Personal Care and Activities of Daily Living
Promote independence while getting the job done
Personal care is where dignity is won or lost. Provide privacy, explain what you are about to do, gather supplies first, and let the resident do every step they can still do - washing the face, holding the toothbrush, choosing the shirt. Encouraging independence is a scored behavior, not a courtesy.
Know the sequences. In a bed bath, wash eyes from the inner to the outer corner with a different area of cloth, then face, neck, arms, chest, abdomen, legs, back, and perineum last - clean to dirty, face to feet. Always wipe perineal care front to back. For oral care on an unconscious resident, position them on their side, use suction or a minimal amount of fluid, and never use water they cannot swallow. Store dentures in a labeled cup, never in hot water or a tissue. Do not cut the toenails of a resident with diabetes or poor circulation, and do not soak fragile feet - report to the nurse. Shave with the direction of hair growth; use an electric razor unless policy permits otherwise.
Dressing rule: put clothing on the weak or affected side first, and remove it from the strong side first. Reposition at least every two hours, inspect skin with every change, keep heels off the mattress, and report any redness that does not blanch. Check water temperature before a bath.
Traps. Answers that do the task for a capable resident for speed, or that skip privacy in a shared room.
Rule of thumb. Wash clean to dirty and front to back; dress the weak side first.