Elaine Kowalke

Text version of Elaine Kowalke's keynote remarks

Hi, I am Elaine Kowalke.  I have worked at St. Clare Meadows Care Center in Baraboo Wisconsin for 25 years as a registered nurse.  One of my hobbies is sewing.  Over the years, I noticed that some of the residents had seams that were torn. I would take the clothing home and sew the seams up. But then they would tear again.
By watching the CNAs assist the residents with dressing, it was plain to see what the problem was.  Many residents have arthritic joints that are painful to move, arms or legs that don’t bend enough to get the clothing on, or the resident was confined to bed.  As a result, the clothes were being torn from the excessive stress when dressing.  In some cases, the clothes were being put on backwards because there was no other way to get the resident dressed.

When commercial adaptive clothing became available, it was costly. Our residents on Medicaid have an allowance of $45 per month to cover their “other costs” which include cable TV, telephone, haircuts and sets, and clothing.  When a shirt from the adaptive clothing catalog costs an average of $20, it is unaffordable to the resident. 

Another drawback to commercial clothing is that it has an institutional look.  Can you imagine what it would be like to give up your favorite pair of comfortable Levi’s for a pair of gray knit slacks? Or your favorite shirt for a floral polyester top?  Most of our residents prefer their own clothes.

After experimenting, I found the easiest solution was to simply split the back of the slacks and add a snap or hook as a fastener. Dresses and shirts can be partially split up the back giving the room for stiff or contracted arms.

Now residents are comfortable in their own clothing.  They are able to dress without tugging on fragile arms and legs.  Our staff can help, with less stress on their own backs and bodies.

The biggest advantage and time saver is in toileting for our immobile residents.  Have you ever thought of all of the steps involved in going to the bathroom if you are unable to stand or walk?  Immobile residents must use a mechanical lift to move from the bed or wheelchair to the toilet.  Without adaptive clothing, the resident would need to be transferred to bed for the clothing to be removed, transferred to the toilet and then back to bed to be redressed.  The resident would be rolled back and forth, side to side to work the clothing up from the ankles to the waist.  With adaptive clothing, residents are brought upright in the mechanical lift, the snap or hook is unfastened and undergarments are removed for toilet use and then refastened when toileting is completed.

It is rewarding to know that residents have an improved sense of self-esteem and dignity with adaptive clothing.  Adaptive clothing fits smoothly without bunching up and residents can get dressed without pain or discomfort or even any injury to fragile skin. 

For me there is much satisfaction in knowing that I have made life a little easier and more comfortable for our residents and staff.  A warm thank you and a big hug let me know what I have done is appreciated.