Basic Patient Care and Activities of Daily Living
What ADLs cover
Activities of daily living are bathing, grooming, oral care, dressing, toileting, feeding, mobility and transferring. Your role is to assist the patient to do what they can for themselves, and to do for them only what they cannot do. Independence preserves dignity and prevents complications.
Core care tasks
- Bed bath: cleanse from cleanest to dirtiest – eyes (inner to outer, separate corner of cloth), face, neck, arms, trunk, legs, then perineum last; change water when soiled; keep the patient covered except the area being washed.
- Pressure area care: inspect skin at each turn; keep skin clean and dry; reposition at least every two hours; use pillows to offload heels and sacrum; report any red, non-blanching area.
- Oral care: every shift and after meals; dentures removed and cleaned; unconscious patients need suction available.
- Feeding: sit the patient upright, check for choking risk, feed slowly, record intake.
- Elimination: offer bedpan/urinal at planned intervals; measure and record urine output; perineal care after each episode.
- Bed making: occupied and unoccupied; never leave the bed rails down on a restless patient.
Worked example
A bedridden elderly patient has a red area over the sacrum that does not blanch on pressure. Reasoning: this is early pressure damage. Reposition immediately, keep the area clean and dry without vigorous rubbing, offload with a pillow, document the site and size, and report to the nurse the same shift. Do not apply talc or massage the red area.
Traps
- Washing the perineum first.
- Repositioning “when convenient” rather than by schedule.
- Feeding a drowsy patient lying flat.
- Not recording intake and output, so dehydration is missed.