Hygiene
Promotes comfort, safety and healthPrevents body and breath odorsRelaxing and increases circulation
Daily Care
Most people have hygiene routines or habits
Routine care is given during day and evening
Assist whenever needed.
Before Breakfast
Am careAssist with:
eliminationface and hand washingOral hygieneDressing and hair careChanging incontinent residentsPositioning for mealsStraightening unit and making bed
Afternoon Care
After lunch and the evening meal
Assist with: eliminationOral hygieneActivitiesChanging incontinent residentsChanging wet or soiled linen
Evening Care
HS CareAssist with:
eliminationOral hygieneChanging into sleepwearChanging incontinent residentsChanging wet or soiled linen
Oral Hygiene
Keeps mouth and teeth clean
Prevent mouth odors and infections
Increases comfortIncreases appetiteReduces risk of
cavities and gum disease
Residents with dry mouth (those using O2) will need frequent oral care.
Follow Standard
Precautions and
Bloodborne Pathogen
Standards:
Wear GLOVES
Oral Hygiene
Equipment:ToothbrushToothpasteMouthwashEmesis BasinDenture CupToothetteWaterGloves
Flossing:
Removes plaque and tarter
Done after brushing
If done only once a day – do at
bedtime
Oral Hygiene for the Unconscious Resident
Use Toothette
Lateral position to prevent aspiration
Use padded tongue blade to keep mouth open
Q2H
Denture CareCleaned as often as natural
teethSlipperyEasily broken when droppedLine sink or basin with
paper towelHot water causes warpingStore in cool water if not
wornUse gauze to grasp teeth if
assistance is needed with removing
Mouthwash for rinsing
Bathing
Cleans the skin Refreshing and
relaxingStimulates
circulationOpportunity to
make observations
Due to dry skin: Older persons usually need a complete bath
2x week.
BathingComplete Bath
Partial Bath (bath with assistance)
Partial Bath
Shower
Tub
Total care provided by CNA
Essentials: Face, hands, armpits, peri-care
Resident can assist. Will usually need assist with back and feet.
Provided by CNA
Provided by CNA
Rules for BathingFollow Care plan
Allow personal choice when possible
Practice Standard Precautions
Provide privacy
Cover for warmth and privacy
Protect from falling
Rules for BathingUse good body mechanics
Check water temperature
Wash from clean to dirty
Encourage resident to help
Rinse thoroughly
Dry between skin folds
Observe
Observations to makeSkin color
Rashes
Bruises
Open skin areas
Pale or red skin
Drainage or bleeding
Swelling
C/o pain
Complete bed bathEyesFaceFar arm, Near armChestAbdomenChange waterFar leg, near legFeetChange waterBackChange waterPeri-care
Use Bath blanket
Make a bath mitt
Use lotion and deodorant
ROM
Soak hands and feet prn
Report and record
Partial bed bathResident is too ill to
have complete bath
Resident had complete bath day before
Resident is having procedure or tests done soon
FaceHandsArm pitsPeri-care
Use Bath blanket
Make a bath mitt
Use lotion and deodorant
Report and record
Partial Bath (Bath with Assistance)Resident is capable
of completing much of own bath
Set resident up with all equipment needed.
Assist with areas resident could not get to, usually: back and feet.
May be done on SOB or in BR
Make a bath mitt
Use lotion and deodorant
Report and record
Shower TUBPrevent slipping,
falls, chills and burns
A chair is usually used
Protect privacy
Water temp 105 F
Prevent slipping, falls, chills and burns
Last no longer then 20 minutes
Clean before and after use
Bath mat
Fill tub before getting in
Protect privacy
Water temp 105 F
Back Massage
Relaxes muscles Stimulates
circulationAfter bath and with
HS careLast 3-5 minutesUse lotion to reduce
frictionSide lyingFirm strokesUpward
Do not massage reddened
areas:
can lead to further tissue
damage
Perineal Care
Peri-care
Cleaning the genital and anal area
QD and prn
Use common terms
Standard Precautions: GLOVES
Perineal CareMale:Retract foreskin if uncircumcised
Clean the tip using a circular motion
Repeat as needed working down the shaft
Rinse, Dry, replace foreskin if needed
Clean around and under the scrotum
Rinse, dry
Clean rectal area
Rinse, Dry
Perineal Care
Female:Separate the labia
Clean front to back using a different part of the wash cloth with each stroke
Repeat until clean
Rinse, Dry
Clean rectal area from vagina to anus
Rinse, Dry
Reporting and Recording
Report bleeding stat
Report Care given
Record on ADL Flowsheets
ADL Flow Sheet
Oral care
Skin care
Hygiene
Peri-care
Back Massage
ROM
Review
If you notice that a resident is incontinent when you begin his bath you should
A. Start the bath as usual, with the eyes
B. Provide peri-care first, change water and begin the bath
C. Pad the area with dry towels, begin the bath as usual
D. Doesn’t matter, begin as you choose.
Review
When providing peri-care
A. Use upward strokes, rectal area to urethra
B. Use bath oil to ensure adequate cleaning
C. Wash the rectal area first
D. Use a clean part of the wash cloth for each stroke.
Review
AC
S
C
C/O
HS
OOB
TID
BID
Before meals
without
with
Complains of
bedtime
Out of bed
3X day
2X day