Personal Care and Activities of Daily Living
Core concepts
Personal care is where dignity is either protected or damaged. Know the sequence and safety points for bed baths, showers, and partial baths, with attention to water temperature, privacy, and draping so only the body part being washed is exposed. Perineal care is always front to back, using a clean area of the washcloth for each stroke, which helps prevent urinary tract infection. Oral care includes brushing natural teeth, cleaning dentures over a basin lined with a towel (never in hot water, which warps them), storing them in a labeled container, and giving mouth care to an unconscious resident with the head turned to the side and no liquids.
Skin care links directly to pressure injury prevention: reposition at least every two hours, keep skin clean and dry, avoid massaging reddened bony areas, keep heels off the mattress, and report redness that does not blanch. Range of motion, whether active or passive, is done gently within the resident's limits and never past the point of pain.
Dressing rule: dress the weak or affected side first, and undress that side last. Encourage residents to do whatever they can for themselves, because independence in ADLs is a care goal, not a convenience issue.
Traps
Watch for questions about cutting a diabetic resident's toenails (do not; report), feeding a resident with dysphagia (sit upright, small bites, follow thickened-liquid orders, stop and report choking signs), and using hot water on skin or dentures.
Worked example
A resident with right-sided weakness needs a shirt. Put the right sleeve on first, then the left, and reverse that order when undressing.
Rule of thumb
Weak side first to dress, weak side last to undress.