Mom / Dad wears too little / too much / the wrong thing / the wrong way / for too long.

TLDR: Mom or Dad is dressing (or not) bizarrely, and it make him, her, or somebody else really uncomfortable.

I’ve gotten a lot of questions lately about clothes. For instance, Mom wears the same outfit for weeks until she smells like a homeless person. Dad walks around in public in nothing but his undershorts. Your husband won’t take off what he was wearing last week when he puts on a new outfit and now looks like a polar explorer. Your wife has her bra on the outside and/or backwards. Here’s some general advice about what’s going on and what to do about it.

The basic questions

Before jumping right away to how bizarre or wrong your loved one’s dressing or undressing behavior is, you need to ask five critical questions:

• Is it causing harm? Is Dad’s walking around all day in his underwear when it’s 5 degrees outside giving him hypothermia; or is Mom’s wearing five layers of clothing indoors giving her a temperature of 102°F.

• Is it causing discomfort? Is wearing all those layers making it difficult for Mom to move?

• Is it creating a health issue? Is not changing clothes for two weeks giving Mom a rash or creating unsanitary conditions that affect other residents of her dementia home?

• Is it creating a social issue? Is Mom taking her blouse off at Red Lobster? Or is it just in the dementia home?

• What’s the real reason for the behavior? Is there a simple explanation for what Mom’s doing that has an easy fix?

If none of the above is true, it’s possible the best strategy is to just “roll with it.”

Is the behavior causing harm?

The primary issue with inappropriate dressing is safety. Look for signs that Dad’s refusal to wear anything but underwear is actually causing him harm. If it’s making him painfully cold to the point of affecting his health, the primary goal is to find some way to get him into warmer clothes. Since he clearly isn’t inclined to wear them himself, you’ll probably never talk him into it. But you can GUIDE him into it with a little misdirection. Bring a button-up-the-front sweater you know fits him and ask him if he’d try it on so you can see how it would look on your son. If Mom’s wearing too many clothes–as horrible as this sounds, “accidentally” spill some water on her outermost layer, “apologize” profusely, then tell her you’ll wash it for her as you ease her out of the wet clothes.

Is it causing discomfort?

Is Mom’s wearing of five sweaters making it difficult for her to move? Does she show evidence of being overheated? (Probably.). If so, she may not be able to voice the discomfort. Look for signs that she’s struggling to get around with all those clothes on and make up reasons to get them off of her. For instance, “That’s a lovely jacket, Mom! May I try it on?” Then ease Mom out of the jacket and leave it folded in your lap. On your way out, make up some story about how you need to mend a (nonexistent) tear in the liner and ask the staff to put it back in her closet when she isn’t looking.

Is it creating a health issue?

This issue usually crops up when folks with dementia refuse to remove clothing. Wearing the same garments for long periods of time can create rashes, fungal infections, and horrible smells that actually endanger the health of other residents, not to mention Mom or Dad. What probably needs to happen is that Mom needs a bath, which she probably doesn’t want because it means taking off her warm clothes. Depending on her living arrangements, keep the bathroom warm, reposition her bath or shower as a “spa treatment”, and lay out a nice outfit for her to change into as soon as she’s dry. She’ll probably need help dressing, so be ready to step in and assist.

Is it creating social issues?

If Mom or Dad’s behavior in public places is inappropriate—whether or not it involves dressing—it’s probably not safe to take them out in public any more. The first time or two, you can probably just explain to whoever’s in charge that you’re dealing with a parent with dementia, beg their forgiveness, and quietly exit the facility.

What’s the real reason for the behavior?

In a lot of cases, what I’ve seen is that the real reason people with dementia have “clothing problems” falls into one or more of the following categories:

• They feel cold when they undress, or too hot when they dress

• They find it physically difficult to dress or undress

• They don’t remember how to dress or undress

• They don’t know how to behave in public any more

• They don’t like being told what to do

• They just don’t like their clothes for some unknown reason

These situations are addressable. When Mom has to dress or undress, keep the room warm and private, and consider putting her clothes on a heating pad. Lay them out so the order to put them on is obvious.

If she finds it difficult to get clothes on and off, replace her clothes with others that are easier to get on or off. She may not remember how to work buttons or zippers, so look at garments with Velcro fasteners. If Dad undresses in public places, look for shirts that fasten up the back, where he can’t reach. There’s actually a WHOLE INDUSTRY of “clothes for dementia patients”, so don’t be afraid to do a little online searching.

If Mom is in the habit of putting on too many layers, limit her closet to just what she’s going to wear this week. Let the staff know to rotate in new outfits when she gets her bath. They’re probably already familiar with the practice, anyway.

If Dad just doesn’t want to wear his yellow button down, accept that and move on to something else, perhaps tying it to some reward (“Dad, your grandson got you this Metallica t-shirt. Can I take your old white undershirt so you can try it on? Once you’ve changed, we can go get ice cream at Sonic.”).

If Dad still lives at home and is in the habit of walking out to the front yard to pee in the flowerbed, don’t try to explain that it’s inappropriate. Quietly let the neighbors know he has dementia and get him professional care, because his days of living at home are numbered. And if Mom takes her blouse off at the seafood restaurant, apologize to the manager, explain quietly that Mom has dementia, and well…it’s time for a drive-through or carryout.

As much as possible, listen to Mom or Dad’s subtle behavioral cues and ask for their “help” with clothing as you help them with dressing and undressing issues. It makes everyone feel good to be needed, even if they’re mentally compromised.

And if Mom or Dad isn’t dirty, uncomfortable, or at direct risk from wearing the same t-shirt four days in a row, relax. As long as your loved one appears safe, clean and comfortable, everything else can slide.