety. We all agreed. She had all her faculties. A week before she died of cancer she fell and had forgotten to put her cellphone in her pocket. She laid there for a day soiling herself until her sister checked on her. That was sad but still her choice. She went to a home and died a week later. Throughout her 2 1/2 year battle with cancer the 3 of us stayed with her when needed. My siblings more than me being retired and closer. I used all my vacation and sick leave to help and it was worth it.

[Tammy]

“ Do Alzheimer's patients still show empathy?”

Yes. But only in the moment. Then they forget. I’ve watched many older women enjoy holding a doll, as if it were a baby.

[dado potato]

, my mother would LOVE nothing more in the world than a dog, but as she loses her abilities, it would fall on us to take care of the dog in addition to Mom.
.

We have a Hasbro battery-powered kitty. Purrs and kneads on Grandma's lap. A totally mechanical pet.

On the daily dressing, I would try to be cheerful and accepting, come what may. As you know, there are vendors who specialize in adaptive clothing, with designs that are simpler for a self-dresser to get into and out of. It might be mutually enjoyable to try simpler designs... Channeling Peter O'Toole in Lawrence of Arabia after his khaki Army uniform was burned in the campfire by his Arab comrades-in-arms.

http://www.buckandbuck.com/shop-by-need/alzheimers-clothing.html