Personal Care, Hygiene, and Grooming
Clean to dirty, front to back, cover what you aren't washing
Personal care is where dignity is won or lost. Before you start: gather supplies, explain what you will do, provide privacy (door, curtain, drape), and test water temperature. Wash from clean to dirty and from front to back - eyes and face first with a fresh corner or cloth, then the body, with perineal care last. Change washcloths and water as they soil. Expose only the area you are washing.
Perineal care on a female resident is always front to back to keep stool away from the urethra; on an uncircumcised male, gently replace the foreskin. Oral care is given at least twice daily and after meals; for an unresponsive resident, turn the head to the side, use a small amount of water and suction per policy, and never put fingers in the mouth. Dentures are removed, brushed, and stored in a labeled cup of cool water - hot water warps them.
Nail and foot care: never cut corns, calluses, or toenails on a resident with diabetes or poor circulation - report and let the nurse or podiatrist handle it. Soaking diabetic feet is avoided. Shaving with an electric razor is safer for residents on blood thinners. Check skin folds, heels, and bony areas for redness during every bath and report anything new.
Dressing tip: undress the affected or painful side first, and dress that side last. Give the resident choices and let them do what they can.
Traps: washing the perineum before the face, leaving a resident uncovered, cutting diabetic toenails, or storing dentures in hot water.
Rule of thumb: clean to dirty, front to back, and keep everything covered except the part you are washing.