Lesson 10: Activities of Daily Living

(Bathing/Shampoo/Perineal Care)
Objectives
•Explain the importance of bathing
•Describe what factors determine the type, time, and frequency
of bathing a resident
•Name what parts of the body are washed during a partial bath
•Explain why perineal care is so important
•Describe what observations can be made during bathing
•Identify the recommended temp for bathing
•Explain the benefits of a back rub
•Demonstrate draping and undraping, back rub, shower, bed
bath, and perineal care, bed shampoo
 Bathing
• Keeps skin healthy and prevents skin problems

• State Reg.: Resident bathed as frequently as

needed, but at least 2 x week

• ~cleans skin of perspiration, dirt, germs

• ~increases circulation to skin
• ~promotes comfort and well being
 Bathing
• Time, frequency & type of bath depends on resident’s
preferences and condition
(past habits, current health/abilities)
Types of baths:
a. Complete bed bath- unable to leave the bed involves
washing entire body
b. Partial bath- done between complete baths, involves
washing: face, hands, underarms, and then perineal area
(done at least daily)
c. Tub bath/whirlpool- relaxing method for those that can
tolerate sitting in water
d. Shower- must be strong enough to move or be moved.
Often with use of a shower chair for safety or resident’s
preference
 Bathing
Observe and report:
a. Color changes of lips, skin, nail beds,
and white of the eyes
b. Rashes, dry skin, bruises, broken skin,
reddened areas, abnormal skin temp
c. Drainage, bleeding, complaints of pain or
itching
d. Excessive hair loss
***Always offer toileting needs before
beginning, regardless of type of bath***
 Bed Bath
• Privacy- door, curtain, drape
• Start with eyes (inner to outer corner)
• Wash and rinse face, neck, ears and behind ears
• Remove gown
• Far arm, Near arm-hands up to armpit/shoulder
• Chest & Abdomen
• Far leg, Near leg-hip to toes
• Change water, wash hands, new gloves, new cloths
• Cath Care (meatus to 4 inches down catheter tubing),
otherwise peri care (front only)
• Change water, wash hands, new gloves, new cloths
• Lateral position, clean anal area front to back
• Change water, wash hands, new gloves, new cloths
• Wash from neck to buttocks, supine, help dress or gown
 Perineal Care
• Cleaning the genital and anal area to prevent infection and
odor and improve resident’s comfort
• Routine part of complete bed bath, but also as needed
between baths especially for: incontinence, diarrhea, and
skin irritation or discharge
When performing peri care:
a. Provide privacy and dignity. Drape.
b. Standard Precautions. Clean front to back
c. Clean catheter from meatus out
d. Retract and clean foreskin of uncircumcised male
e. Separate labia of female
f. Provide comfort with warm water, being gentle, and rinsing
well.
g. Know when to change gloves, water, & washcloths
 Whirlpool/Tub Bath
• Procedure depends on whirlpool/tub type
• In general there will usually be a lift bath
trolley or a tub chair designed specifically for
the tub
• Clean with washcloth and soap and rinse
using shower handle
• Will need 3 washcloths and 2 towels
• If tub has a reservoir, be sure to fill it first
• Still follow same order as bed bath
*Head to Toe, Clean to Dirty, Inward, Outward
 Bed Shampoo
• Shampooing hair should be done at least
once a week
• Done in bed if they are not able to get out
of bed to shower
 Back Rubs
• Offered after a bath and before bedtime
• Keep skin healthy and prevent skin breakdown
• Stimulate circulation and relieve tension
*Bedridden resident’s need more frequently*
When giving a back rub:
a. Use lotion to reduce friction
b. Keep nails short
c. Check skin before beginning back rub
d. Use good body mechanics
e. Use long, smooth strokes up spine to shoulders to relax
muscles
f. Use short, circular strokes down sides of back from
shoulders to lower back to stimulate circulation
g. For 3-5 minutes
 Bathing
• Have resident do as much as possible to promote
independence
• Check water temp before resident checks it
ISDH used to recommend temp at point of use between
100º-120ºF; bath temp approx. 105ºF
• Never leave unattended in bathing/shower room
• Clean tub/shower and shower chair before & after each use
• Always help resident in and out of shower to prevent falls
• Wash from cleanest to dirtiest
• Dry skin by patting with a towel
 Lesson 10: Activities of Daily Living
(Bathing/Shampoo/Perineal Care)
Objectives
•Explain the importance of bathing
•Describe what factors determine the type, time, and frequency
of bathing a resident
•Name what parts of the body are washed during a partial bath
•Explain why perineal care is so important
•Describe what observations can be made during bathing
•Identify the recommended temp for bathing
•Explain the benefits of a back rub
•Demonstrate draping and undraping, back rub, shower, bed
bath, and perineal care