Is it common for someone with dementia to wear several layers of clothes?

A fellow caregiver asked...

I am a caregiver for a senior man with mild dementia who I see a few hours during the week. Lately there is no underwear in the drawer because he has six in the hamper and I think the other six pairs are on him. I have checked dresser drawers and there are no underclothes in the drawers or under the bed etc. Is that normal for a dementia patient to wear numerous briefs at the same time. He says he does not have a bladder problem.

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

It is not at all uncommon for people with dementia to be confused about clothes. Some will add layers on top of layers, skirts on top of slacks, brassieres over sweaters, or several shirts on top of each other. Some will wear the same clothes for days or weeks, unless someone intervenes. Others will constantly change their clothes, going through a whole closet in one afternoon, much to the distraction of caregivers; still others will simply undress.

A person with dementia may have lost awareness of seasonal temperature changes. He may see snow out of the window and still not grasp that he needs a coat, scarf and gloves to go outside. After all, he's in a warm room and is perfectly comfortable. Rather than arguing with him, just keep all his outerwear handy, because he will ask for it as soon as you open the front door.

If his skin is dry and itchy, he may remove what he thinks is the cause: his clothes. As we age our skin has a tendency to be dry and we need to use body lotion to make up for this age related issue. Once you've eliminated dry skin as a reason for his undressing, you can make it more difficult for him to get out of his clothes, especially if he starts undressing in inappropriate places. Jumpsuits especially designed for Alzheimer's patients zip up the back, so a person cannot get in or out of them by himself. These garments are available online.

In your particular case, the man you're caring for may have been told as a child always to wear clean underwear. He remembers that he needs to put on a fresh pair, but forgets to remove the old ones first. Talk to his other caregivers about this. You'll want to encourage him to dress himself as long as he's able, but you can help him by eliminating everything except what he needs. Example: one pair of underwear in the drawer at a time and only one shirt and one pair of slacks in his closet. When he asks about the rest of his clothes, you can tell him they are in the laundry.