Personal Care Skills
Pre-care basics
Personal care covers bathing, oral care, hair, nails, shaving, dressing, toileting, perineal care, bed making, and skin care. Every task has a dignity and independence component: knock, identify yourself, explain, close the curtain, expose only the body part you are washing, and let the resident do whatever they can do even if it is slower. Check bath water temperature with a thermometer or your inner wrist - about 105°F (40°C) - and never leave a resident alone in a tub or shower.
Order matters
Wash from clean to dirty: face and upper body first, then trunk and limbs, then the perineal area last, changing washcloths and water as needed. Perineal care always goes front to back so stool stays away from the urethra. For the uncircumcised male, clean the tip and replace the foreskin. Oral care continues for NPO and unconscious residents - position an unconscious resident on the side and use no water.
Traps
- Cutting a diabetic resident's toenails yourself, or soaking feet without an order.
- Using a disposable razor on a resident taking blood thinners (use an electric razor).
- Cleaning dentures over a hard sink; line it or use a basin.
- Storing dentures dry - they must sit in water in a labeled cup.
Rule of thumb
Never do for a resident what they can do for themselves; assist only the parts they cannot manage.
Worked example
During a bed bath, your resident can wash his own face and chest. Hand him the washcloth, let him do those areas, then wash his back, legs, and feet - and document how much he did independently.