1. Assistive Devices to Maximize Function: Aids for Hygiene and Dressing

2. Think about a person who has difficulty completing basic tasks of personal hygiene or dressing. What effects does this have on the persons life?

3. Difficulty in performing hygiene or dressing can lead to Daily frustration Unwanted dependence Loss of ability to live in own home Decreased self-esteem

4. Assistive devices can maximize person-environment fit. They often make it possible for a person to perform hygiene and dress independently.

5. Before we start dressing, lets look at a few assistive devices for hygiene.

6. People who have arthritis often have difficulty grasping small-diameter handles. Using a toothbrush can be a challenge in such a situation. See the next slide for a low-cost solution.

7. Enlarge the diameter of the handle! Wrap the handle in a washcloth and secure it with rubber bands or string. Or, insert the handle in a foam cylinder.

8. Note the suction cups on these brushes. How might they be useful?

9. This is a nail brush. Suction cups anchor it for use by a person who has hemiplegia. Can you identify the other brush?

10. This is a denture brush, designed for use by a person who has hemiplegia.

11. Now, lets look at a few assistive devices for dressing.

12. A True Clinical Story: Mr. D., a 74-year-old man who had severe emphysema and congestive heart failure moved to an assisted living facility after his wife died. He used supplemental oxygen when dressing, performing personal hygiene, and using his walker. He often took an hour to dress in the morning, because he needed frequent rest breaks due to dyspnea. After 2 years at the facility, he stopped wearing socks. Continued

13. Noticing the change, an astute nurse discovered that Mr. D. stopped wearing socks because he became too short of breath when he leaned over and tried to put on his socks. Mr. D. was independent and did not ask for help easily. What assistive device is available to help Mr. D. put on his own socks?

14. This is a sock aid. Note the large diameter of the handles, for ease of gripping. How does this device work?

15. Begin by inserting the sock aid into the sock.

16. The sock aid is ready. Lets see it in use.

17. Lower the loaded sock aid to the floor, holding the handles to guide it. Slip the foot into the device.

18. Pull the handles toward the body and move the foot forward into the sock. As the foot slides into the sock, the sock aid slides out past the heel.

19. The sock is on the foot! Remove the sock aid by lifting the foot or dropping one cord and pulling the other to the side.

20. Look again at the shape of the sock aid and you will see how it works.

21. Mr. D. had severe emphysema and congestive heart failure. Can you think of other conditions that would make it difficult to lean over and put on socks? What happens if the person drops a sock on the floor and cant bend over to retrieve it?

22. Some people call this device a grabber. A reacher comes to the rescue!

23. Reachers have many uses beyond retrieving dropped clothing.

24. Lets look at one more assistive aid for dressing. Ask yourself what conditions can cause people to have difficulty fastening buttons. Make a brief list before you continue.

25. How many of these conditions did you list? Do you have other examples? Examples of conditions that cause difficulty fastening buttons: Arthritis (rheumatoid or osteoarthritis) Hemiplegia Parkinson disease Peripheral neuropathy in the fingers Assistive device for buttoning

26. One hand operates a button hook without needing fine motor control.

27. Note the large diameter handle for ease in gripping.

28. Many other assistive devices for hygiene and dressing are available. Occupational therapists are knowledgeable about these assistive devices. If you are working with a person who has physical difficulty with dressing, bathing, toileting, or cooking, ask the physician or nurse practitioner to provide a referral to an occupational therapist.

29. When you see an older adult having difficulty with hygiene or dressing, ask yourself: Would an assistive device maximize this persons function? Should we request a referral to occupational therapy?

30. Assistive Devices to Maximize Function was prepared by Linda Felver, Ph.D., R.N. for the Older Adult Focus Project, OHSU School of Nursing. Photographs by C. Van Son