Why Do People with Dementia Take Their Clothes Off in Public?

Kim Trevey on Apr 11, 2024

What Happens During Dementia - Barton House, Sugar Land, Texas

Table of Contents

Why do people with dementia take their clothes off in public?
Why does my loved one with dementia take his clothes off?
- How can I get my loved one to keep her clothes on?

Why do people with dementia take their clothes off in public?

If you’ve ever been a parent to a toddler or taken care of one, you know how difficult it can be to get your toddler to put his clothes on and keep them on. It seems every time you leave the house you have to explain to your child why he must wear clothes while out in public. And still, your child will try to take off his shoes, jacket or other apparel he just doesn’t feel like wearing anymore.

If you’re caring for a loved one with dementia, you might be experiencing some déjà vu in the clothing department. Your loved one might try to take her clothes off in public or at inopportune times. You try to reason with her and tell her when and where she must wear clothes, but your reasoning doesn’t seem to register. She tries to disrobe anyway.

While inconvenient, frustrating and often embarrassing, the tendency for those who are living with dementia to take off their clothes in public can be common. And while this may mimic toddler behavior in some ways, those who are living with dementia are not trying to practice their will or test their caregivers. They are taking off their clothes for different reasons, and their motivation is usually very innocent. With dementia comes the loss of inhibition, confusion, disorientation and other reasons your loved one may think they are in a place where taking off their clothes is ok.

Some types of dementia like frontotemporal dementia directly affect the frontal lobes of the brain. This part of the brain controls our social behavior—what’s ok and what’s not ok to do, especially in public. As this area of the brain deteriorates, so does someone’s inhibitions. This can lead to a number of inappropriate social behaviors, including disrobing.

But even if your loved one doesn’t have frontotemporal dementia, other factors could be affecting his inhibitions and ability to know when and where he should be wearing clothes.

Why does my loved one with dementia take his clothes off?

According to the dementia association of Australia, someone who is living with dementia may feel the urge to take off his clothes for a number of reasons, including:

Confusion: Your loved one may confuse you for a spouse or someone else she would feel comfortable undressing in front of.
Discomfort: This is often the primary reason those with dementia feel the urge to take off their clothes. They may feel hot, or their clothing could be uncomfortable in some way, causing them to try and take it off. If they’ve soiled themselves, they feel wet and uncomfortable. Taking off their clothes is simply a sign they need to change them.
Memory loss: Your loved one may not remember the importance of clothes, he may not remember where he is, or he may not remember where the bathroom is. Taking off his clothes could be a signal to you to remind him where he is and usher him to the nearest bathroom for privacy.
Disorientation: Dementia can also cause confusion around what time of day it is. It could be that your loved one thinks it’s nighttime or bath time, so she tries to take off her clothes to prepare to go to bed or take a shower.

How can I get my loved one to keep her clothes on?

As a caregiver, you may feel exhausted with your loved one trying to take off his clothes in inappropriate places. You may feel tempted not to take him out anymore because you’re at a loss for what to do and feel powerless in public settings.

The most important thing you can do when your loved one tries to disrobe in public is try and understand why. Consider the list above. Could these be any of the reasons your loved one is taking off her clothes? Is she hot or uncomfortable? Does she need to go to the bathroom? Is she confused about where she is or what time of day it is?

When you understand why your loved one is taking off her clothes, then you can respond accordingly.

Once you understand the why behind the behavior, then you can start to preemptively prevent it by preparing for every outing. Here are a few things to consider before going out in public to ensure your loved one stays clothed for the entire outing:

Make sure your loved one is dressed in weather-appropriate clothes, especially if it’s hot outside.
Make sure your loved one likes the clothes he is wearing and that he feels comfortable.
Use the bathroom before leaving to prevent any accidents.
Go somewhere familiar and comfortable for your loved one, so he is less likely to forget where he is or get distressed.
Avoid going out in the evenings if your loved one is prone to sundown syndrome.
Consider adaptive clothing that will keep your loved one comfortable but is harder for him to take off, such as shirts that zip in the back or pants with buttons on the side.

Geropsychologist Dr. Natali Edmonds encourages caregivers to stay curious when it comes to challenging behaviors in their loved ones. Rather than labeling what your loved one is doing is “offensive” or “inappropriate,” use this behavior as an opportunity to learn more about your loved one and where she might be coming from. Assuming a posture of curiosity rather than judgment will help you have more patience for your loved one and will help distance you from your frustrated or anxious emotions, so you can decide what your loved one really needs at that moment, whether it’s a change of clothes, a nap or a trip to the bathroom.

Caring for someone with dementia is difficult. But remember when you are having a hard time with your loved one, she is probably having a hard time too. She might feel confused, disoriented or uncomfortable. Ask yourself why she might be engaging in this behavior before reacting. Then respond accordingly, assuming a posture of curiosity rather than judgment.

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Continuing an Environment of Caring in Times of COVID-19

Safety of Residents and Staff

As the coronavirus (COVID-19) pandemic continues to evolve, our communities are focused on keeping our Residents and staff safe while also maintaining Resident engagement and daily fulfillment. We are taking a cautious approach, balancing the highest level of safety within the least restrictive environment.

We will continue to follow and augment State and C.D.C. safety recommendations:

Screening: We screen every employee every day. We require our staff to complete a questionnaire (inquiring about possible symptoms, recent travel and exposure), have their temperature and oxygen level checked before entering the building. Staff are also required to clean their cell phones, keys and wash their hands while being observed. We monitor our Residents’ health closely with temperature and oxygen level checks at least twice a day. We help our Residents wash their hands throughout the day and encourage them to wear a mask or face covering.

Cleaning: We have enhanced our cleaning products with regard for their effectiveness in killing COVID-19 particles and proper sanitization and disinfection, using the EPA’s specific list of disinfectants for use against the coronavirus. We are using this list and training staff on how long cleaning solutions must be kept on a surface before wiping it off to ensure its effectiveness. We prioritize cleaning high-touch areas and horizontal surfaces, cleaning them several times a day.

Physical Distancing: We encourage 6 foot distancing between Residents and with staff unless they are providing direct care to a Resident.

Testing: We test all Residents and staff for COVID-19 every three weeks, and more as needed. Our nurses utilize a PCR test, which we send to a private lab to expedite results.

Physical Changes: We have installed ultraviolet lights in our air conditioners that supply air to the common areas of the houses. This method is believed to be helpful in killing bacteria that is cycled through the systems and pushed back into the house. We’ve also enhanced our HVAC filters to near HEPA levels, trying to add additional layers of protection to keep COVID-19 out of the building. Most importantly, air purifiers have been added to common areas and each resident room.

PPE: Staff members wear masks at all times and we encourage Residents to wear masks when outside their rooms. We also encourage physical distancing between our Residents. Staff wears additional protective equipment when deemed necessary while caring for our Residents. Staff are continually trained on when and how to use personal protective equipment (PPE).

Individual Needs Stay Paramount

The uncertainty surrounding COVID-19 affects us all. At our communities, we are not letting it stop us from safely offering a life well-lived. Above all, we are providing the utmost attention to the safety and well-being of our Residents. Our Program has always revolved around the individualized needs of each Resident and this has not changed during COVID-19. Residents are still able to connect with each other and staff while maintaining a safe physical distance. Weather permitting, we enjoy the patio and large backyard. We continue to keep our Residents engaged through cognitive, physical, recreational experiences. We offer enjoyment and connection throughout the day even during these unprecedented times.

Visitors

Since early March we have restricted facility access to prevent the spread of COVID-19.

Essential Visitors: Healthcare providers including physicians, home health, private duty services, physical therapy and hospice staff have not been allowed in the communities unless there is an acute, essential need for our Residents. These services continue as needed through FaceTime, tele-med and phone conversations. If physical access is absolutely necessary, the individual will complete our questionnaire and screening for temperature and oxygen stats. No one is allowed in the community if they fail to meet our screening criteria.

Families: We are happy to help schedule window visits, FaceTime, Zoom and phone calls with your loved ones based on what is allowed and prudent. To ensure the proper support from our staff, our visits are scheduled ahead of time.

Tours and Move-Ins

Tours: We recognize that regardless of the changes with COVID-19, your need for senior living hasn’t changed. For the safety of you, our Residents and staff, we are currently offering virtual tours where you can see our community, as well as meet our staff. Please contact our Community Relations Director to set up a virtual tour.

Move-Ins: We are accepting a limited number of move-ins (unless otherwise instructed by public health department). New Residents must be tested for COVID-19 prior to move-in. Upon admission, we will place a new resident in their room to quarantine as an additional precaution.

We will share community-specific information with residents and families as our quarantine measures continue to evolve with new information of COVID-19.

We are honored to care for your family member and loved one.

Comments we’ve received from our families during COVID-19.

“We appreciate all of your efforts. Your team clearly is a leader in the response to COVID. Thank you for keeping our loved ones safe.”

Joseph

“Thank you, thank you, thank you for ALL you have done and are doing to keep the residents and staff in a safe environment! The continuous learning and improvements empower caregivers and families to do better at home and in our communities.”

Tommy

“I appreciate you taking the time to update us and share them with my family living in AL, GA, VA, MD, FL…we are extremely grateful and comforted by your proactive and decisive measures! We’ll continue to keep you in prayer for health, safety and more.”

Rebecca

“In keeping with the parade theme you had, the employees there are super heroes. They are plowing forward in the midst of this horrible virus and taking care of their patients selflessly. I just wanted to acknowledge their bravery and dedication and thank them from the bottom of my heart for the goodness in their hearts and their dedication to their patients and jobs.”

Abigail

“Thank you! You locked down early & your diligence has paid well.

The Bader support group continues meeting once a month by Zoom. We all appreciate you so much. Everyone comments on how grateful we are that our parents are at Barton House!

We appreciate everything: sending us pictures, calls, alerts to bring supplies/clothes as needed, staying in virtual contact with hospice.
Blessings to each of you.”

Marsha

“Thank you for all y’all and all the staff are doing for my mom and the other residents. We truly appreciate your hard work.”

Carol