Session 92 BATHING

Welcome to the
BATHING
Bathing
Introduction
Bathing is an essential component of personal
hygienic measures. It gives comfort and cleanses
the body. Though bathing is considered to be part of
hygiene , it also helps to protect the body from
infection. HHA assist a person in bathing when the
client is not able to do it anymore by himself totally
and need assistance. © Health Careers Institute
Slide No 3
Version 1 – February 2016
Learning objectives Bathing
At the end of the session student will be able to:
• describe importance of bathing

• detail different types of bathing, frequency and the
time for bathing
• enlist points to observe during bathing which need
to be reported
• understand need of after bath care. © Health Careers Institute
Slide No 4
Bathing
Importance of bathing
• Bathing helps to:
• remove perspiration, dirt, and germs
• refresh patients and make them more comfortable
• stimulate circulation.
• provide small amount of exercise for the muscles.
© Health Careers Institute
Slide No 5
Bathing
Importance of bathing
• relax body and stimulate sleep

• boosts immune system
• reduce stress
• relieves muscle pain

• promote feeling of self worth.
Slide No 6
Bathing
General guidelines for bathing
• Provide privacy at all times by screening the patient and

closing the doors.
• Close windows, drapes, and doors to reduce drafts.
• Keep the patient covered with a cotton bath blanket
for warmth and privacy.
• Keep the water temperature at the temperature
recommended by your facility.
Slide No 7
Bathing
General guidelines for bathing, continues..
• Rinse the patient completely because soap dries

the skin
• Pat the skin dry; do not rub it.
• Apply lotion to dry skin area to protect them.
• Observe the condition of the patient skin. Report
any redness, broken skin, or tender places to your
supervisor.
Slide No 8
Bathing
Guidelines for dressing and undressing
the patient
• Provide privacy at all time. Cover the patient in a bed

with a bath blanket.
• Begin undressing the patient’s strong or unaffected side
first.
• Begin dressing the patient’s weak or affected side first.
• Encourage the patient to do as much as possible.
Slide No 9
Bathing
Types of bath
Slide No 10
Bathing
Complete Bed bath
• Bath is provided to a totally

dependent client in the bed.
Slide No 11
Bathing
Procedure for complete bed bath

• Equipment needed
• Basin of warm water

• Soap
• Towels and wash cloths
• Top sheet/bath blanket(drape)
• Mackintosh
Slide No 12
Bathing
• Clean dress
• Body lotion
• Hamper or bag for soiled linen
• Under pad
• Pitcher and water
• PPE
Slide No 13
Bathing
• Client preparation for bed bath

• Greet client and explain the procedure
• Provide privacy
• Offer bedpan if necessary
Slide No 14
Bathing
• Wash hands and wear PPE

• Remove any extra pillows or blankets
• Lower the side rail on the side closest to the care
provider and position the patient.
• Place a folded top sheet/bath blanket as drape
across the patient’s chest horizontally to provide
privacy
Slide No 15
Bathing
• Procedure
• Ask the patient to hold the top edge of the drape and
pull it to the foot of the bed
• Remove the top covers underneath the top sheet and
patient’s gown (be careful to keep patient draped)
• Raise the side rail while preparing the bath water. The
water should be warm – check with inside of the
wrist
Slide No 16
Bathing

• Giving the bed bath
• Lower the side rail and remove the pillow under
the patient’s head or place a towel over the pillow
• Fold drape to expose the area being cleaned.
• Spread a towel across the patient’s chest
Slide No 17
Bathing
• Face and neck

• Wash patient’s face and neck
• Moist the bath mitt with water and wash one eye area from the
nose to the outer edge near the ear
• Use separate part of the mitt to wash the other eye area. Dry well.
• Rinse cloth and wash forehead from the centre to each side, wash
the rest of face using a circular motion around the mouth. Rinse
and dry the face well.
• Wash, rinse and dry each ear and the neck.
Slide No 18
Bathing

• Upper extremities
• Place the towel under the far arm, make a bath mitt,
use soap, and wash the entire arm with long sweeping
strokes from distal to proximal (towards the axilla).
• Give special care to the axilla with extra soaping. Rinse
and dry well.
• Wash the hands and fingers, rinse and dry.
• Move the towel, and wash and dry the near arm and
hand in the same manner.
Slide No 19
Procedure for complete bed bath Bathing
• Chest and abdomen

• Keep the towel over the patient’s chest and pull the drape
down to the waste line.
• Make a bath mitt and wash under the towel over the entire
chest, wash breast with circular movement.
• Wash skin folds under the female patient’s breasts by lifting
each breast.
• Rinse and dry well
• Fold the drape to the top of the pubic bone and wash the
lower abdomen, rinse and dry well
Slide No 20
Bathing

• Lower extremities
• Expose the far leg, and tuck the drape around the
patient to prevent chilling
• Flex the leg and place a towel lengthwise on the
bed
• Wash from the foot to the knee with long
sweeping strokes and then from the knee to the
hip in the same manner.
• Rinse and dry the leg well.
Slide No 21
Bathing
• Place the bath basin on the towel and lift the foot,
placing your hand under the heel, and place it into
the water. Wash the foot and dry it
• Dry each toe separately, and place the leg and foot
under the drape
• Wash the near leg in the same manner
• Change the bath water after washing the legs and
feet
Slide No 22
Bathing
• Back
• Turn the patient to the side, place a towel
lengthwise along the back, and wash the back with
long, sweeping motions.
• Rinse and dry well. Then wash the folds of the
buttocks and anus well
• Turn client to recumbent position
• Perineum
Slide No 23
Bathing
• Wear another gloves and use another wash clothe

to wash, rinse and then dry the perineum
• After the bath
• Groom the patient, tidy up the bed and place the
patient comfortably
• Replace the articles
• Remove gloves and wash hands
Slide No 24
Bathing
Partial bed bath
• Partial bed bath is provided to

dependent patients in need of partial
hygiene or self sufficient bedridden
patients who are unable to reach all
body parts.
Slide No 25
Bathing
Procedure
• Provide privacy
• Wash hands and wear PPE
• Assemble the equipment
• Provide a sitting position and cover the patient so
that areas not being washed are not exposed.
• During this process make sure to position a towel
under the client to prevent the moistening the bed
sheets. © Health Careers Institute
Slide No 26
Bathing
Procedure
• Start with the face. Use a wet washcloth without

soap and clean the face. With the eyes, begin with
the inner canthus and then the outer canthus.
When you move on to the next eye, be sure to use
a different portion of the washcloth so as to avoid
contamination. Also, ensure that the face is dry
before moving on.
Slide No 27
Bathing
Procedure
• Using a small amount of soap on the washcloth,

then move to the neck, arms, hands and chest.
Once washed, ensure these areas are dry before
moving on.
• Then have the patient turn on their side so that you

can now wash their back.
Slide No 28
Bathing
Procedure
• If the resident is able to wash their perineal area, then provide

them with the means to do so, if not, then change your gloves and
perform as necessary.
• Groom the patient, tidy up the bed and place the patient
comfortably
• Replace the articles
• Remove gloves and wash hands
Slide No 29
Bathing
Tub bath
• A patient who is not confined to bed

and is not helpless, in some cases, be
recommended to have a tub bath. Any
assistance in getting in and out of bed,
getting in and out of the tub, and/or
reaching areas of the body while
bathing need to be rendered by the
HHA .
Slide No 30
Bathing
Procedure
• Gather all items necessary for bathing
• Make certain tub or shower appliance is clean.
Place non-skid mat on tub or shower floor and
disposable mat outside of tub or shower.
• Gather all items necessary for bathing
Slide No 31
Bathing
Procedure
• Assist patient to tub or shower. Be certain patient

wears robe and slippers..
• If tub is used, fill with warm water. Have patient
test water; adjust temperature if needed. Instruct
patient on use of faucets–which is hot and which is
cold. If shower is used, turn water on and adjust
temperature.
Slide No 32
Bathing
Procedure
• Caution patient to use safety bars. Discourage the use

of bath oil in water. Check on patient every 5 minutes.
Do not allow the patient to remain in tub more than 20
minutes.
• Assist patient out of tub and with drying. If patient
complains of weakness, vertigo, or syncope, drain tub
before patient gets out and place towel over patient’s
shoulder.
Slide No 33
Bathing
Procedure
• Assist patient into clean gown, robe, and slippers.

Accompany to room and position for comfort in
either chair or bed.
• Return to shower or tub. Clean according to
organisational guidelines . Place all soiled linens in
laundry bag and return all articles to patient’s
bedside.
• Wash hands.
Slide No 34
Common observations
during bathing Bathing
Physical Things to be observed

observations
Odour May be caused by sweat secreted by the sweat glands; by
abnormal conditions, such as infection or kidney disease; or by
bodily discharges (urine, faeces ) that need to be cleaned.
Texture Smooth and elastic or dry and rough; nutritional deficiencies can
influence skin texture.
Colour Reddened areas that could indicate pressure, cyanosis (bluish
tinge) or jaundice (yellowish tinge).
Temperature Hot skin could mean fever; cold skin could mean poor
circulation. Sensitivity. Pain, tenderness, itching, or burning.
Sensitivity Pain, tenderness, itching, or burning.
Swelling (edema) Stretched or tight appearing; usually begins in the ankles or legs
or any other dependent part; may be associated with injury.
Skin lesions Rashes, growths, or breaks in the skin. Slide No 35

Bathing
After Bath Care

• As part of after bath care the HHA is expected to
do the following:
• Check for rashes and sores, especially if the person
is incontinent or unable to move around.
• Seat the person while drying and putting on fresh
clothes.
• Be gentle on the skin. The person’s skin may be
very sensitive. Avoid scrubbing, and pat skin dry
instead of rubbing.
Slide No 36
Bathing
After Bath Care
• Apply lotion
• Use talcum powder under the breasts and in the
creases and folds of skin.
• Apply creams , deodorant and other cosmetics
according to patient preference.
Slide No 37
Bathing
Back care
• Help the patient relax

• Give the HHA an opportunity to observe the skin of
the patient.
• It also helps to relieve muscular tension and
prevents bed sore in bed ridden clients
Slide No 38
Bathing
Back care
• Procedure
• Greet and explain the procedure to the patient
• Assemble equipment. This include
– Bath blanket
– Bath towel
– Wash cloth
– Skin lotion
– Disposable gloves (used if skin breakdown
present , incontinent patient) © Health Careers Institute
Slide No 39
Bathing
Back care
• Wash hands
• Provide privacy to the client
• Position the client .
Slide No 40
Bathing
Back care
• Cover the patient with a bath blanket and expose

only the required areas.
• Warm the hands and apply lotion
• Begin massage from the base of the spine and
move upwards to the shoulders.
Alternate through the three basic massage
strokes
Slide No 41
Bathing
Back care
– Effleurage (stroking) —is a long sweeping

movement with palm of hand conforming to the
contour of the surface treated, over small
surface (on the neck) the thumb and fingers are
used. Strokes should be slow, rhythmical and
gentle with pressure constant and in the
direction of venous stream.
Slide No 42
Bathing
Back care
• Kneading—performed with the ulnar side palm

resting on the surface and the fingers, and thumb
grasping the skin and subcutaneous tissues which
move with the hand of the operator
Slide No 43
Bathing
Back care
• Friction—is performed with the whole palmar

surface of the hand or fingers and thumbs over
limited areas. This movement is a circular form
of kneading with pressure against the
underlying part of tissue which cannot be
grasped.
Slide No 44
Bathing
Back care
• Use lotion as required during massaging.
• Finish massaging using firm long strokes.
• Remove excess lotion if present using a bath towel.
• Provide comfortable position to the patient.
• If gloves is used, remove gloves and wash hands.
Slide No 45
Bathing
Conclusion
Bathing and after bath care is a inevitable component
of personal hygiene measures. These are sensitive
hygienic practices a person does by himself and
assisted by a home health aide when he is unable to
do so. Bathing and after bathing ensures hygiene ,
prevents infection and protects the skin of the client.
Ensuring comfort of the patient is very important
through out the procedures as the care practice is
intimate in nature.
Slide No 46
Bathing
Exercises
• List down the benefits of bathing.

• What are the general guidelines for bathing?
• What is partial bed bath?
• What is after bath care?
• What is the importance of back care?
Slide No 47
References Bathing
Personal Hygiene. 2016. Personal Hygiene.

[ONLINE] Available at:
http://www.atitesting.com/ati_next_gen/skillsmodu
les/content/personal-hygiene/equipment/bathing.h
tml
[Accessed 07 December 2016].
Slide No 48

Session 92 BATHING

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Session 92 BATHING

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Welcome to the

At the end of the session student will be able to:

• describe importance of bathing

© Health Careers Institute

• relax body and stimulate sleep

• relieves muscle pain

© Health Careers Institute

General guidelines for bathing

• Provide privacy at all times by screening the patient and

© Health Careers Institute

General guidelines for bathing, continues..

• Rinse the patient completely because soap dries

© Health Careers Institute

• Provide privacy at all time. Cover the patient in a bed

© Health Careers Institute

Complete Bed bath

• Bath is provided to a totally

© Health Careers Institute

Procedure for complete bed bath

• Basin of warm water

© Health Careers Institute

Procedure for complete bed bath

© Health Careers Institute

Procedure for complete bed bath

• Client preparation for bed bath

© Health Careers Institute

Procedure for complete bed bath

• Wash hands and wear PPE

© Health Careers Institute

Procedure for complete bed bath

Procedure for complete bed bath

© Health Careers Institute

Procedure for complete bed bath

• Face and neck

Procedure for complete bed bath

• Chest and abdomen

© Health Careers Institute

Procedure for complete bed bath

Procedure for complete bed bath

Procedure for complete bed bath

Procedure for complete bed bath

• Wear another gloves and use another wash clothe

© Health Careers Institute

Partial bed bath

• Partial bed bath is provided to

© Health Careers Institute

• Start with the face. Use a wet washcloth without

© Health Careers Institute

• Using a small amount of soap on the washcloth,

• Then have the patient turn on their side so that you

© Health Careers Institute

• If the resident is able to wash their perineal area, then provide

• A patient who is not confined to bed

© Health Careers Institute

• Assist patient to tub or shower. Be certain patient

© Health Careers Institute

• Caution patient to use safety bars. Discourage the use

• Assist patient into clean gown, robe, and slippers.

Physical Things to be observed

Skin lesions Rashes, growths, or breaks in the skin. Slide No 35

After Bath Care

After Bath Care

© Health Careers Institute