Topic: 9

How to Give a Bed Bath and Attend to Personal Hygiene

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What You Need to Know

People who are sick and weak and who are struggling to help themselves, have the same priorities as you do. They want for themselves what you want for yourself:

  • To maintain a sense of dignity and privacy, as much as possible;
  • To maintain a sense of control, as much as possible;
  • To be treated with respect, sensitivity and an awareness of their feelings; and
  • To avoid being a burden to their family and friends, as much as possible.

By focusing on the priorities, the experience of providing a bed bath will be more pleasant for both you and the person you are caring for. Helping with a Bath or Shower When the person can go into the bath or shower you may find the following tips useful:

  • Before the person goes into the bathroom, have all the things they will need ready. Run the bath and check the water for the person's preferred temperature. Have the soap, washcloth, shampoo and other items (razor blade, cream, etc) nearby. Have the towels within easy reach. If possible, put the towels in the dryer for two minutes to warm them up so the person can feel warm when they dry
  • Helping people to stand up or sit/lie down can be very difficult on your own body. It is important to remember all the rules of lifting and leaning over that you were taught in school. Remember to bend at the knees when you are picking up an object and keep your back as straight as possible. Remember as well, that the closer you are to the person or object you are lifting, the less strain you put on your lower back, arms and legs. Some regular squatting exercises will help strengthen your legs and lower
  • If you get quite sore by helping someone get up or down, ask your family doctor, visiting home nurse, occupational therapist or chiropractor to give you clearer instructions of how to lift someone properly so that you do not continue to hurt
  • Help the person into the bath or shower making sure you bend your knees slightly and keep your back as straight as you can. You may want to put a long towel under their arms to help lower them into the
  • If the person is able to help themselves more, you can help them sit on the side of the tub (on a warm, non-slip towel or mat), swing their legs over and help them to ease into the tub. Reverse the procedure when they want to get out.
  • Make sure the bath or shower has a non-slip bath

If the person needs help for weeks or months, it may be wise to adapt your bath or shower with handles and other safety aids. Check with an occupational therapist or physiotherapist through your home care program.

  • If the person prefers a shower, rent or borrow a bath chair or use a water- resistant chair so they can sit down comfortably. Your home care program may be able to arrange
  • The person may feel more comfortable if their genital area is covered. You can use a short apron or modified towel with Velcro tabs so the person has the privacy they

(“Caring for the Terminally Ill: Honouring the Choices of the People, Person/Family/Community, 3rd Edition, August 2014)

How to Give a Bed Bath

Remember to wash another person as if you were having the bath given to you. The bath is a form of exercise for the person being cared for, even if you are doing it for him or her. Even with you doing the moving and lifting of limbs, the person still must use their own energy to assist you.

 Step 1: Wash your Hands and Gather Equipment Wash your hands with warm, soapy water if available or with a hand sanitizer. How long should you wash your hands? How long it takes to sing “Happy Birthday” is just about right.

 Step 2: Gather the supplies that you will need

  • Flannel sheet to cover the person
  • Two washcloths and two towels-one set for face and body, other set for genital care
  • Soap and soap dish
  • Moisturizer
  • Clean pajamas, nightgown, or clothes, underwear, socks
  • Incontinent brief if required
  • Clean sheets
  • Basin of warm water
  • Note: Vaseline is not to be used if a person wears oxygen. Powder should be avoided as it is a lung irritant and, if spilled, can cause slippery floors.

Step 3: Prepare the person to be washed

  • Remove the blankets
  • Check the basin of water for warmth-not too hot, not too cold
  • Wet the washcloth; many people prefer no soap on their face.

Step 4: Wash the Person’s Face, Neck, and Behind Ears

  • Wash the face first, making sure to carefully wash eyelids, wiping from the inside corner outward.
  • Wash behind the ears and the back of the neck
  • Rinse the cloth out
  • Dry well

Step 5: Wash the Arms and Hands

  • Remove the pajamas
  • Uncover one side of the body first
  • Soap up the same wash cloth that used for the face
  • Lay a towel under one arm of the person. Wash the arm and hand and between fingers. Rinse off all the soap, and dry well
  • Wash the armpit
  • It is a good idea to place the person’s hand right in the basin of warm water.

Step 6: Wash the chest, abdomen, back, each leg, and then feet

  • Wash the chest first, then the abdomen, leg and foot
  • Rinse as many times as needed to get all the soap off
  • When drying, make sure the skin under women’s breasts is dry.
  • You may want to use some moisturizer on the back, arm, leg, foot or other dry skin areas to soothe and comfort the person. Remember to be gentle.

Now repeat Steps 4 and 5 on the opposite side of the body first covering up the washed side.

Step 7: Wash the genital area

  • Using the second wash cloth, clean the genital area by folding the washcloth like a mitt and wipe the area with a small amount of soapy water.
  • Rinse and dry thoroughly.
  • Never use the water for washing after you have cleaned the genital areas.

Step 8: Put the patient in clean pajamas or clothes.

Step 9: Dispose of the water and washcloths and towels.

  • Put the wash cloths and towels in the laundry.

Watch this video to see a demonstration of a caregiver giving a person a bed bath at home.

General Hair Care

People need their hair clean, combed/brushed (at least twice a day), cut and set. The condition of one's hair often tells visitors and the person themselves how well they are doing. Clean and groomed hair is important for good health and feeling good about yourself. Dry Shampoo You can wash someone's hair using 'dry' shampoo like a commercial dry shampoo, cornstarch or natural (unscented) talcum powder. For someone who needs their hair washed in bed, dry shampoo can sometimes be a quick alternative to a normal wash. Do the following:

  1. Place a towel under the person's
  2. Sprinkle powder on the scalp and massage the hair and scalp
  3. Brush the powder out of the hair with slow, even strokes. If hair is tangled, hold it firmly near the scalp before brushing through to the end.
  4. Wash the hairbrush after each dry

Wet Shampoo If the person needs a normal hair wash but cannot use the bath or shower, you can wash their hair in bed. You will need:

  • A plastic sheet to protect the bed
  • A waterproof cape (like in a hair salon) or a plastic garbage bag with a hole for the head and cut along the sides to make a cape
  • A jug or pitcher of warm-to-hot water (several if the person has long hair)
  • A bucket or large basin to collect water, (there are also special shampoo trays available through some drug stores)
  • A wash cloth or small towel, plus two larger towels for drying
  • Pillow(s)
  • Shampoo
  • Comb or brush
  • A hair dryer (if needed)

To help the person wash their hair if they are not able to do it themselves:

  • You may want to put a towel or plastic sheet on the floor under the bucket to catch any spilled
  • Have the person lie on their back with their head over the side of the bed (adjust pillows, covers, etc. so they are comfortable). Put the bucket or basin on a small table under the person's
  • Cover the area with the plastic sheet and have the person wear their cape with the back side covering their pillow rather than tucked under
  • Pour warm water from the jug over their hair so that the water falls in the bucket or basin
  • Put the shampoo into the hair and gently massage it in to lather the hair and scalp.
  • Rinse the hair with the remaining
  • Dry the hair with a towel and then with the dryer if
  • Empty the bucket and tidy up the bed. Remove the cape and plastic sheet. Place the other dry towel on the pillow to soak up any moisture still in the hair.

Other tasks like setting or coloring the hair can be done in bed using the same common sense approach to comfort and cleaning as described here. (“Caring for the Terminally Ill: Honouring the Choices of the People Person/Family/Community 3rd Edition August 2014)

Personal Hygiene

The person that you are caring for may be susceptible to colds and viruses that visiting family and friends may carry into your home.

The Chain of Infection

Organism: This is where it all begins. Any microorganism can cause illness including a bacterium, a virus, a parasite, a fungus. Organisms can cause an infection because they have the ability to multiply and grow and they have the ability to enter tissue.

Reservoir: This is the place where the microorganism resides, thrives and reproduces. It could be on a toilet seat, in mucous droplets, in a glass of water, in human feces, on a door knob, a tissue, etc.

Portal of Exit: This is the place where the organism leaves the reservoir. It could be a nose, mouth, blood or vomit etc.

Transmission: This is the means by which the organism transfers directly or indirectly from one person to another. If the mucous droplets that are shot out during a sneeze and land on you, then the organism has transferred directly to you. The same can happen with feces or blood or urine, or saliva, etc. or the organism can be transferred to you indirectly if you pick up a dirty Kleenex, or a used drinking glass etc.

Portal of Entry: This is the place where the organism enters your body such as an open wound, a feeding tube, a urinary catheter, a mouth, a nose etc.

Vulnerable Host: Several factors make a person at risk or more susceptible to the infection including age (young and elderly people are generally more at risk), underlying chronic conditions such as illness, diabetes, asthma, conditions that weaken the immune system like HIV, chemotherapy, feeding tubes, open wounds etc., lack of sleep, poor nutrition, etc.

How can you protect the person and yourself from getting sick?

The way to stop germs, infections, viruses, bacterium from spreading is by breaking this chain at any link.

Break the chain!

  • DO wear gloves whenever you come in contact with anything that is “ooey, gooey, wet, not yours”.
  • DON’T touch your face when wearing contaminated gloves.
  • DON’T touch surfaces when wearing contaminated gloves.
  • DO WASH YOUR HANDS FREQUENTLY
  • DO stay up to date with your vaccines and flu shots.
  • DO cover coughs and sneezes.
  • DO clean and disinfectant the environment regularly.
  • DO follow safe injection practices.
  • DO follow prescriptions exactly.
  • DO use dishwashers with sanitize settings.

Remember these simple rules!

Will your hands be exposed to blood, excretions, secretions, contaminated towels or linens? WEAR GLOVES

Will your face be exposed to coughing, sneezing, a spray? WEAR A MASK

Wash Your Hands Often Watch the video by Public Health Ontario to make sure that you are washing your hands correctly. https://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/JustCleanYourHands/Pages/JCYH-videos.aspx

How to Make a Simple Household Disinfectant 

1 part water, 1 part rubbing alcohol or Hydrogen peroxide  Spray and leave after you’ve cleaned a surface, Use only use where required i.e. points of contact in the bathroom.

  • Rubbing alcohol– at least 65% USP in order for it to qualify as a disinfectant, can be mixed with water
  • Hydrogen peroxide– naturally occurring bleach, used in Oxy powders. Uses oxygen to break bonds between dirt and bacteria and the surface they are on. A great disinfectant, stain remover and natural whitener.

How to Give a Simple Massage

People dealing with a variety of issues—some that are physical and some that are more emotional—can benefit from a simple massage. Very slow, gentle and gently applied techniques are the most appropriate. The overarching goal is to provide comfort without doing harm and, as with all massage, tailoring the massage to the individual. Remember:

  • The massage should not be painful. It should feel good. Be sure to check if the pressure is comfortable.
  • Don’t massage anything that feels bony. Bones don’t relax. They also tend to be very pain sensitive. So everything you massage should feel relatively soft.

To learn how to give a massage visit: https://www.goodnet.org/articles/5-relaxing-massage-techniques-anyone-do-at-home

 

Complete the chart below. For each task explain how you could break the chain of infection. If you can’t think of an answer, review the content above.

Task: You pick up dirty dishes from the person’s meal including a drinking glass, fork, knife, plate and a used napkin.

How will you break the Chain of Infection? You assist the person with toileting.

How will you break the Chain of Infection? You help the person brush their teeth.

How will you break the Chain of Infection? You change a dressing as the nurse has shown you.

How will you break the Chain of Infection? You give a bed bath.

How will you break the Chain of Infection? You provide the person with their medications.

How will you break the Chain of Infection?

 

Use these additional resources to learn more about the topic.

Community & Home Assistance to Seniors: Infection Prevention and Control
http://www.chats.on.ca/InfectionControl

Caregiving Takes a Toll on your Back
http://www.nextavenue.org/keep-caregiving-taking-toll-your-back/

Protecting your Marriage while being a Caregiver for a Loved One
http://www.3rdactmagazine.com/aging/care-caregiving/protecting-marriage/

The Flu
https://www.ontario.ca/page/flu-facts

Changing an Occupied Bed