NURSING IN THE CASE OF ALZHEIMER'S DISEASE: DRESSING AND PERSONAL APPEARANCE

Difficulties with dressing fall into two basic categories. The first involves the selection of the right clothes and the second the ability to put them on properly. Selection of appropriate combinations may be helped by keeping clothes together in sets. This means hanging together the trousers, jackets, pullovers, shirts, etc., that go together. As the confusion progresses, it will be necessary to lay out the clothes in the correct order and having a clear idea in your own mind of what goes with what is helpful. Similarly, keeping clothes together in sets will avoid the need to hunt around for articles in different places. It will also be easier for a confused person if clothes that are inappropriate - summer wear during winter, for example - are stored separately.

Most people with dementia eventually have difficulty with buttons, shoe-laces, buckles, zips, and so on. A careful adaptation of existing clothes or buying new ones to avoid the need for these relatively complicated dressing manoeuvres will help maintain independence a little longer. Buttons can often be replaced with Velcro tape, but in the later stages it may be best to avoid, as much as possible, clothes that are a potential problem.

Remember also to avoid materials that need dry cleaning. Clothes tend to get dirtier when the person wearing them is muddled and not only is dry cleaning expensive but it is also inconvenient. Bear in mind that many modern fabrics don't need ironing.

Personal appearance is much affected by hairstyling and, for women in particular, by make-up. There are many short, attractive hairstyles for women that are easy to manage; most men prefer their hair cut relatively short in any case. Many of my patients' relatives have arranged for a hairdresser to cut the sufferer's hair in his or her own home. There are more mobile women's hairdressers than there are men's, but most woman hairdressers will also be prepared to cut a man's hair.

Hair-washing can be a problem. If it is difficult to manage this during a routine bath or shower, then sitting the person concerned on a chair in front of the kitchen sink or bathroom basin, if big enough, may make for a less physically demanding task. A shower attachment, even if it is not a permanent fixture, is a great help.

It is very important not to forget the need to cut toenails. Fingernails are usually not forgotten and are relatively easy for the carer to manage. If toenails are a problem - and they are often hard and horny in older people - it may be better to arrange for a regular visit to or from a chiropodist. In many parts of the country this is not as simple as it sounds as there is a shortage of trained chiropodists. If this is the case in your own area, you may well find that the district nurse will undertake this task for you.

For many husbands, helping a confused wife to apply make-up seems a waste of time. This is by no means always the case, particularly early on in the course of a dementing illness. The application of even simple make-up such as face powder and lipstick often seems to have a positive effect, although sometimes it is difficult to define quite what this is. It may have an effect on the manner in which other people, even the husband himself, relate to the sufferer. Many people with dementia are still capable of responding to encouragement and this includes positive comments about their appearance.

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General Health