Personal Care and Activities of Daily Living
Concepts to master
Personal care includes bathing, oral hygiene, grooming, dressing, toileting, and skin care. Know the principles of privacy, dignity, and resident preference - encourage independence and allow the resident to do what they can. Standard precautions apply: gloves for contact with body fluids, hand hygiene before and after. When bathing, check water temperature (generally around 105°F/40°C, never above 110°F/43°C to prevent burns), especially for residents with neuropathy or decreased sensation. Perform skin checks during care and report redness, breakdown, or bruising.
Dressing and toileting
Encourage the resident to choose clothing and dress the affected side first when one side is weak. For toileting, follow a toileting schedule for incontinence, provide privacy, and never restrict fluids without an order. Oral care should occur at least twice daily and after meals; dentures are removed and cleaned, and the mouth is checked for sores.
Traps
Questions often test whether you respect autonomy versus efficiency. Rushing a resident or doing tasks for them when they can do them is a common wrong answer. Another trap is ignoring a resident's refusal of care - refusal must be reported, not forced. Also watch for answers that skip hand hygiene, forget to check water temperature, or fail to report skin changes.
Worked example
A resident with diabetes has a reddened area on the heel. The correct action is to report it to the nurse and document it; the wrong action is to massage the area. Rule of thumb: redness over a bony prominence is a pressure injury warning - report, do not rub.