Personal Care Skills
What you must understand
Personal care is where dignity is won or lost. Always provide privacy - close the door, pull the curtain, expose only the body part you are washing - and explain what you are about to do. Gather supplies first so you do not leave the resident alone and uncovered.
Key techniques: wash from clean to dirty, and wash eyes from the inner corner outward using a different part of the cloth for each eye. Give perineal care front to back, washing the urethral area first. In bed baths, wash the face and upper body first, change the water when it becomes soiled, and keep the resident covered except for the area being washed. Check water temperature before use and never leave a resident in the bath or shower unattended if they are at risk.
For dressing, dress the affected (weak) side first and undress the affected side last. For oral care, brush teeth and gums, and clean dentures over a basin or towel - never in hot water, which warps them. For shaving, use an electric razor for residents on blood thinners or with bleeding disorders. Do not cut the toenails of a resident with diabetes or poor circulation; report to the nurse. Encourage self-care: hand the resident the washcloth, let them brush their own teeth, and only finish what they cannot do.
Skin care and pressure injury prevention belong here: turn and reposition at least every two hours, keep skin clean and dry, inspect bony areas, avoid dragging the resident across sheets, and report any reddened area that does not blanch.
Traps the exam sets
- Washing back to front in perineal care.
- Cutting a diabetic resident's toenails, or soaking their feet without an order.
- Cleaning dentures in hot water or in the sink without padding.
- Doing the whole bath for a resident who can wash their own face and hands.
Rule of thumb
Front to back, clean to dirty, and never more exposure than the task requires. Worked example: for Mrs. L's perineal care, you close the curtain, put on gloves, wash from the front toward the back, rinse, pat dry, and report any redness or discharge.