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Dress For Success: Strategies for Dressing After Stroke

2. 3. Dress for Success. Increases confidence and comfort throughout the dayProvides independence, a sense of control, and self expressionProvides meaning and purpose Therapeutic

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Dress For Success: Strategies for Dressing After Stroke

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    1. Dress For Success: Strategies for Dressing After Stroke Lori Blue, OT Reg (Ont) Tuula Jodoin, OT Reg (Ont)

    2. 2

    3. 3 Dress for Success Increases confidence and comfort throughout the day Provides independence, a sense of control, and self expression Provides meaning and purpose Therapeutic – physically, cognitively, and emotionally

    4. 4 Possible Causes of Dressing Difficulties After Stroke Hemiparesis Dressing is a bilateral task and hemiparesis makes all aspects of dressing more difficult May increase risk of injury during dressing tasks

    5. 5 Possible Causes of Dressing Difficulties After Stroke Perceptual Deficits Neglect – Decreased awareness and attention of the affected side Figure-Ground Discrimination – Difficulty finding objects as they may blend into the background Right-Left Discrimination – Difficulty distinguishing between right and left

    6. 6 Possible Causes of Dressing Difficulties After Stroke Apraxia Inability to plan out movements despite having the necessary range of motion, strength, and co-ordination May cause difficulty in planning or initiating the task May account for inconsistencies in an individual’s ability to dress

    7. 7 Possible Causes of Dressing Difficulties After Stroke Perseveration Difficulty with moving from one idea or movement to the next May interfere with an individual’s ability to go onto the next step of the task

    8. 8 Possible Causes of Dressing Difficulties After Stroke Fatigue An individual may get easily fatigued during dressing May require frequent rest breaks Monitor for signs of fatigue Fatigue increases the risk for injury and falls

    9. 9 Set Up – Be Sure to Plan Ahead Have all necessary items within reach before starting, including assistive devices and mobility aids Have the individual positioned in a manner appropriate to his/her abilities It may be necessary to simplify the task

    10. 10 Set Up – Promoting Independence CUE NOT DO Provide choice whenever possible Respect premorbid clothing styles Allow adequate time to get dressed Adaptive clothing and assistive devices can facilitate independence

    11. 11 Examples of Assistive Devices

    12. 12 Dressing Techniques and Strategies Perceptual Deficits Clothing may need to be placed at midline or on the unaffected side Provide an anchor/cueing towards the affected side Use colour contrast Orient clothing prior to starting the task

    13. 13 Dressing Techniques and Strategies Apraxia Plan and structure the task prior to starting Provide cues as needed Use labels to aid orientation of clothing Use consistent set up and sequencing Practice

    14. 14 Dressing Techniques and Strategies Perseveration Have the person plan the task prior to beginning Provide cueing as needed It may be necessary to stop one task and redirect the person to go on to the next step

    15. 15 Dressing Techniques and Strategies Fatigue Encourage the individual to take rest breaks as necessary Proper set up, adaptive clothing, and assistive devices may conserve energy

    16. 16 Dressing Techniques and Strategies Hemiparesis Dress the affected side first Use the affected side as much as possible Use compensatory strategies to promote independence and protection of the affected side

    17. 17 Hemi-Dressing Techniques and Strategies Shirt/Sweater Neither front fastening or over the head type shirt is necessarily easier for all individuals Dress the affected arm first; undress the affected arm last Assistive devices – button hook, Velcro closures, elastic loops for buttons at cuff, zipper pull, labels

    18. 18 Donning a Shirt

    19. 19 Donning a Shirt

    20. 20 Donning a Shirt

    21. 21 Hemi-Dressing Techniques and Strategies Upper Body Underclothing Fasten the bra in front vs. reaching around the back Pull strap over shoulder of affected limb first Adaptive clothing – Velcro closures, front closure bra, sports bra, camisole May require assist to don bra despite all compensatory strategies

    22. 22 Donning a Bra

    23. 23 Donning a Bra

    24. 24 Donning a Bra

    25. 25 Donning a Bra

    26. 26 Hemi-Dressing Techniques and Strategies Pants/Underpants Dress affected leg first; undress the affected leg last Don underpants, pants, and footwear, prior to standing to pull up clothing to conserve energy Pull pants up over feet prior to standing Use appropriate mobility devices and level of assistance for standing

    27. 27 Hemi-Dressing Techniques and Strategies Pants/Underpants Adaptive clothing – drawstring waist band, Velcro closures Assistive devices – long handled reacher, dressing stick, button hook, zipper pull, clips/suspenders/loops

    28. 28 Donning Pants

    29. 29 Donning Pants

    30. 30 Donning Pants

    31. 31 Hemi-Dressing Techniques and Strategies Skirt May be donned over the head and pulled down to waist while seated May require assist to stand to adjust skirt

    32. 32 Hemi-Dressing Techniques and Strategies Socks Can don either sock first Position the body appropriately Sock aid may or may not be beneficial May require assist to don socks despite all compensatory strategies Assistive devices – sock aid, long handled reacher to adjust socks, long handled shoe horn to remove socks

    33. 33 Donning Socks

    34. 34 Donning Socks

    35. 35 Donning Socks

    36. 36 Using a Sock Aid Squeeze to hold sock aid between knees.

    37. 37 Using a Sock Aid Gather up sock and stretch over end of aid.

    38. 38 Using a Sock Aid Slip foot into aid. Pull up on cord handles until sock is on foot and aid slides out of the sock.

    39. 39 Hemi-Dressing Techniques and Strategies Shoes/Slippers Can don either shoe/slipper first Position the body appropriately One-handed shoelace tying Footwear with no heel support is NOT recommended Assistive devices – Velcro closures, elastic shoelaces, long handled shoehorn, long handled reacher

    40. 40 One-Handed Shoelace Tying

    41. 41 One-Handed Shoelace Tying

    42. 42 One-Handed Shoelace Tying

    43. 43 Hemi-Dressing Techniques and Strategies Belt Put belt onto pants prior to donning pants Assistive devices – belt fasteners may include Velcro closures, toggle, D-ring

    44. 44 Conclusion Using appropriate compensatory strategies, assistive devices, and level of assistance can make dressing easier and less frustrating for the individual and the caregiver!

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