Having established that the individual is willing to have a bath or shower, discuss the procedure, provide for privacy ad ensure the person’s safety.
Wash your hands. Gather needed supplies:
- Gloves (if the individual presents with an infectious skin condition and/ or assisting with toileting),
- Lotion (optional),
- Deodorant or antiperspirant (optional),
- Clean clothing
Ask the individual if (s)he needs to use the toilet before bathing.
Assist the individual to the bathroom using his/her mobility aid e.g. walking frame, walking cane.
If the individual will be taking a bath, check the temperature of the water and make sure the non-skid mat is secure. If the individual will be taking a shower, turn on the water and adjust the temperature until the water is comfortable for the individual.
Assist the individual with undressing and help him/her into the bath or shower. A shower chair or stool may be placed in the shower for the person to sit, if necessary. A bath seat makes it easier for the person to get out of the bath with assistance.
For safety a slip math should be placed in the base of the bath or shower.
If the individual can bathe herself/himself, either partially or completely: • Place bathing supplies within easy reach.
If the individual is unable to bathe herself/ himself or requires assistance: • Put on gloves if the individual presents with an infectious skin condition and/ or assisting with perineal care (genital area)
If necessary, ask the individual what parts of the body were not washed. Assist the individual as needed with completing the bath. Wash the cleanest areas first and the dirtiest areas last. Use a washcloth mitt.
When full assistance is required
Eyes: Wet the mitt with warm, clean water. Ask the individual to close her/ his eyes. Place your washcloth-covered hand at the inner corner of the eye and stroke gently outward, toward the outer corner. Use a different part of the washcloth for each eye.
Face, neck, and ears. Ask the individual if they use soap on the face or refer to the individual’s care plan. Rinse the washcloth and apply soap, if requested. Wash the face, neck, and ears, moving from the top of the head to the bottom (so that the nose and mouth are washed last). Rinse thoroughly.
Arm and axillae (armpits): Rinse the washcloth and apply soap. Place your washcloth-covered hand at the shoulder and stroke downward, towards the hand, using long, firm strokes. Wash the hand. If necessary, assist the individual with raising her / his arm so that you can wash the axilla. Repeat for the other arm and axilla.
Chest and abdomen. Using long, firm strokes, wash the individual’s chest and abdomen.
Legs and feet. Place your washcloth-covered hand at the top of the thigh and stroke downward, towards the foot, using long, firm strokes. Wash the foot. Repeat for the other leg.
Back and buttocks. Wash the individual’s back and buttocks, moving from top to bottom and using long, firm strokes.
Clean the perineal area in the female from front to back, using a separate washcloth. Ensure that all skin folds are cleaned.
Make sure that soap is thoroughly rinsed from all parts of the body.
Remove your gloves, if wearing of same has been deemed necessary, and dispose of them in the black bin. Warning (thin surgical gloves are extremely flammable)
If the individual is taking a bath, drain the water and carefully assist the individual out of the bath, into a towel-covered chair. If the individual is taking a shower, turn the water off and assist the individual into the towel-covered chair.
Wrap a towel around the individual, using another bath towel, help the individual to dry off, patting the skin dry. Take care to ensure that areas where “skin meets skin” are dried thoroughly (for example, in between the toes and underneath the breasts).
Help the individual to apply lotion, deodorant, antiperspirant, or other personal care products as the individual requests.
Help the individual into the clean clothing. If the individual is wearing night wear, help her/him into a dressing gown and slippers.
Assist the individual out of bathroom.
- Provide for comfort
- Ask the individual if (s)he is comfortable.
- Ask the individual if there is anything else you can do for him/her.
Complete a safety check
- Lower the bed to its lowest position, if in use.
- Raise or lower bed rails, if in use.
- Assistive devices are within reach e.g. walker, walking stick and wheelchair.
- Floors are free of spills and clutter.
- Wash your hands,
Clean and replace equipment
- Clean bathroom or shower.
- Place towels and washcloths in laundry.
- Soiled sheets and underwear may be steeped in a bucket of disinfectant of your choice such as Napisan or Dettol until they are washed on a high temperature. This helps to reduce malodour in the case of urinary or double incontinence.
- Solid matter should be flushed down the toilet
What you Document and Report
- The date and time
- Level of assistance needed
- Any unusual observations
(adapted from Carter, 2012, Sorrentino, 2011)
Muiriosa Foundation Practice Guidelines on Intimate and Personal Care 27-05-2014 issue 4