1. 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

2. 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

3. 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

4. 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

5. (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)

6. 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

7. 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

8. 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

9. 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

10. 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

11. *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

12. 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

13. 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?