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Personal Care

What is Personal Care?

Includes eating, bathing, shaving, caring for the skin, hair and mouth, and moving around from chairs, toilets or bed. During a normal lifetime all these activities are taken for granted until weakness or a disability makes them difficult to accomplish independently or in safely. Giving assistance requires knowledge, patience, skill and physical strength.

Bathing another person requires strength, special equipment and skills. Carers should ask the family doctor or a physical therapist for special instructions on how to do this safely.

Shampooing and Shaving - visits to a barber or hairdresser can be very uplifting experiences or alternatively the barber can come to the home. Wetting hair with alcohol or cream rinse helps to remove tangles. Dry shampoos can be used for the bed bound. Diabetics or patients on anti-coagulants are safer to use an electric shaver to reduce the risk of cuts. It is much easier and safer to shave another person with an electric razor. Hair pieces should only be washed carefully in cold water with the shampoo obtainable from the wigmaker and allowed to dry naturally before being combed out.

Skin Care - keep skin clean and dry, especially when there are problems with bowel and bladder control. Use mild soap sparingly, rinse well, and dry thoroughly applying scent free talcum as required.

Massage skin gently using a light, circular motion. Change the position of older people at least every two hours, particularly for those confined to a bed or wheelchair. Encourage them to shift their weight between position changes to redistribute pressure onto other areas.

Encourage good eating habits and adequate fluid intake. If eating an adequate diet is a problem give a multi-vitamin every day to ensure proper nutrition. Check with your doctor about the best supplements.

Bed linen should be clean, dry and free of wrinkles. Disposable pads can be used if necessary to keep sheets dry and reduce the need for frequent changes. Mattresses and chairs should be soft and form-fitting such as egg crate overlays or sheep skin, rather than hard and rigid. This spreads the weight over a larger skin area, decreasing the pressure under the bones.

Encourage movement or mild exercise to stimulate the circulation. Combing hair and helping with bathing and dressing are good ways for frail people to get exercise and be more independent.

Look out for possible sources of pressure or anything which interferes with good circulation, such as tight shoes, socks or undergarments.

Bony areas can be liable to skin breakdown. These are the heels, feet, behind the knees, hips, buttocks, sacrum, elbows and shoulder blades. A special air mattress may be ordered by the doctor to prevent skin breakdown.

Be vigilant for any redness or any break in the skin and report it immediately to your doctor or nurse, and keep the affected zone clean, dry and free from pressure until medical attention comes.

Toileting

Safety features in the bathroom, such as grab bars and raised toilet seats, make using the bathroom safer for the disabled person even if they can be an inconvenience for male members of the family.

During the night if flexibility or distance from the bedroom to bathroom is a problem a commode may have to be set up in the bedroom. A small amount of water with added detergent in the bowl can be very effective. Lack of control over bowel or bladder functions are embarrassing and some may try to hide it from carers and professionals. Be sensitive about the person's feelings, and mention this to the doctor.

Loss of bowel and bladder control is not a part of normal ageing and can often be controlled or managed with medications. For anyone with bowel or bladder problems it helps not to miss a visit to the bathroom every 2 hours. It's essential to take the patient to the loo when the need arises. Using catheters before they are really required to avoid inconvenience to nursing staff is not recommended as it weakens bladder control. Some treatments exist to retrain bladder and bowel functions and your doctor should be able to advise on this.

Constipation or Irregularity

Many people become constipated due to medicines such as painkillers and inactivity. If this is the problem the doctor can prescribe a stool softener such as Lactulose. Dietary factors are also important - eat plenty of fresh fruit, vegetables and foods high in fibre - drink at least 8 glasses of water a day and avoid constipating foods like cheese, rice, bananas, etc. Exercise as much as possible and be sure your doctor is aware of all medicines being taken.

Assisting with Eating

Eating can be very time consuming, especially if the patient has to be fed. Encouraging independent eating saves time for carers, and promotes the independence and self worth of the patient. Try to relax yourself and enjoy the time spent with your care receiver. Here are some suggestions for encouraging independence:

Reminder: Treat any adult who is being fed as an adult, never as a child regardless of mental capacity. If you are in the habit of using table linen and proper cutlery continue to do so where at all possible. Criticism about poor eating habits should be avoided. Should there be a lack of interest in food, there will usually be a valid reason such as illness, mouth ulcers or just plain boredom with the recipes.

Moving people

Those who cannot move around safely by themselves require skill, knowledge, and some strength on the part of the carer. For every type of disability, there is a specific technique or equipment to use. Ask a doctor, therapist or attend carer training for specific techniques. In all cases, remember:

When lifting,

  1. get in close and keep your balance centred
  2. move your feet so that you face the other person
  3. never add your own weight to the load
  4. don't twist when you are lifting
  5. keep your spine straight.
  6. use your strong leg muscles to do the work
  7. NEVER EVER use your weak back muscles to lift

Rest and Sleep

As people age their sleep patterns change. The elderly require less sleep and it takes longer for them to fall asleep. Also, awakenings during the night increase. Scheduled rest times are important. A few naps during the day can refresh and revitalize but if you notice that sleep only happens for brief periods during the night there could be a medical problem. Or a generous whisky or sherry might help.

Encouraging Independence

Allow the care receiver to do as much as possible for themself; and only give as much help as needed. When people do most of their own personal care, it is a form of exercise which helps maintain strength as well as promote independence. No matter how small the activity it is important that the person be able to participate.

Adapt your home to allow the care receiver to do more things. Install equipment such as grab rails in the bathroom, wheelchair accessible sinks and mirrors, bath bench for the shower or bathtub, and lights with switches or remote controls that can be easily reached. A powered reclining chair allows comfort and different seating positions during the day.

Ask therapists or nurses to teach you how to perform personal care tasks safely and effectively.

Learn about the disability and what you and others can do to help him or her function as independently as possible. If a certain activity can't be done fully, see if there is a some part that can be done. For example, dressing the upper body can be done independently when sitting, but some help is needed to dress the lower body.

Whenever possible, include the care receiver in making plans for his or her care. Take suggestions and feelings into consideration and encourage full involvement. Sometimes, relaxing the pace of an activity allows people to do more for themselves.

Be aware of subtle changes in the care receiver's health and abilities. Your plans for care have to keep pace with changing circumstances.

Last updated 25-02-2013