Clothing That Works for
BY CAROL SIEBERT, OCCUPATIONAL THERAPIST
Getting dressed and undressed — a daily task mostly taken for granted. But after a stroke, the garments we wear can demand effort and attention that forces unwelcome choices: Do I have to give up tailored pants for sweatpants? Will I need someone to help me in the bathroom? I’m invited to a wedding and I can’t put on clothing that is appropriate for the event.
There are four common challenges associated with dressing after a stroke:
- managing dressing with one hand
- grasping and manipulating fasteners
- moving garments over less mobile body parts
- accommodating orthotics/braces
These challenges may exist alone or in combination. There are two common responses to these challenges: wearing simple clothing and seeking assistance. Simple clothing includes garments that stretch and have few or no fasteners. Assistance may be necessary for clothing that is less forgiving or to manage tricky fasteners. But independence should not require a wardrobe of sweatpants or having to sacrifice personal style.
An alternative approach is to modify the demands of dressing to match one’s abilities while maintaining personal expression and style.
Long-handled shoehorns, reachers and dressing sticks are often the first dressing tools encountered after a stroke, especially during rehabilitation. These are tools that extend reach to manipulate garments around the body or over limbs. These are also tools to manipulate fasteners. A button hook enables the user to fasten and (with a bit more effort) to unfasten buttons with one hand. Most of these tools are available online. Some are available in medical supply stores or drugstores.
The tools listed above can be used with one hand. Tools designed specifically for one-handed dressing include the Bra Angel™, for donning and fastening a bra and Norco™ Easy-Pull™ Sock Aid, for donning socks.
Adapt Existing Garments and Techniques
You may already use this strategy. For example, if you leave some buttons always buttoned on a skirt or shirt so you can pull it over your head or feet, you’ve adapted the garment and technique to fit you. Some adaptations require basic sewing skills (yours or those of a helper or a tailor). What follows are some simple, low-cost adaptations to garments that make dressing simpler and easier.
Buttons: Re-attach buttons using elastic thread, so buttons can remain fastened while garment is pulled over the head or over arms (cuff buttons). Another option is to sew buttonholes closed, sew the unused button over the buttonhole and replace with hook and loop or magnetic fasteners (like Velcro®).
Snaps: Replace with magnetic or hook-and-loop fasteners.
Zipper: Attach a small ring through the hole in the zipper pull so zipper can be grasped by hooking a finger into the ring/loop.
Shoelaces: Elastic shoelaces include single straight elastic laces that are tied and curly elastic laces that stay in place without being tied.
A common post-stroke challenge is preventing pants from falling down while tucking in a shirt or manipulating fasteners. This can be especially difficult when adjusting clothing for toileting. This task can be managed with a simple “DIY” tool: two small, spring-loaded clips attached by about 12 inches of cord. Before unfastening the pants, attach one clip to the front hem of the blouse or shirt and the other to the front waistband of the pants. When the pants are unfastened, the front of the pants will not fall to the floor. The length of the cord can be adjusted to the stature of the user.
An alternative to the clips and cord is to sew a loop of cord or ribbon inside the waistband on the affected side. The loop can be hooked over the affected hand or wrist to keep the front of the pants from falling away when the pants are unfastened.
Purchasing adaptive clothing
Adaptive clothing has been available for many years. Early producers focused on clothing for individuals using wheelchairs or prioritized ease for caregivers over style for the wearer. The next evolution of adaptive clothing focused more on function and style. However, stroke survivors have not always been aware of these products or their sources. Producers have depended on catalogs, websites and word-of-mouth to market their products.
Recently, larger clothing manufacturers and retailers have started to recognize both the need for adaptive clothing and the significant market for such clothing. Target, Nike, Tommy Hilfiger, Zappos and others have introduced lines of adaptive clothing or footwear. Simultaneously, some clothing manufacturers have developed products that are more “universally” designed. These items are targeted to the general public but have features that make them a good fit for the needs of stroke survivors.
The large companies that have introduced adaptive clothing are targeting a broad market, including those with sensory sensitivities and wheelchair users. Not every item will meet the needs of stroke survivors. But many of these lines also feature simplified fasteners and ease of access, all with a focus on style. The products are featured on an “adaptive” section of these companies’ websites. Some include filters or menus to tailor the search to specific needs, such as easy closures, ease of movement and seated wear (Tommy Hilfiger) or magnetic closures and “AFO friendly” (Zappos). Adaptive clothing is available for men, women and children. Currently these companies are selling their adaptive lines via websites.
UNIVERSALLY DESIGNED CLOTHING
Some companies have developed garments and accessories that are not marketed as “adaptive,” but the design reduces some of the demands of dressing. For example, designing men’s shirts to be worn untucked may be a way to blend style and comfort, but it also reduces some of the demands of donning and adjusting shirts with long tails. A footwear manufacturer producing shoes with removable insoles also may produce an AFO-friendly shoe.
The production and marketing of stylish clothing for people with varied abilities is still in its early stages. But it has begun. Visiting the websites where these items are marketed, giving feedback and purchasing the items sends a message to manufacturers and retailers that this is a significant market. The need for adaptive and universally designed clothing, clothing that works, is real.