Personal Care and Activities of Daily Living
Bathing and hygiene
Gather supplies first, explain the plan, offer choices, and provide privacy throughout. Wash from clean to dirty: eyes first with a clean corner of the cloth moving from inner to outer corner, then face, neck, arms, chest, abdomen, legs, back, and finally perineal area. Wash the perineal area front to back to prevent urinary infection. Keep the resident covered except for the area being washed, and check skin folds, heels, and pressure points as you go. For mouth care, brush teeth and gums, and with dentures remove both, clean over a lined sink or basin, and store in a labeled cup. For an unconscious resident, position side-lying, use a small amount of solution, and suction or allow drainage - never leave fluid in the mouth. Diabetic residents' nails and feet are not trimmed or soaked by the aide; report problems to the nurse.
Skin, positioning, and dressing
Reposition at least every two hours, keep heels off the surface, and never massage a reddened area. Dress the weaker or affected side first, then the stronger side; undress the strong side first.
Toileting and catheter care
Offer toileting on a schedule, answer call lights quickly, and clean front to back. For catheter care, wash from the meatus outward with a circular motion, never pull on the tubing, and keep the bag below the bladder.
Traps
Watch for washing back to front, soaking a diabetic's feet, leaving a resident without the call light, bathing with water that is too hot, or skipping privacy.
Rule of thumb: clean to dirty, head to toe, front to back - and let the resident do whatever they can do themselves.