Lesson 11 Objectives: ADL’s- Oral Care/Grooming/Nail Care Explain the importance of oral care/denture care Demonstrate competence in assisting a resident with oral care/denture care Explain the importance of hair care and shaving Demonstrate competence in assisting a resident with hair care and shaving Explain the importance of providing fingernail and foot care to residents Demonstrate competence in providing fingernail and foot care to a resident

Grooming/Personal Hygiene Promotes good health Prevents illnesses that result from poor personal habits -hand washing -bathing -flossing -brushing teeth -nail care -shaving -brushing hair -foot care Allow independence Allow them to make choices Establish Routines

Oral Care Fowler’s position Unconscious residents placed in lateral position Clean Mouth, Lips, Tongue, and Teeth Per ISDH= at least once a day Recommended in morning and before bed Reduces # of pathogens in the mouth Improves self-esteem, appearance, sense of taste/appetite Decreases mouth odor

Denture Care Handle carefully and store in cool water Denture cup should be labeled Observe for poorly fitting dentures and report concerns to the nurse If they have a partial, may need to brush the remaining teeth with toothbrush and an oral swab for gums Encourage residents to wear their dentures to prevent gum shrinkage, improve speech, allow for proper chewing and improve self-image and appearance

(Oral Care Should Be Done Last) Oral and Denture Care If using mouth wash dilute half mouth wash, half water Observe M L T T for Odor, Cracks, Sores, Bleeding, Discoloration, and Loose Teeth (Oral Care Should Be Done Last)

Oral Care More frequent oral care is needed by residents who: ~are unconscious ~breathe through mouth ~have been vomiting ~have high temp ~are taking certain medications ~are dehydrated ~are being given oxygen ~are dying ~have a history of mouth, tooth or gum problems

CNA’s Role Provide privacy Use Standard Precautions Report any unusual findings, pain, or discomfort to the nurse immediately Perform mouth care gently to prevent injuries to oral cavity Rinse toothpaste from mouth thoroughly

Hair Care Improves appearance, self-esteem, & sense of well-being Brushing and combing increases circulation and promotes healthy scalp and hair Hair is shampooed at least once a week or more if necessary Remove tangles by dividing hair into small sections and gently combing out from ends of hair toward scalp Hair style is a personal choice *Never cut a resident’s hair unless specifically instructed by the nurse

Shaving Part of daily routine, especially for men, occasionally for women ~Residents have right to grow facial hair and choose preferred method of shaving if not medically contraindicated Facial hair for women should be removed according to their preference. Many may prefer an electric razor Safety Razors to be disposed in a sharps/biohazard container

Electric Razor (plug in or battery operated) Do not use near Pacemaker, Oxygen, & Water (P-O-W) Use pre-shave and after-shave lotion as resident requests/wishes Shave with up and down motion for foil head razor Shave in circular motion for a three head razor Clean razor after each use

*Do not trim diabetic resident’s fingernails Fingernail Care *Requires daily attention and if nails appear dirty or have jagged edges Clean, trimmed, and smooth nails prevent infection, injuries, and odor Check nails for Temperature, Color Swelling, Cuts, & Splits Soak nails to soften and Clean under and around nails Cut nails straight across File smoothly, gently rounding corners *Do not trim diabetic resident’s fingernails

Foot Care *Requires daily attention Feet should be checked for irritation, sores, ingrown toenails, swelling and discoloration on a daily basis Poor circulation is a common complication of diabetes (small cuts can end up as large wounds, hard to heal) Report any abnormalities Submerge residents feet for 5-10 minutes Clean with soap, rinse, dry and apply lotion *CNA‘s do not cut toenails, especially if a resident is DIABETIC or has IMPAIRED CIRCULATION ~Only a nurse, physician, or podiatrist should cut toenails of a diabetic resident *Westminster policy CNA’s DO NOT trim toenails at all

Review Questions When doing oral care, what areas of the mouth should be checked and what should the CNA check for? Nursing Assistant are not allowed to clip the fingernails or toenails of a resident with what diagnosis? True of False? When giving oral care to an unconscious resident, he/she should be in a Fowler’s position. Identify 3 types of residents who should receive oral care more frequently than twice a day. True or False? When brushing a resident’s teeth, start with the top teeth. What are 3 contraindications for the use of an electric razor?