Personal Care and Activities of Daily Living
What this domain covers
Personal care includes bathing, oral and denture care, perineal care, nail and hair care, shaving, dressing, bed making, toileting, feeding, and mobility. The exam tests whether you protect privacy and dignity, promote independence, and notice changes in the skin or the resident's condition while you work.
Core concepts
Bath water should be comfortably warm, never hot, and tested before use. Drape the resident so only the body part being washed is exposed. Perform perineal care front to back to reduce infection risk. Store dentures in a labeled cup, never in hot water or wrapped in a tissue. For an unconscious resident, give oral care in a side-lying position and do not put fluids in the mouth. Check the skin at every turn: a reddened area over a bony prominence that does not blanch is an early pressure injury and must be reported. Reposition at least every two hours, keep heels off the mattress, and never massage a reddened area.
For dressing, dress the weak or affected side first, then the strong side; when undressing, reverse the order. Encourage each resident to do whatever they can for themselves, and allow choice wherever safety permits.
Traps that appear in questions
- Cutting a diabetic resident's toenails or corns instead of reporting them.
- Feeding a resident who is lying flat, or giving thin liquids to someone on thickened liquids for dysphagia.
- Using a bath as an opportunity to chat about other residents or to rush a resident who is slow.
- Choosing a task-centered answer over one that preserves privacy, dignity, or independence.
Rule of thumb
Weak side first when dressing, strong side first when undressing.
Worked example
A resident with right-sided weakness needs a shirt. Put the right sleeve on first, bring the shirt across the back, and then place the left sleeve. To remove it, take the left sleeve off first, then the right.