4.5 Bathing and Grooming Bedridden Adults |
| The purposes for giving a bath in bed are:
- To cleanse and refresh the person, thereby increasing self-esteem.
- To eliminate skin waste and help prevent infection.
- to aid in stimulating circulation.
- to provide passive and active exercise.
How often a bath is given depends upon such factors as the physical
condition, age and skin type of the person. Older people have less
oil and perspiration. Therefore, a daily bath with soap may not
be desirable.
Washing the rectum, genitals and armpits may be all that is needed.
A cool sponge bath may be needed if the person perspires profusely.
A few points to follow in bathing a person:
- Choose a bath time convenient for the family and the person.
- Make sure the room is warm and equipment organized.
- Keep the person warm with a sheet or blanket while bathing.
- Place a towel under the part being washed to keep the bed dry.
- Change water when soiled, soapy or cool.
- Test water temperature on the inner wrist to make sure it is
not too hot.
- Provide as much privacy as possible for the person.
- Assess the condition of the person as he is bathed. Note skin
changes.
- Use soap sparingly.
- Encourage the person to participate in bathing. In doing so,
he gets some exercise and develops security in doing for himself.
Procedure:
- Explain what will be done and the reasons for the various techniques.
- Place a cover over the top cover to be used as a bath blanket.
A bath blanket can be made by sewing several large towels together.
Slide the top covers from under the bath blanket. Help to remove
the bed clothes as needed.
- Place a towel under the person's head.
- Wrap the washcloth around the fingers and palm, anchoring it
with the thumb; fold over the part extending beyond the fingers
and tuck under at the bottom edge of the cloth. (This eliminates
dangling ends which may be uncomfortable to the individual.)
- Wash eyes with clear water, cleansing from inner corner of the
eye to the outer part of the eye (as the normal flow of tears
is from the outer to the inner part of the eyes), using opposite
corners of the cloth for each eye.
- Wash the face from midline outward using a firm but gentle motion.
Use clear water, unless the skin is oily. Some people prefer creams
for cleansing.
- Wash, rinse and dry ears.
- Place a towel under the arm and another towel near the hand
and the basin.
- Lower the person's hand into the basin. Allow it to soak as
the arm is being washed.
- Wash and rinse the other arm and soak hand, drying carefully,
especially between the fingers. Push cuticles back and clean under
the nails.
- Put towel over the chest and abdomen. Bring bath cover down
to thighs.
- Wash, rinse and dry neck, chest and abdomen. Cover chest and
abdomen.
- Remove the bath cover to expose the leg and place towel under
the leg.
- Place a towel under the basin near the foot.
- Lower foot into the basin to soak. This will help soften the
nails and skin.
- Wash, rinse and dry leg.
- Repeat above steps for other leg.
- Dry carefully between the toes.
- Observe feet and use pumice stone or emery board to smooth callouses.
- Clean under the nails.
- Turn the person on the side. Drape a towel around the back and
buttocks
- Tuck the towel along under his buttocks and shoulders.
- Wash, rinse and dry his back and buttocks. Cover his back.
- Use fresh water for genitals.
- Teach the person to wash carefully between the buttocks and
the genitals. Rinse and dry thoroughly. Remind the female to wash
from the front to the back to avoid bringing germs from the rectal
area to the vagina and bladder. If the person is unable to wash
his buttocks and genitals, the caregiver should complete this
part of the bath for him.
- Apply body lotion or powder, as desired.
- File or clip nails cautiously and dispose of clippings into
paper towel.
- Persons with a urinary catheter or an ostomy should be taught
to wash carefully.
|
Shampooing in Bed |
Shampoos may be given in bed with the person sitting up or lying
on his back. Persons with heart or respiratory disease may need
to have the head elevated. Shampoos improve appearance, increase
circulation of the scalp and make the person feel better.
A trough is necessary to protect the bed and to direct the flow
of water from the person's head into a bucket. A trough may be improvised
from a shallow, rectangular plastic box. Cut a curved piece from
one end and remove the other end. Pad the curved end with a cloth.
The plastic box should be long enough to direct water into the bucket.
The bed should be protected with newspaper and a plastic sheet.
A trough may also be fashioned from six to eight layers of newspaper
with the side edges rolled to the middle and covered with a 36"
X 24" plastic sheet. It should be rolled to direct the water into
the bucket of waste water.
Procedure:
- Check temperature of the room.
- Place towel around the shoulders.
- Place trough under the head with run-off into bucket on the
floor.
- Apply sufficient water to wet the hair (a pitcher can be used).
- Work up a good lather, working from the front to back of the
head.
- Rinse thoroughly.
- Work quickly so the person will not be chilled. Avoid drafts.
- Dry with a towel or hair dryer. Dry shampoo, available at cosmetic
counters, may be used. Follow directions on the product. Spray
or apply to small sections of the head and brush.
|
Special Foot Care |
Some persons who are ill for a long time or who have conditions
affecting circulation and ambulation may need foot care. The feet
should be examined for any unusual appearance, such as swelling
and nail discoloration. Note any temperature difference between
one foot and the other.
Procedure:
- Observe feet carefully.
- Soak the feet first, if only foot care is being given.
- Clean under the nails.
- Use pumice stone or emery board to smooth callouses and nails.
- Massage the feet and legs with lotion to increase circulation.
- If special foot care is needed, do not cut or trim the toe nails.
This should be done by a professional.
- Dry carefully between toes.
|
Shaving a Man With a Safety Razor |
Shaving may be done at the same time as bathing. Whenever possible,
the man should be encouraged to shave himself. An electric razor
is more convenient to use. If a safety razor must be used, make
sure you have:
razor with a fresh blade;
shaving cream;
hot water in basin;
towel and wash cloth.
Procedure:
- Place a towel over the chest.
- Wash the face with soap and water, leaving it wet.
- Rub shaving cream into the beard. Do not use soap.
- Pull skin tight over the area to be shaved.
- With gentle, short strokes shave in the direction the hair grow.
- Rinse the person's face and pat it dry.
|
Giving a Back Rub |
Back rubs increase circulation, relax the person and increase
the person's comfort.
Procedure:
- Explain what will be done.
- Face the head of the bed with the outer foot slightly forward
and the knee slightly flexed so that you can rock back and forth
as pressure is applied.
- Place the person on abdomen.
- Put lotion or cream in hands to warm and then apply to the person's
back.
- Apply pressure with palms of both hands, beginning at the lower
back and moving up toward the shoulder, using long, firm, but
gentle strokes, sweeping upward, outward and downward.
- Note bony areas and massage gently around them.
|
Mouth Care |
Mouth care provides a person with a feeling of cleanliness and
well being, and prevents gum disease, cavities and bad breath.
Things needed:
- soft bristled toothbrush
- towel
- toothpaste (bicarbonate of soda and salt, or dentrifice)
- dental floss
- glass of cool water
- emesis basin or empty container
- drinking straw cotton swab
- moisturizer for lips and mouth (optional)
Organize the equipment and place it within easy reach of the person.
Encourage him to do as much as possible.
Procedure for brushing teeth:
- Explain what will be done.
- Put the person in an upright position if possible. If not, with
the bed flat, turn the person as far toward his abdomen as possible
so the saliva and fluids will run out.
- Place a towel under his head.
- Place emesis basin at the side of his head.
- Gently brush the teeth and tongue.
- Place the toothbrush at an angle against the gum line.
- Gently scrub outer and inner surfaces of each tooth with short
strokes.
- Scrub the chewing surfaces. Tilt the brush's rounded front end
to brush the inside of the front teeth and gum tissue vertically.
Procedure for Flossing Teeth:
- Break off approximately 18 inches of dental floss and wrap most
of it around the middle finger of one hand. Wrap the rest around
the middle finger of the other hand with about one inch of floss
between the hands.
- Guide the floss with the thumb and forefinger. A floss holder
may help to reach the back teeth.
- Gently insert the floss between the teeth using a sawing motion.
- Curve the floss into a letter "C" around the tooth at the gum
line.
- Slide it gently into the space between tooth and gum. Hold the
floss, curve it around the next tooth and scrape it.
- Repeat the process for each tooth.
To Care for Dentures
The person who has dentures may need help with their care. He should
be encouraged to wear them most of the time, but they should be
removed and cleaned at least once a day.
Procedure:
- Wash hands before and after handling dentures.
- Use tissue to pick up dentures.
- Place dentures in container filled with water.
- Clean dentures over a basin filled with water to avoid chipping
them.
- Use a denture brush or soft toothbrush and cleaning agents,
such as peroxide or baking soda and water.
- Store dentures in liquid to avoid denture warp.
- Apply denture cream or adhesive as needed.
- Bring mouthwash and basin to the bedside so the person can rinse
his mouth before the dentures are reinserted. Check gums and tongue
for sore spots and food deposits.
- Be sure to check dentures for chips and rough edges.
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