Performance of personal care tasks for clients, including: bathing, skin care, hair care, nail care, mouth care, shaving, dressing, feeding, assistance with ambulation, exercise and transfers, positioning, toileting, and medication reminding.
Personal Care
Just think of personal care as all the activities you do when you wake up each morning:
Toileting
Bathing
Brushing your teeth and hair
Dressing into your clothing
Caregivers assist seniors as they may have physical challenges or memory loss which require assistance to keep their personal care on track for the day. They may also have difficulty with easily moving and coordinating physical activities due to age-related illnesses and the natural aging process.
Personal Care Activities include the following:
Bathing
Skin Care
Hair Care
Mouth Care (brushing/dentures)
Shaving
Dressing
Eating
Feeding
Assistance with Ambulation
Exercise
Transfers from chair, toilet, bed
Positioning
Toileting
Medication Reminders
Bathing
Assisting seniors with bathing first requires assessing the bathroom to make sure necessary safety items are in place, such as grab bars and floor mats and shower chairs. Understand the size of the senior and obtain special instructions from the senior’s medical doctor or physical therapist for special equipment needed if physical challenges are present. Seniors recovering from a stroke or hip replacement, for instance, will receive physical therapy and advice on medical equipment for their bathroom.
Water temperature: check to be sure the water is warm and not hot
Secure soap, wash cloth and bathing utensils before the senior steps into a shower or bathtub.
Discuss how you will assist the senior in and out of the shower or bathtub
Discuss tasks senior can do themselves and promote their dignity by allowing them to do so
Towels and bathrobe: be sure the senior immediately has a warm, dry towel and clothing to put on
Non-slip mats and rugs: be sure the bathroom has non-skid and non-slip mats
Be sure necessary grab-bars are installed
Men may find warm water prompts an erection - stay professional and either ignore it or use light humor but be aware that this can happen
Seniors may sometimes refuse a shower or bath - call your Care Manager for guidance
Reassure the senior throughout the bathing or showering process
Skin Care
Skin care becomes vital when a senior becomes bedridden. The aging process causes skin to lose elasticity and become what we call “wrinkled” and thinner and more susceptible to bruising. In addition, dryness can also be a challenge. Avoid bed sores and maintain healthy skin care by doing the following:
Keep skin clean and dry
Use mild soaps, rinse well and dry thoroughly
Keep bed linens clean
Use disposable bed pads to wick away dampness and keep skin dry
Reposition the senior every 2 hour if they are bedridden
Massage skin gently when repositioning if confined to a wheelchair or bed
Use pillows, gel cushions, water cushions, or foam wedges to help reposition the body when a senior must remain in bed or chair
Investigate using plush sheep rugs or a foam egg crate mattress which can spread weight over a larger skin area
Encourage appropriate exercise to stimulate circulation or assist with moving the arms and legs if the senior cannot do so on their own
Avoid moisture: dampness or thick layers of lotions or general wetness can promote the formation of sores
Friction can cause a pressure sore on aging skin - avoid sliding, moving or sitting on a hard surface
Rashes or skin irritations may cause a break in the skin and promote pressure sore from forming
Just remember skin becomes delicate, just like you must be careful when handling an object you don’t want to drop and break, you must be very careful when caring for a seniors.
When a Senior Displays Resistance to Bathing
Sometimes you will care for a senior who no longer desires to keep up with their personal care habits and maintain personal hygiene. This can happen because the senior is experiencing:
Memory loss
Depression
Physical challenges
Fear of falling
Loss of smell or eyesight or continence
Nobody likes to be embarrassed because they can no longer easily maintain a daily function. Most seniors also fear losing control over their daily activities and reminders of the natural aging process happening to them. Perhaps they have heard about a neighbor or friend who no longer can live alone after falling and breaking their hip. They will often resist bathing when they feel they cannot easily do this on their own.
Seniors with memory loss such as Alzheimer’s disease also can become resistant to bathing. There are ways to combat this by implementing a strategy and supporting them to overcome their fears.
Watch this video for tips for assisting seniors who are resistant to bathing:
Hair Care
Seniors experience the natural aging process with hair care which includes hair-loss or natural hair color “going gray” (or white).
The process can be stressful, especially if a senior has hair loss or hair thinning accelerated cccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccbecause of medications or a newly diagnosed disease.
Hair salon or barber shop visit: try to facilitate visiting a hair salon or barber as long as the senior is able to leave their home as this establishes a feeling of inclusion in a social life and also can be a fun activity
Dry shampoo: available if the senior is bedridden
Comb, brush and style hair daily
Maintain all facial hair (waxing and tweezing by professionals if the senior cannot maintain facial hair upkeep themselves)
Explore wigs as options
Note: discuss bringing a hair-care professional to the home for cuts, styles and waxing if the senior cannot easily go to the salon or barber. Our hair texture, color and thickness changes as a natural part of the aging process. Each person has to decide how to manage through these changes. Hair care experts can help to discuss options for caring for these changes.
Teeth and Denture Care
Special dental care needs should be included in the senior’s care plan. Denture care will have a plan of action for cleaning to follow. Regular teeth cleaning includes brushing the teeth after meals and after awakening each morning and before retiring to bed. Some seniors will experience challenges with bad breath due to their own loss of smell and because of medications or certain digestive issues. Assist the senior to obtain a mouthwash and mints to maintain fresh breath throughout the day.
Remember, our sense of smell changes as we age too. This is why it can be easier for a senior to have a bad breath or spray on too much cologne - they simply are not able to smell as well anymore. Provide kind feedback to them to know if there is an unpleasant odor or perhaps too much of a good thing.
Dental Tips for Seniors
Toothbrushes: gums become more sensitive as we age. Brush teeth using a soft toothbrush. One way to make toothbrush bristles softer is to soak the brush in hot water or use a gauze-wrapped popsicle stick or cotton swab.
Rinse mouth with baking soda and 2 cups of water if mouthwash is not available.
Keep lips moist for mouth comfort: use lip balm
Use a flashlight to identify specific issues inside the mouth before reporting to a doctor
Contact a Care Manager if: gums bleed, you find sores or cuts in the mouth
Shaving
Refer to the Care Plan for the senior’s routing. If the senior can shave themselves, this is preferable, as they are able to maintain their dignity and life-long routine. However, the caregiver should monitor the senior before and after shaving and assist the process to go smoothly.
Dressing
Assist the senior in getting dressed each day based on their needs. Realize that getting dressed for the day is part of a healthy daily routine. If a senior does not want to get dressed, this could be a sign of depression or indicate they are not feeling well and you should explore why they are not in the mood to get dressed. Assist the senior with choosing their outfits, if this is needed. If a senior has physical limitations and needs help with dressing, discuss how you will be tackling the task ahead of time so that everyone will be comfortable. Remember to keep a sense of humor and to respect the senior’s dignity.
Eating
Refer to the senior’s care plan to follow their prescribed diet.
Remember that meals are a time to relax and enjoy each other’s company.
Everyone has favorite foods and has meal preferences for holidays and special occasions.
Establish a meal routine and monitor the senior’s eating for the care plan.
Follow a nutritious diet based on the senior’s health condition.
Variety is the spice of life.
Find ways to make meal time special by creating centerpieces and setting the table with different tablescapes.
NOTE: Changes in eating can be a sign of depression or other health issues and be sure to document this in the Daily Care Plan Notes and inform the Care Manager.
Make a pretty table setting complete with folded napkins and place cards with names - use your imagination! You could fold napkins together with your senior client and come up with ideas for special themes and make it a fun activity.
Feeding
Sometimes a senior will need assistance with eating and the caregiver will assist in feeding them and helping them drink. Discuss the routine and be mindful of their feelings.
Hydration
Drinking fluids is a key to healthy living. Make sure the senior drinks enough water throughout the day. Be aware that seniors with incontinence problems may want to avoid drinking liquids. OUr bodies are machines - they will operate according to a schedule and assist the senior to learn to eat and drink on a regular schedule to allow their body to also eliminate the fluids on a intake around schedule outing.
Signs of Dehydration include; urinary tract infections, confusion, lethargy, or dry skin.
20% of your Body Fluids come from Food = the other 80% should come from Beverages.
Feeding Tubes
A registered nurse, care manager or medical doctor will manage the feeding tube. The caregiver should follow the Care Plan instructions if assistance is needed in maintaining the liquid in the feeding tube, as prescribed, and draining and cleaning the feeding tube.
Assistance with Ambulation
Understand the senior’s walking limitations. Always be near a senior when they are walking and if they need a cane or walker, use the guard method of maintaining an arm near their waist or under their arm and shoulder. Always be next to a senior with ambulatory challenges in order to be able to block a fall.
Beware of Balance
Remember, balance issues can happen from changes in the inner-ear canal and even a senior with strong and healthy legs may lose their balance more easily as part of the aging process. Always stay near a senior you are caring for when they are walking.
Exercise
Physical exercise should be part of everyone’s routine at every age. Develop a healthy exercise routine you can do with the senior. Walking, legs lifts, arm lifts and dancing may all be options. An exercise routine should be included in the senior’s care plan. The National Institute of Health (NIH) also offers a booklet on senior exercises. Muscle mass loss will progress if a senior does not use their muscles. Especially if there has been a hip or knee replacement, exercise is vital to maintain the joint’s movement and avoid pain.
EXERCISE REMINDER: IF YOU DON’T USE IT, YOU LOSE IT!
Transfers from Chair, Toilet, Bed
Be Careful to perform safe transfers based on what is required for the size and capabilities of the senior.
Guard and assist when walking: drape your arm under the seniors arm and around their opposite shoulder when escorting for safe ambulation.
Gait Belt: use to assist with transfer from bed to chair and toilet and back
Transfer from bed to edge of bed: take another folder flat sheet (drawsheet), position under the senior from their neck to calves, roll the senior to one side, place the sheet under them, then use the sheet to pull the senior to the edge of the bed. Then swing their legs to the side of the bed to proceed with transfer.
Transfer from Bed to Wheelchair or Toilet: use gait belt and stay near the senior’s body.
Positioning
Being in a comfortable position in a bed or chair can be a welcome pleasure for a senior who may be struggling with age-related diseases. Discuss what position the senior prefers while sitting or sleeping and honor this. You will assist some seniors who have slept in a reclining chair for their naps for 20 years and this is what they prefer, rather then in bed. By understanding how the senior finds comfort while sitting or sleeping, you can assist them to be in a comfortable position. REPOSITION EVERY 2 HOURS, if the senior is bedridden or has memory loss and may not be aware of the neet to reposition.
Toileting
Safety and respect must both be considered when assisting a senior with toileting. As our body ages, the bowels and urinary tract may lose functionality. Diseases, medications and loss of physical capabilities from a stroke or hip replacement or heart surgery can all cause changes to toileting needs.
Types of toileting assistance include the following:
Catheter care
Incontinence care
Constipation
Catheter Care
Follow the instructions provided based on the type of catheter.
Usually you will just need to empty the container the catheter empties into.
Be very mindful that respecting the challenges of catheter care are vital.
One of the ways to successfully discuss this challenge is to put yourself in their shoes and tell the senior you know it is a challenge and that you want their feedback on how to make the process go smoothly.
Discuss the schedule for the catheter care and ask them if they would like you to check it at certain times throughout the day.
Incontinence Care
Loss of bladder and bowel control are not normal parts of aging. However, women who have had children are very likely to have loss of bladder control eventually. Medical solutions exist for loss of bladder control and bowel control and as a caregiver, you should discuss the situation with the senior to be sure their medical doctor has been informed.
Adult diapers are one solution that can be used if more advanced medical solutions or retraining programs are not performed. Todays adult diapers use modern technology and come in many shapes and sizes to make it very easy to be discreet.
Pee-proof underwear: these are also available in all shapes and sizes and even younger people are wearing these for protection…. Share with seniors that people of all ages are now wearing underwear that protects them from leakage.
In addition, going to the bathroom every 2 hours may be helpful.
Also discuss bedtime solutions such as special bed sheets or bed pads.
Remember, a regular eating and drinking schedule will result in regular times for elimination and will be helpful for seniors who are incontinent.
How to apply and change adult diapers:
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Constipation
Inactivity and medications can contribute to constipation. There are both natural remedies as well as medications which can help “loosen” the situation. Discuss the following with the senior and make sure they have informed their medical doctor.
Stool softeners
High fiber foods: fresh fruit, vegetables, prune juice
Drink more water: a full glass of water upon waking and throughout the day
Avoid foods such as: cheese, rice, bananas
Exercise as much as recommended
Review Medication side-effects
Call the Doctor if bowels aren’t “moving” regularly - daily bowel movements are a sign of a healthy digestive system.
Medication Reminders
A medication schedule should be included in the care plan. Reminding a senior to take their medication means monitoring the medication is taken.
As medication can impact appetite, sleep and mood, it is very important to understand the instructions for the medications and to monitor the medication schedule and any changes you may notice when medications are changed.
Prescription Drugs
Prescribed by a medical doctor
Over the Counter Drugs
Purchased over the counter by anyone at a store
Over-the-counter drugs may change the way a prescription drug works.
This means a caregiver must require the senior to obtain permission from their medical doctor if they want to take an over-the-counter medication. SOmetimes the senior’s care plan will include over-the-counter medications are appropriate but be sure to check with your Care Manager if a senior requests an over-the-counter medication.
Prescriptions Medications
Follow the medication chart created for the senior in their care plan.
Medication Monitoring Means:
Remind senior to take their medication at the time prescribed in the medication chart
Observe the senior taking the medication orally or applying a lotion or liquid
Document the medication was taken or applied
If the senior is refusing the medication, inform a Care Manager and document
Monitoring when refills will be needed
Pay attention to expiration dates on over-the-counter medications
Be mindful of foods and fluids to take or NOT to take with the medications
Documenting any new conditions which could be side-effects when a new medication begins
Note: A Care Manager will be managing the prescription medication refills.
💡 Tip Sheet
Bathroom safety equipment includes grab bars, shower chair and no-skid rugs, avoid bedsores by repositioning every 2 hours, exercise to stimulate circulation, use soft toothbrushes for sensitive gums