Decline in competence associated with putting on or removing clothing independently

• Anxiety
• Decreased activity tolerance
• Decreased motivation
• Impaired physical comfort
• Impaired physical mobility
• Impaired postural balance
• Muscle hypotonia
• Pain
• Prolonged inactivity
• Self-neglect
• Unaddressed environmental constraints
• Weakness

• Mental disorders
• Musculoskeletal impairment
• Neuromuscular diseases
• Significant comorbidity
• Stroke
• Wounds and injuries

• History of neurologic, sensory, psychological, or musculoskeletal impairment
• Age
• Self-care abilities, including knowledge and use of adaptive equipment, preparation of equipment and supplies, and technical or mechanical skills
• Musculoskeletal status, including coordination; functional ability; gait; mechanical restriction (such as cast, splint, and traction); muscle tone, size, and strength; range of motion; and tremors
• Neurologic status, including cognition, communication ability, insight or judgment, level of consciousness, memory, motor and sensory ability, and orientation
• Psychosocial status, including coping mechanisms, family members, lifestyle, patient's perceptions of health problem and self, and personality

• Difficulty choosing clothing
• Difficulty fastening clothing
• Difficulty gathering clothing
• Difficulty picking up clothing
• Difficulty putting clothing on lower body
• Difficulty putting clothing on upper body
• Difficulty putting on various items of clothing
• Difficulty removing clothing item
• Difficulty using assistive device
• Difficulty using zipper

• Patient will have dressing self-care needs met.
• Patient will have few, if any, complications.
• Patient will communicate feelings about limitations.
• Patient and family members will demonstrate correct use of assistive devices.
• Patient and family members will carry out dressing program daily.
• Patient and family members will identify resources to help cope with problems and discharge.

Suggested NOC Outcomes

• Assess patient's functional, cognitive, and perceptual level at periodic intervals. Document and report any changes. Ongoing assessment allows you to identify changing needs and adjust interventions accordingly.
• Observe patient's functional, perceptual, and cognitive level every shift; document and report any changes. Careful observation helps you adjust nursing actions to meet patient's needs.
• Perform the prescribed treatment for the underlying musculoskeletal condition. Monitor patient's progress, reporting favorable and adverse responses to treatment. Applying therapy consistently aids patient's independence.
• Encourage patient to voice feelings and concerns about self-care deficits to help patient achieve the highest functional level.
• Provide privacy to enhance patient's dignity.
• Provide enough time for patient to perform dressing and grooming. Rushing creates unnecessary stress and promotes failure.
• Monitor patient's abilities to dress and groom daily. This identifies problem areas before they become sources of frustration.
• Encourage family members to provide clothing patient can easily manage. Patient may benefit from clothing slightly larger than regular size and Velcro straps. Such clothing makes independent dressing easier.
• Provide necessary assistive devices, such as a long-handled shoehorn and zipper pull as needed. Instruct patient on use. Appropriate assistive devices encourage independence.
• Assist with or perform dressing and grooming: fasten clothes, comb hair, and clean nails. Provide help only when patient has difficulty to promote feeling of independence.
• Instruct patient and family members in dressing and grooming techniques (you can give family members written instructions). Have patient and family members demonstrate dressing and grooming techniques under supervision. Return demonstration reveals problem areas and increases self-confidence.
• As needed, refer patient to a psychiatric liaison nurse, support group, or home health care agency. Extra resources reinforce activities planned to meet patient's needs.

Suggested NIC Interventions

• Patient meets dressing self-care needs.
• Patient accepts help from staff if needed.
• Patient participates in activities designed to minimize risk of complications.
• Patient expresses feelings about self-care limitations.
• Patient and family members demonstrate appropriate use of assistive devices.
• Patient follows daily dressing and grooming program. Family members assist, as needed.

• Patient's expression of feelings and concerns about self-care limitations and their impact on body image and lifestyle
• Patient's willingness to participate in dressing and grooming
• Observations of patient's impaired ability to perform dressing and grooming
• Interventions to provide supportive care
• Patient's response to nursing interventions
• Instructions given to patient and family members, their understanding of instructions, and their demonstrated skill in carrying out self-care functions
• Evaluations for expected outcomes

• Buse, C., & Twigg, J. (2018). Dressing disrupted: Negotiating care through the materiality of dress in the context of dementia. Sociology of Health & Illness, 40(2), 340-352.
• Kosar, C. M., Thomas, K. S., Gozalo, P. L., & Mor, V. (2018). Higher level of obesity is associated with intensive personal care assistance in the nursing home. Journal of the American Medical Directors Association, 19(11), 1015-1019.
• Raffaele, B., Biagioli, V., Cirillo, L., De Marinis, M. G., & Matarese, M. (2018). Cross-validation of the Self-care Ability Scale for Elderly (SASE) in a sample of Italian older adults. Scandinavian Journal of Caring Sciences, 32(4), 1398-1408. doi:10.1111/scs.12585