Personal Care and Activities of Daily Living
Bathing and hygiene
Gather everything first, provide privacy, keep the resident covered, and let them do as much as they can. Wash from clean to dirty, from proximal to distal on the limbs, and front to back at the perineum, using a fresh area of the cloth for each stroke. Bathe the face with plain water and wash eyes from the inner to the outer corner. In a complete bed bath, save the perineum for last.
Mouth, hair, nails, feet
Brush teeth at least twice daily. Provide mouth care to an unconscious resident by turning the head to the side, using a small amount of water with suction, never with the head flat. Clean dentures over a basin of water - a dropped denture breaks - and store them in a labeled cup. Do not cut the toenails of a resident with diabetes or poor circulation; report to the nurse. Shave in the direction of hair growth with warm water.
Dressing and grooming
Dress the weak side first; undress the strong side first. Encourage the resident's own clothing choices.
Skin and pressure
Check skin at every bath and every repositioning: redness, warmth, blisters, or breaks over the sacrum, heels, hips, elbows, and ears. Reposition at least every two hours, keep skin clean and dry, and never massage a reddened area.
Traps
Questions about cutting diabetic toenails, soaking dentures in hot water, or rushing a resident who can do part of the task. Independence is the goal, not speed.
Rule of thumb
Work clean to dirty and proximal to distal; when in doubt about skin, report rather than treat.