2.  AM and PM Care › AM care:  Offering bedpan/urinal or assist to bathroom  Assist residents with washing face and hands  Performing mouth care before or after breakfast as needed › PM care:  Offering bedpan/urinal or assist to bathroom  Assist with washing face and hands  Mouth care  Snack and back rub as allowed

3.  How you assist the resident is essential to promoting independence and dignity  What skills you assist with and how much help you provide is different for each resident › A person who has had a stroke recently would need more assistance than someone who has a broken foot that is nearly healed

4.  Maintain a professional attitude  Be sure to explain to the residents exactly what you are going to be doing  Offer the bathroom or a bedpan first  Allow them to make as many decisions about the care as possible - encourage them to do as much as they can during care

5.  Observe the resident for any problems or changes that have occurred  Look at their environment › Look especially for physical and mental changes as well as unsafe surroundings › Report concerns to the nurse  Take a break if the resident becomes tired.

6.  Ask if the resident would like anything else  Leave the resident’s room neat and tidy  Call light within reach  Bed in lowest position

7.  Skin color, temperature and reddened areas  Mobility  Flexibility  Comfort level  Strength and ability to perform ADLs  Mental and emotional state  Resident complaints

8.  Safety Razor › Has a safety casing over the blade to prevent cuts. › Requires shaving cream or soap  Electric razor › Easiest and safest to use › Doesn’t require soap or shaving cream  Disposable razor › Discarded after use › Requires soap or shaving cream

9.  Explain to Resident and ask permission  Gather supplies and wash hands

10.  Place gloves after washing hands  Place towel over resident’s chest to protect clothing

11.  Before using razor (safety or disposable) › Soften beard and skin with warm washcloth for a few minutes › Lather the face with shaving cream

12.  Then using the razor go with the direction the hair is growing.  Generally shave cheek area first, around mouth and then the neck.

13.  Use basin of water to rinse off razor after each stroke.  Clean all of the shaving cream off the resident’s face and neck.

14.  Notify the nurse if you nick the resident  Avoid shaving directly over prominent Adam’s apple  Apply after-shave if resident desires  Always replace call signal and needed items within resident’s reach.

15.  How your hair looks affects your mental well-being  Some residents get their hair done at a salon  Brushing and combing hair  Always place a towel across the shoulders

16.  Alopecia: hair loss › Baldness › Cancer treatments, skin diseases, stress, poor nutrition, pregnancy, and hormone changes.  Hirsutism: excessive body hair in women and children  Dandruff: excessive amount of dry, white flakes  Pediculosis: infestation of lice

17.  Know the resident’s limitations  Affected side › Side of the resident that is weakened due to stroke  When dressing, start with the affected side first (reverse this when undressing) › Put the weaker arm through a sleeve first › With pants, have the resident sit down and pull the pants over both legs

18.  Allow the resident to pick his/her own clothes (but check cleanliness and if appropriate for weather)  Encourage the resident to dress in regular clothes rather than pajamas  Provide privacy  Allow the resident to do as much as is possible to dress/undress themselves  Front-fastening bras are easier for residents to manage alone

19.  Ask the resident if they have a cleaning cloth, and if so then use that.  Otherwise…. Use a washcloth, soap and warm water to wash off glasses.

20.  Types of bed pans and urinals › Fracture pan  Flatter than a regular bed pan  Used for residents that cannot raise their hips › Regular Bedpan › Urinal › Portable commode  Chair with a toilet seat and a removable container underneath

21. Incontinent  Patients who cannot control the muscles of the bowels or bladder  Diarrhea can cause temporary incontinence  Be sure to offer the bathroom very frequently  If they are wearing incontinence pads or briefs, change often (at least every 2 hrs)  Keep the resident clean, dry and odor free  Frequent perineal care is required

22.  Helps with mobility for bed bound patients  Wash face, hands, underarms and perineum daily to every other day › Perineum: area between the genitals and the anus  Elderly: older skin produces less perspiration and oil › If the skin is especially dry and fragile, the resident should only bathe once or twice a week.

23.  Use products approved by the facility or that the resident prefers  Make sure the room is warm enough prior to bathing  Make sure the water temperature is safe and comfortable  Gather all supplies before giving the bath so that the resident is not left alone  Follow the care plan

24.  Check with the nurse to see if a shower or a tub bath is more appropriate than a bed bath  Partial Bed Bath › Done on days when a complete bed bath or shower is not done › Washing face, underarms and hands, perineal care

25.  Clean tub and shower before and after use  Make sure bathroom or shower room floor is dry  Check that hand rails, grab bars and lifts are working correctly  Have resident use safety bars when getting into or out of the tub or shower.

26.  Place needed items in reach  Never leave the resident alone.  Avoid using bath oils  Test water temp with your wrist before resident gets in; it should be warm and not scalding hot