Grooming: Dressing and undressing

Changing clothes promotes comfort, hygiene, and well-being. Clients usually change clothes when they wake up in the morning and before they go to sleep at night. Τhey also change clothes for bathing as well as when the clothes get wet or dirty.

Now, most people are able to dress and undress on their own, but as a nursing assistant, you will come across clients that will require your assistance, such as those that are recovering from a surgery, are weak due to an illness or advanced age, or have a disability on an arm or leg due to a neurological disease, such as a stroke.

Some clients will only need minimal assistance, like securing a zipper or selecting clothes, while others will require your assistance for the entire procedure of dressing and undressing. Allow the client to dress themselves to the fullest possible extent.

Now, a client’s clothes can vary depending on the type of the facility. In hospitals, people usually wear gowns, while in long-term facilities they often wear their own clothes during the day and sleepwear, such as nightgowns or pajamas, during the night.

Keep in mind that it’s very important to allow the client to choose their own clothes whenever possible. If they’re not able to decide their own clothes, make sure to choose clothes that are comfortable and appropriate for the client’s activities and the environment.

Also, for clients who have a weakness or disability, be sure to choose clothes that are easy to put on and take off.

In addition, there are assistive devices, such as hook and loop straps or fasteners instead of buttons, that can make changing clothes much easier.

Now, before we talk about assisting a client with dressing and undressing, here are some general considerations.

Before beginning the procedure, find out from the nurse the plan of care, how much help the client usually needs, and if the client has any issues that require extra care, such as a cast, splint, wound, or weakness.

At all times, respect the client’s privacy and modesty by remembering to close the room’s door, shutting all window covers, and ensuring the client is properly covered.

Some clients may also find it comforting to have someone of their own sex present in the room. Also, make sure the ambient temperature is comfortable for them when they’re undressed.

Encourage the clients to participate as much as possible and don’t rush the procedure. Another important tip when assisting certain clients, like those wearing a cast or those with weakness, is to undress starting with the strong, or unaffected, side. In contrast, when helping the client dress, make sure to start with the weak, or affected, side.

Okay, so, when assisting with changing clothes in bed, first gather the supplies you’ll need, including gloves, a bath blanket, laundry hamper, and clean clothes.

Start by making sure the wheels on the bed are locked. Lower the head of the bed so the bed is flat and raise the bed to a comfortable working height and ensure the side railings on the side you’ll be working are down.

Put the gloves on. Assist the client into a supine position, meaning onto their back, and cover the client with a bath blanket.

Ask the client to hold the corners of the blanket or place the corners under the shoulders. Fanfold the linen to the foot of the bed.

Okay, first, let’s discuss how to help the client undress. Ask the client to raise their head and shoulders and bring the sides of the garment around the neck.

For garments that open in the back, start by undoing any buttons, zippers, snaps, ties, or other closures. Starting with the strong side, slide the garment off the shoulder and the arm.

Repeat the procedure for the other arm. If the client can’t lift their head and shoulders, help them turn on their side facing away from you.

Take the near side of the garment and fold it onto the chest. Take the far side and move it under the client. Then, turn them into the supine position and slide the clothing off their shoulder and arms.

Now, for front-opening clothes, first unfasten any closures. To remove the top, ask the client to sit up or lift the head and shoulders; in some cases they might need your assistance.

Then, starting from the client’s strong side, remove the garment off the shoulder and the arm and repeat for the other side to remove the garment completely.

Now, for the bottoms, undo any fasteners and then ask the client to lift the buttocks off the bed; assist them if needed. Pull the bottoms down over the hips and buttocks.

If the client is unable to raise the hips off the bed, ask them to turn on their weak side and slide the bottoms on their strong side.

Repeat the procedure for the other side. Then, slide the bottoms down the legs and over the feet to remove the garment completely.

Alright, now after helping the client undress, take the soiled garments in the laundry hamper. For clients that are wearing their own clothes, make sure that their clothes are returned to them as soon as they’re laundered. Also, don’t forget to hang any clean clothes in the closets to keep the client’s room orderly.

Okay, now let’s discuss assisting a client with dressing. Let’s start with the undergarments. For the underpants, stand so that you’re facing the foot of the bed and hold the underpants at the leg opening and at the waistband.

Slip one of the client’s feet through the underpants into the leg openings and then repeat for the other foot. Then, slide the underpants up the client’s legs and ask them to lift their buttocks off the bed; assist if needed.

Slide the underpants over the buttocks. If they are unable to lift the buttocks, help them turn on their strong side and slide the underpants on their weak side.

Repeat the procedure for the other side to finish putting on the underpants. Make sure the underpants are comfortable for the client.

As for the bra, slip the arms through the straps, starting with the person’s weak side. Move the straps up the arms. Adjust the cups of the bra over the chest.

Ask the client to lift the head and shoulders and lean forward so that you can fasten the bra; you might have to assist some clients with this.

Now, for the undershirts and garment tops that need to be pulled over the head, start with the weaker side and slide the undershirt or garment top up the arm and shoulder.

Next, bring the top over the head and neck of the client, then slide it down the shoulder and arm on the stronger side. Pull the top down the torso of the client.