Being with our friend and simplifying may seem to be opposites. We can become so overwhelmed with day-to-day living and getting through that simply adjusting to a new aspect is a hurdle to get over.
Our friend wants help but not to feel as though the only way something can be accomplished, now that they are unable to accomplish on their own, is to treat them as a child. Let’s look at the ADL’s (Activates of Daily Living) for an example of maintaining autonomy. It is hard for our friend, who has dressed themselves for the last 50 or so years to have someone else telling or helping them with this task. The first part is for us to determine what the appropriate dress is for the day. It is very possible we know of an appointment or a visitor that our friend has forgotten. Now we know what appropriate clothing is, where is our friend in their process of knowledge? If there is still some cognitive ability to select the clothing, we will want to honor our friend’s decision. We should place the clothing right in front of the closet door. This will be the first item seen by our friend and then it will be more easily accepted for wear. If our friend is past the closet select point, then lay the clothing out on the bed or in a chair for them to select. The first thing to remember is to make our selections without our friend present. This will help to maintain our friend’s autonomy and make it easier for both of us.
Our friend will at some point become weaker and need assistance in putting on the clothes. This is difficult because our friend is embarrassed and we are tired. This is a good time to begin simplifying clothing. Slowly over a period of days or weeks, change out clothing that goes over the head (this can be a challenge for many healthy people). When replacing clothing select clothing with zippers or Velcro closures, button shirts are the first to go along with button fly pants. As our friend needs more and more assistance gradually substitute less restrictive clothing. An example would be to change out the jeans and khakis for athletic wear. Warm up suits are great for our friends on two levels; (1) these are easier to put on and (2) will keep our friend warmer. Now about the shoes – this is an item of safety. We do not want our friend tripping over shoestrings. We can go to Velcro closures on shoes. Or we can go to a heavy slipper. Whichever is decided upon we need to be sure of the fit. Just as dangerous as shoestrings is walking out of a shoe, checking the appropriate size and fit is key to safety.
Now we must, at some point, get to the topic of underwear. This is again a very difficult decision and one, which may be very upsetting to our friend. We should try to balance a very big plate as we make this decision. We do not want our friend embarrassed should there be an accident out in public. But we do not want to cross the bridge of Depends or Assurance or any of the others before necessary. The item chosen for use should be designed by the manufacturer specifically for the male or female friend we are serving. Next we need to make the decision if it is more appropriate to have ones that will lay flat and have closure on the sides, or ones, which pull up. The timing of this decision and style of the garment should be made by you as the caregiver and then the article provided to our friend. It seems easier to simply undo the side closure and discard the used garment and then provide the next garment in a standing position in public restrooms than to try to balance our friend and pull up the undergarment.
The absolute most important decision we make is to continue to provide the dignity and respect necessary for our friend to maintain their self-respect. We must respect our friend enough to give them the help they require to maintain their dignity.