Getting dressed with one good arm, a new hip, or a bad back: what our occupational therapists teach

Being able to get dressed by yourself is a bigger deal than it sounds. It is often the difference between a patient feeling like a patient and feeling like themselves. It is also one of the first things people lose after a stroke, a hip replacement, or a shoulder or back surgery, and one of the first things our occupational therapists work to give back.

I am a physical therapist, so I asked our OT team to walk me through what they teach most. Here it is.

The universal rules

Sit down. Every step that can be done seated should be. The edge of the bed or a firm chair with arms is the dressing station. Standing on one leg to put on pants is how healthy people fall, let alone recovering ones.

Weak side first, weak side last. After a stroke or with a painful shoulder, dress the affected arm or leg first, because it is easier to thread a limb into a sleeve or pant leg when the other side is still free. Undress the affected side last, for the same reason.

Lay it out in order. Clothes stacked in the sequence you will put them on, within reach, so you are not twisting and hunting.

Choose the clothes that cooperate. Front opening shirts, elastic waists, slip on shoes with a closed back, and a size that is easy rather than fitted. Nobody needs to fight a button down after surgery.

After a hip replacement, with precautions

If your surgeon has told you not to bend the hip past 90 degrees, you cannot reach your feet, and that is where the tools come in.

• A reacher to pull pants over the feet and up to the knees, then stand with the walker to finish.
• A sock aid, a plastic trough that holds the sock open while you pull it up with cords.
• A long handled shoehorn and elastic laces, so shoes go on without bending or tying.
• A dressing stick to hook a sleeve or a waistband.

These cost little and are often packaged as a hip kit. We teach the technique in the patient's own bedroom until it is smooth.

After a stroke, with one strong arm

The one handed method for a shirt: lay the shirt on your lap, feed the weak arm into its sleeve all the way past the elbow, then use the strong arm to pull the shirt around the back and find its own sleeve. For pants, cross the weak leg over the strong one to bring the foot within reach, thread it first, then the strong leg, then stand with support to pull up. Button hooks and zipper pulls handle fasteners, and Velcro replaces buttons on the shirts you wear most.

With a bad back or a painful shoulder

Dressing from a seated position with the feet propped on a low stool reduces bending. A reacher and sock aid do the rest. For shoulders, the affected arm goes in first for shirts and jackets, and pullover tops go on by leaning forward rather than lifting the arm overhead.

Energy is the hidden limit

After a hospital stay, dressing can take everything a person has before breakfast. Our therapists teach pacing: dress in stages, rest in between, and do the hardest step when energy is highest. Sometimes the right answer for the first week is a bath robe and slippers, and that is fine.

When a caregiver is helping

Help with the step that is unsafe and let the person do the rest. Handing over a shirt already turned right side out, or steadying a walker while they pull up pants, keeps them working and keeps dignity intact. The goal is always for the patient to need you less next week than this week.

Getting occupational therapy at home

Occupational therapy is covered under Medicare home health when a physician orders it, and it is available for patients recovering from stroke, joint replacement, surgery, or a significant loss of function. Ask your physician or discharge planner to fax orders to 904-638-8752, or call 844-808-9096 and we will reach out to the office.

This article is general information, not medical advice. Follow the specific precautions from your surgeon and the techniques taught by your therapist.