Strategies for Dressing a Stroke Patient

  1. 1 Hi,
    I'm a 4th quarter nursing student, and we are required to give AM care to our patients. My patient is overweight and previously had a stroke which left her left side weak and immovable.

    I'm having a really hard time putting her shirt on without it getting bunched up in her armpit. Since her shirts don't fit too well (they're on the small side) it's really hard to unbunch it. I always put her head in first, then her affected arm.

    Her pants also get stuck around her butt becuase she can't lift her legs for me to slide her pants up, and she's too big for me to lift. I put her affected leg in first and then her unaffected leg in.
    Are there any good solutions or tricks for putting her shirt on without it getting stuck and her pants over her buttocks??
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  3. Visit  maggie1990} profile page

    About maggie1990

    Joined Mar '12; Posts: 20; Likes: 4.

    12 Comments so far...

  4. Visit  Enthused RN} profile page
    0
    Normally I put the arms in first and then have them pull their head through for shirts. As for pants, maybe you can have them roll to one side in bed while you pull up that side; then roll to the other side and pull that other side up. Bigger patients are always a little more difficult.
  5. Visit  RunnerRN2015} profile page
    0
    If she's too big for you to lift by yourself, can you ask for help? I work at a no-lift facility and we get written up if we try to do something on our own instead of getting a 2nd person and/or using one of the lifts.
  6. Visit  northernguy} profile page
    0
    Are you getting the patient dressed in bed? If the patient can ambulate, or at least stand, I find it easier to get them on a commode or toilet, then get them dressed there. Put the pants up over the legs while they sit, then pull them up when they stand. Of course this can be difficult if the person needs two people to help them stand, unless you have a device that helps them stand like an EZ stand, then its simple(the stroke might rule that out if they cant use one hand at all).

    If they cant stand, then rolling side to side while you pull one half of the pants up to their waist is about all you can do. You may have to roll them back and forth a few times while you work each side up if the pants are tight fitting. It helps to have loose clothing, but you got to work with what you got. For the shirt Im not sure how you are attemping to do it, or even if they are lying in bed or sitting up. If they are in bed, I would sit them up and pull the shirt down that way.

    Wait til you have to get people dressed whose arms are so stiff and constricted they are like mummies, and they have extremely limited range of motion and tight fitting non stretchable clothing the family insists they wear. Then its like getting someone in and out of a straight jacket. You almost have to be Houdini to get some of these people dressed and undressed.
  7. Visit  maggie1990} profile page
    0
    Christi M: I use a 2 person assist when i get her out of bed into her wheelchair. She can pivot herself which helps a lot. But I don't need a 2 person assist or to lift her while I'm doing her AM care.
  8. Visit  maggie1990} profile page
    1
    NorthnGuy: I've had a patient with Parkinson's but luckily she had dresses! She can't really ambulate outside of her wheelchair so the commode is unfortunately not an option and getting help in the facility isn't easy, as all of my fellow classmates are doing AM care for their patients. Just thought maybe someone would have a strategy for ways to put the clothes on-like put right arm in first or something along those lines. I think it's just her size and the fact that her clothes are a bit too small.
    RunnerRN2015 likes this.
  9. Visit  JDZ344} profile page
    1
    I usually put the affected arm in, then over the head and then the unaffected arm. If you are then able to sit the patient forward (may need help), then pull the top straight. If not, you can roll the patient side to side to adjust the shirt.

    Trousers: You may need to roll the patient from side to side to pull them up and make sure they are not bunched.
    mindyfromcali likes this.
  10. Visit  maggie1990} profile page
    0
    katieP86: thank you so much! definately will try that! we usually put her head in first.
  11. Visit  mindyfromcali} profile page
    0
    In CNA school they teach us weak limb first, then the other for dressing. Opposite for undressing. Like the others have said I wouldn't recommend going head first.
  12. Visit  loriangel14} profile page
    0
    If you are getting a second person to help you transfer into the chair then use that opportunity to hike her pants up all the way.Support her with one arm and use the other hand to pull up your side of the pants and have the other person do the same.If her shirt needs fixing/straightening it can be easier after she is up in the chair.
  13. Visit  maggie1990} profile page
    0
    Thanks Loriangel14. We did that yesterday.
  14. Visit  student forever} profile page
    0
    Quote from northernguy
    Wait til you have to get people dressed whose arms are so stiff and constricted they are like mummies, and they have extremely limited range of motion and tight fitting non stretchable clothing the family insists they wear.
    No kidding! My wrist hurts just reading your post! That dead weight is awesome, like they weigh another 100 lbs. And getting my arm under their armpit for a transfer is really difficult. The family does not realize why the clothing gets so torn and battered and they have sports jackets hanging in his closet!!?? I recommended Goodwill for a shopping spree for soft pull on stuff. It took them a few minutes to calm down and realize I had their loved ones best interests at heart. Where is comon sense??????
  15. Visit  student forever} profile page
    0
    I usually put the weak arm in first, then the strong arm, then be sure the top is over both elbows up close to their arm pits, and then pull quickly over the head.


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