An Assistive Wardrobe to Support Dressing Independence

DESCRIPTION (provided by applicant): Dressing is a complex task with many steps, ranging from being able to get to where the clothes are stored, being able to reach them, being able to get them off/out of the storage location, managing clothing in preparation for donning, donning and readjusting. It requires strength and stamina and may be impacted by degree of mobility, weight-bearing status, balance, range of motion, and poor vision. Many older adults, in settings ranging from homes in the community to senior apartments and HUD housing to assisted living and nursing homes require, or at least receive, assistance with dressing. In Phase I, a prototype assistive wardrobe unit was developed and tested with 26 elders living in a range of housing settings. The unit was designed to specifically address physical and safety concerns experienced by these residents. Results from Phase I strongly indicate that the prototype assistive wardrobe unit increased residents' ability to access their clothing, with greater ease and safety (p< .003). In Phase II, the assistive wardrobe unit will be refined to include supports for people with cognitive impairment. A repeated measure design with two interventions (wardrobe alone, and wardrobe with restorative training program) will assess the impact of the assistive wardrobe system on the normal daily dressing routine of 45-50 elders with a range of physical and cognitive deficits. There are 4 hypotheses: #1 The assistive wardrobe system will enhance independence and safety in accessing clothes; #2 Residents will complete more of the dressing process independently when using the assistive wardrobe system than when using their traditional wardrobe; #3 Staff will spend less time and provide less assistance to residents in getting their clothes out and getting dressed when using the assistive wardrobe; #4 Results will be stronger after residents participate in a six-day restorative dressing program using the wardrobe. The expected outcomes will be positive both for residents and facilities. Loss of functional abilities, such as dressing independence, is linked to decreases in self worth and well-being, therefore maintenance or improvements in dressing independence may increase sense of self-worth. Further, given the current and expected future shortages in staffing, especially at the CNA/STNA level, environmental prostheses that increase efficiency without compromising resident safety will be increasingly important.