Dressing and Undressing

Helping patients dress and undress is a daily CNA responsibility. Proper technique protects both the patient and the CNA from injury while maintaining patient dignity and encouraging maximum independence.

Basic Principles

The Golden Rule of Dressing/Undressing:

Dress the weak side first, undress the weak side last.

This rule applies to patients with weakness on one side due to stroke, injury, or arthritis. It minimizes movement of the affected limb and reduces pain.

Example for Patient with Left-Sided Weakness (Right-Handed Stroke):

• Putting on shirt: Left arm goes in sleeve first
• Taking off shirt: Right arm comes out first, then left arm

Promoting Independence

Always encourage patients to do as much as possible themselves:

• Provide choices - Let patient select clothing
• Allow extra time - Rushing creates frustration
• Use adaptive equipment - Button hooks, long-handled shoehorns, Velcro closures
• Position items within reach - Lay clothes out in order of dressing
• Offer verbal cues - Guide through steps without doing everything

Dressing a Patient in Bed

Upper Body (Shirt/Gown):

1. Provide privacy
2. Assist patient to sitting position if possible
3. If side-lying, roll patient to access back
4. For weak arm: Gather sleeve, guide arm through, pull up to shoulder
5. For strong arm: Patient can assist
6. Fasten buttons/snaps from bottom up

Lower Body (Pants/Shorts):

1. With patient lying down, gather pant leg
2. Slide over weak foot first, then strong foot
3. Pull pants up to thighs
4. Have patient raise hips (or roll side to side) to pull over buttocks
5. Fasten waistband

Dressing a Patient in Chair

Upper Body:

1. Position patient comfortably in chair
2. Lean patient forward slightly
3. Guide weak arm through sleeve first
4. Patient reaches strong arm through sleeve
5. Smooth fabric across back
6. Fasten front closures

Lower Body:

1. Patient crosses weak leg over strong leg (with assistance)
2. Guide pant leg over weak foot
3. Lower leg, then lift strong leg to put on pant
4. Stand patient (with support) to pull up pants
5. Use gait belt for safety during standing

Undressing Techniques

Follow the reverse order: strong side first, weak side last.

Shirt Removal:

1. Unfasten buttons/snaps
2. Remove from strong arm first
3. Slide shirt behind back
4. Gently remove from weak arm last

Pants Removal:

1. Unfasten waistband
2. Lower pants over hips (patient lifts or rolls)
3. Slide pants down legs
4. Remove from strong foot first
5. Remove from weak foot last

Adaptive Clothing and Equipment

Many devices help patients dress independently:

Special Considerations

Patients with IV Lines:

1. Thread IV bag and tubing through sleeve first
2. Keep bag below heart level during dressing
3. Don't kink or pull on tubing
4. Never disconnect IV to dress patient

Patients with Casts/Splints:

• Choose loose-fitting clothes that fit over device
• May need to cut seams or use adaptive clothing
• Check circulation after dressing (color, warmth, sensation)

Patients with Dementia:

• Simplify clothing choices (2 options maximum)
• Use familiar, easy-on clothing
• Provide step-by-step verbal cues
• Be patient—allow extra time
• Watch for agitation or resistance