Day-to-Day Care

 

Personal Hygiene:  Bathing the Patient

 

 

Purposes of Bathing

 

Cleanse the skin.  Bathing remove dirt, perspiration, sebum, some bacteria, and slough off dead skin cells.  It helps to prevent irritations and rashes that would otherwise transform into infections.
 
Stimulate blood circulation.  Good circulation is promoted through the use of warm water and gentle stroking of the extremities.  You feel revitalize and relax through the washing process.
 
Improved self-image.  Bathing promotes relaxation and a feeling of being refreshed and comfortable.  It helps you to maintain an acceptable social standards of cleanliness, both appearance and olfactory.
 
Reduce body odors.  Excessive secretion of sweat cause unpleasant body odors.  Bathing and use of antiperspirants minimise odors.
 
Promote range of motion exercises.  Movement of the upper and lower extremities during bathing maintains joint function.
 

 


Items Required for Bed Bath

 

Essential toiletries (e.g.. talcum powder, mouth gargle, nail clipper)

Basin with warm water (temperature adjusted to patient's comfort)

Wash towels for cleansing the body

Moist cotton wool for washing the genital area

Toilet paper

Bath towel

Face towel

Bed linen as required

Clean clothes

Disposable diapers (optional)

 


Giving a Bed Bath

 

A patient who cannot get out of bed need to have his bathroom needs attended in bed.  Bed bath should be performed at least once a day. Find out the patient's preferences for bathing practices, such as frequency of bathing, time of day bathing preferred, and type of hygiene products used.

 

Tips on Giving a Bed Bathing:

 

Make sure that the fan or air-con is switched-off to prevent the patient from catching chills.

 

Offer a urinal or bedpan, if required, before bed bathing.

 

Prepare all the items you need and bring them to the bedside so that they are within reach. 

 

Be comforting.  Don’t rush through the procedure!

 

Be sure the water temperature is not extreme.

 

Allow patient to participate as much as his condition allows.

 

Expose only the areas to be cleansed to preserve modesty.  For example, cover top half of body while washing legs.

 

To reduce embarrassment, talk to the patient throughout the procedure.

 

Begin by washing and drying the face, then the neck and ears, then the chest and arms.

 

Change water as often as necessary.

 

 

Continue with the lower part of the chest, abdomen and sides of the body, followed by the umbilicus and lower limbs.

 

 

The patient is then turned and his back thoroughly washed and dried.

 

Tidy the bed at the same time when the patient is turned on his side for you to clean his back.  Remake the bed with clean linen, if necessary.

 

 

Wash the groins and genitalia region with moist cotton wool.  If the patient is well enough, he should do this for himself.

 

Always wash and dry the areas immediately.  Pay special attention to the skin folds, particularly those beneath the breasts, in the groin and between the buttocks and between the toes.

 

Be sure to pat your patient dry, and remember that rubbing can be harsh for sensitive skin.

 

Take this opportunity to assess the skin condition.  Take note of any redness or broken skin.

 

Take this opportunity to massage pressure areas with firm circular movements to promote circulation.

 

Apply skin lotion to keep skin soft and supple.  Excessive use of talcum powder should be avoided as it can cause the skin to be dry and itchy. This can lead to skin infection.

 

 

 

Self-Wash in Bed
 
This procedure is required if the patient is unable to get out of bed but is capable of washing himself.

 

Make sure the patient has privacy and the room is kept warm.

 

Explain the procedure and offer a bedpan or urinal before you begin.

 

Close the door and draw the curtains to ensure privacy.

 

Provide a basin with three-quarters full of warm water.  Collect all the washing equipment and put them on the bed table across the bed so that they are within reach.

 

Undress the patient, if he needs help, and make sure he is covered by a sheet or blanket.

 

Allow the patient to wash in private.  Ask him to wash his genitals last and to call you when he is ready to wash his back.

 

Change the water as often as required.

 

Ask the patient to turn to his side for you to clean his back if required. Place a towel under his back.  Wash, rinse and dry his back.  Turn the patient to complete cleansing the other side. Repeat for the buttock.   If the patient is breathless, clean his back while he sits upright and leaned forward.

 

If the patient can manage to wash his own anal region, hand him the disposable wipes soaked in soap and water and put a plastic bag within his reach for disposing the used wipes.  Make sure that the anal region is properly rinse and dry.

 

Help the patient dress and comb his hair, if necessary.

 

Replace the bed table and place all the equipment required for mouth care and facial shaving (or make-up for woman) within reach.  Assist him if necessary.

 

Wash you hands and re-open any windows that you closed.  Make sure the patient is comfortable.

 

 

 

Note:  Bed making is performed at the same time for patient who cannot get out of bed.  While the patient is turned on his side for you to clean his back, replace and tidy the bottom linen on one side.  Do the same thing when he is turned over to the other side.  Remake the bed with clean linen, if necessary.
 

 


Bathing in the Bathroom
 

Patient who can go to the bathroom should be encouraged to have his usual bath with your assistance, if necessary. If you are doubtful about getting the patient into the bathroom, consult your healthcare professionals first. The patient may be worried about having a bath, particularly if he has recently undergone surgery and has a wound.  You can help to alley any fears by been sympathetic and understanding. Certainly, the patient will feel refreshed and much better after a bath.
 
Tips on Bathing in the Bathroom:

 

Keep the bathroom warm to prevent the patient becoming chilled.

 

Always check with the patient if he needs to go to the toilet before bathing.

 

Assess the level of assistance the patient required.  Some patient may only need help in undressing, washing his back and feet (these areas may be too difficult for him to reach and clean), drying  and dressing.

 

If the patient is using the bathtub, run the cold water into the bathtub first to prevent the bottom from becoming hot enough to burn.  This will also helps to reduce the amount of steam in the bathroom.  Test the temperature of the water with your elbow. The water should be comfortably warm.  There are a wide range of equipment you can buy to make the bathtub safe for the patient.

 

If the patient is using a shower, provides him with a shower chair if he is less mobile.  This would enhanced safety and also prevent him from becoming exhausted.

 

For patient who can help himself, make sure that the toiletries and clean clothes are in the bathroom within easy reach.  Provide him with washing aids, such as a long-handle brush, if necessary.  Advise the patient not to lock the door from inside, in case of emergency,  for safety reason. You may  leave him alone in the bathroom but stay within call, so that if he feel unwell you can help.