Personal hygiene is one of the most effective ways to protect ourselves and others from illness. Hygiene doesn’t just keep a person clean – hygiene helps the skin fight infection, hygiene prevents injuries, hygiene removes substances from the skin that might promote the growth of bacteria and hygiene keeps a person’s mouth and gums healthy. Good personal hygiene makes a person feel more comfortable and relaxed, while boosting their spirits. A person who is clean and well-groomed is pleasant to be around.
While most older adults and people with mental illness or mental retardation are capable of taking care of their own personal hygiene needs, many need help. The type of help and the amount of help that is needed will be identified through an assessment. In providing assistance, from the beginning, it is important to communicate to residents two important things:
- He/She is expected to do as much as they can do for him/herself and not be overly dependent on direct care staff persons. Keep in mind however that residents are in a personal care home because they need personal care services, and it is the job of the direct care staff person to help provide these services.
- The resident’s preferences of personal hygiene will be respected.
Maintaining personal hygiene enhances an individual’s physical and emotional well-being. Yet, when it comes to a person becoming dependent on you to keep their skin, nails, hair and mouth clean, he/she can experience a deep loss of independence and self-esteem. With this in mind, remember that self-care is always the goal. Although it may take longer for a resident to do a particular task, it is best for the resident to do as much as they can for him/herself. For example, someone who is paralyzed from the waist down and still has movement of their arms, can brush their teeth and wash their face. This keeps the resident from becoming completely dependent and losing self-help abilities. It also helps the resident to feel capable and it is good exercise.
The way in which you assist with personal care and hygiene ties to feelings of self-esteem and can reinforce the feeling of being valued. Does the resident prefer to take a shower or bath at night or in the morning? Many adults have been doing personal care routines for many years and these rituals have become engrained in daily schedules. Also keep in mind that personal hygiene habits can vary from culture to culture. When you attempt to understand and respect cultural differences related to personal hygiene, you convey respect for the individual. This will help build a positive relationship between you and the resident. Providing the option to continue with personal choices and routines will certainly help the resident feel comfortable and in control.
Bathing can be an enjoyable and refreshing experience. A bath can be therapeutic by improving blood flow, easing discomfort and helping the resident to relax.
Always listen, consider and try to accommodate the wants and wishes of the resident’s bathing routine. The following is a list of ways in which you may assist a resident with a shower or tub bath, depending on his/her level of independence in bathing:
- Gather all needed supplies ahead of time, prior to getting the resident into the bath or shower.
- Make sure the bathroom is a comfortable temperature and the door is closed to give as much privacy as possible.
- Make sure there is a non-slip safety mat (or other surface) on the bottom of the shower or tub to prevent falls.
- Place a shower bench or seat in the shower so the resident can sit down while he/she showers.
- Place a nonskid bathmat (not a towel) on the floor in front of the shower or tub.
- Be aware that an older person’s skin is thin and sensitive to high temperatures, irritation and harsh soaps. Be aware of any health problems that may be affected by water temperature.
- Check the water temperature and water pressure and make adjustments before the resident gets into the tub or shower. Never turn on hot water once the resident is in the tub or shower.
- Be aware that getting into and out of a tub may be difficult for the resident and offer assistance if needed.
If a resident is unable to enter a tub or shower, but still wants to personally care for his/her hygiene, a good alternative is to provide a washbowl or assist them in using the sink. Providing this alternative allows the person to move at their own pace while giving them the independence of caring for him/herself. Offer the resident the option of standing or sitting on a stool or chair.
An individual’s appearance makes a statement about how they feel about him/herself. Encourage the resident to care for his/her hair so that they can present a neat and attractive appearance. Washing, drying and styling a resident’s hair can take 30-60 minutes. Consider scheduling a shampoo on a non-bath day to conserve the resident’s energy.
Hair should be combed or brushed every day to stimulate scalp circulation and distribute natural oils to the ends of the hair shafts. A daily washing is not necessary, but hair should be washed on a regular basis, at least once a week, with a mild, non-irritating shampoo. Include the resident in the planning of this routine. Be sure to check the individual’s hair and scalp before each shampooing to determine if any changes are needed in things like the type of shampoo.
Skin changes with age. But the fundamentals of keeping aging skin clean and healthy aren't very different from those of caring for young skin.
Normal skin changes in aging include:
- The outer layer of skin begins to thin making it more sensitive and easier to damage.
- The normal fat layer under the skin begins to disappear. This makes it easier for an elderly person to develop pressure sores as well as feel colder more quickly.
- Oil glands do not function as well and this makes the skin dryer. The skin begins to sag and wrinkle and it is easily bruised; bumps and scrapes tend to tear it. Dry skin is also more sensitive to chemical irritants, soap, infection and poor hygiene.
- Liver or age spots appear on the face, arms and back of hands.
- Sweat glands decrease in activity and this makes it harder for an elderly person to lower their body temperature in hot weather.
- Blood flow to the skin decreases and this makes it harder to heal skin injuries.
The nails of an older adult tend to be ridged, grooved, thick and brittle. They grow at about half the rate than those of younger adults. Weekly attention to an older adult’s hands keeps nails attractive and in good condition. This should include:
- Wash hands under running water and clean under the nails using the pointed end of an orangewood stick (a kind of wooden stick with a rough surface that is used in manicuring nails). After cleaning, be sure to rinse the orangewood stick off or dispose of it. The use of a metal instrument may roughen the nail and make it easier to collect dirt.
- Massage the nails and cuticles with a lotion. Make sure to massage the sides of nails and the areas where the nail extends over the finger. This massage stimulates circulation, and this helps strengthen nails and prevent thickened nails. Lotion massaged on cuticles helps to prevent hangnails.
- Soak the nails in warm, soapy water for 3-5 minutes. This will make the cuticles and nails softer and easier to manipulate.
- Push cuticles back gently. Harsh rubbing or poking at the cuticles can cause them to split into hangnails and could cause infection.
- Shape nails into an oval using the fine side of an emery board, making sure not to file too close to the sides of the fingers. Filing too close to the side of the finger could cause injury to the cuticle and skin around the nail. Cutting the nail tends to make them brittle. Move the emery board in one direction rather than using a sawing motion that can leave rough edges.
Good mouth care is valuable to the health and well-being of everyone, but it is especially important to the health and well-being of the elderly and persons with mental illness or mental retardation.
As a person ages, soft tissues of the teeth tend to harden. Pain perception is reduced so it is more difficult to detect painful toothaches. Gum tissue recedes from around the teeth and oral membranes become pale and dry. Aside from dental problems, older adults are more prone to problems with the gums, salivary glands, lips, muscles and jawbones. Tobacco smoke, food pigments and saliva salts cause discoloration of teeth that cannot be removed by surface cleaning. Be aware that the amount of saliva (which cleans teeth) decreases with age, leaving the mouth more vulnerable to tooth decay and infection. Pair that with the inability to brush and floss, and the risk soars.
Good oral hygiene prevents sores and bad breath and keeps mucous membranes from becoming dry and cracked. Poor oral hygiene can contribute to poor appetite, leading to weight loss and malnutrition. Poor oral hygiene is also associated with the development of pneumonia in older adults. It is extremely important that you encourage residents to brush their teeth daily, especially at bedtime.
Regular brushing and flossing can prevent decay and mouth disease, improve blood flow and enhance appetite. Additionally, the individual will look and feel better. Dentures also need regular care to ensure a healthy mouth and should be checked regularly for proper fit. Dentures should be cleaned at least once a day to prevent staining, bad breath and gum irritation. If you assist a resident with oral hygiene, examine the mouth on a regular basis for signs of redness, swelling or bleeding. A dentist should check any red or white spots or sores that bleed and do not go away within two weeks.
Regular teeth brushing will also prevent bad breath making it more pleasant for friends, family and other people to be around the resident.
- Training Overview
- Safe Management Techniques
- What are ADLs and IADLs?
- Personal Hygiene
- Care of Residents with Dementia/Mental Illness/Mental Retardation
- Gerontology and Normal Aging
- Assessments and Support Plans
- Nutrition, Food Handling and Sanitation
- Recreation, Socialization, Community Resources, Social Services and Activities in the Community
- Meeting the Care Needs of Residents in a Culturally Diverse Environment
- Safety Management/ Hazard Prevention
- Infection Control
- Care for Individuals with Mobility Needs