Personal Care and Activities of Daily Living
Bathing and hygiene
Gather supplies first, offer the toilet, explain the steps, and provide privacy throughout. Check water temperature before the resident gets in and stay with a resident in the tub or shower. Wash from clean to dirty: face and upper body first, perineal area last. During every bath you are also observing skin, so note redness, rashes, bruising, or breaks and report them.
Mouth, hair, nails, and devices
Provide oral care at least twice daily and after meals. Remove dentures over a basin or towel, clean with a brush and cool water, and store them in a labeled cup. For an unconscious resident, use a mouth swab with the head turned to the side and no water. Shave with an electric razor unless the care plan permits otherwise. Do not cut the toenails of a resident with diabetes or poor circulation; report the need instead.
Dressing and perineal care
Dress the weak or affected side first, then the strong side; undress the strong side first. Perineal care is always front to back, washing the urinary area before the anal area, using a clean portion of the cloth each stroke.
Traps that appear on exams
Massaging a reddened area over a bony prominence, using a safety razor on a resident taking a blood thinner, leaving a resident alone in the tub, or trimming a diabetic resident's toenails are all wrong answers. So is telling a resident they cannot have a bath because it is not their scheduled day; negotiate a time that works for them.
Rule of thumb
Clean to dirty, front to back, and check the water before the resident checks it for you.