An Assistive Wardrobe to Support Dressing Independence

DESCRIPTION (provided by investigator): The majority of individuals in long term care settings have significant and often severe limitations in their ability to complete basic activities of daily living (ADLs). MDS data indicate that over 80% of individuals in nursing homes are unable to dress independently with verbal prompts, and over 55% of individuals in assisted living also need assistance. Decreased ability to provide self-care has negative consequences on self-image, whereas increasing ability to complete ADLs independently supports more positive self-image and higher quality of life. The aim of this project is to develop a closet system/wardrobe that can be easily customized to support specific and common physical and cognitive disabilities of nursing home and assisted living residents. The basic hypothesis is that an adaptable wardrobe, designed to universal design principles, will increase independence in dressing in residents in long-term care settings with either physical or cognitive impairments. This in turn will decrease the amount of time staff needs to spend on assisting residents with dressing. The project will develop a prototype unit and test it in several assisted living facilities and nursing homes. Universal design principles are not routinely incorporated into the design of products such as wardrobes, despite substantial evidence of their efficacy. Features that do not need to be "learned" to use, such as a light colored interior, an interior light that automatically turns on and off, and door and drawer knobs that can be easily seen and used by someone with significant strength or range of motion impairments, would be included. Recognizing both the significant range and degree of physical and cognitive impairments of long term care residents, additional features will be designed as "add on" components, which can be tailored to the specific needs of an individual resident. Facilities are increasingly recognizing the importance of resident centered care practices, in which the specific needs and abilities of individual residents are considered when developing care plans. The physical environment, however, seldom provides opportunities to be customized for individual residents. This project would create a wardrobe that could be easily modified by nursing home staff, with little or no specialized training, to meet the unique needs of the residents.