Faculty of Nursing

Patient Care Technician Program

MODULE 4
 
CHAPTER -13

Assisting with Personal Cleanliness

and Grooming

Prepared by:
Dr. Ibrahim Abbakr
Dr. Badria Alfaki
 Faculty of Nursing
Patient Care Technician Program

MODULE 4
 
CHAPTER -13

Dressing and Undressing, Vision and Hearing

Aids, and Hand and Foot Care, and Skin Care
8:00 am – 10:00 am
 Out line
1. Dressing and Undressing . . . . . . . . . . . . . . . 194
2. Vision and Hearing Aids . . . . . . . . . . . . . . . . 195
3. Hand and Foot Care . . . . . . . . . . . . . . . . . . . 196
4. Skin Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
Objectives
By the end of presentation the audience will be able to:
• Explain general principles to follow when assisting a person with
dressing or undressing.
• Explain how to assist a person with maintaining vision and hearing
aids.
• Explain why hand care and foot care are important.
• Explain the benefits of bathing.
• Explain the benefits of a back rub.
 1\ DRESSING AND UNDRESSING
Clothing changes occur several times throughout the day.
At minimum, people usually change clothing in preparation
for the day ahead and in preparation for sleep.
 In addition, whenever an article of clothing becomes soiled
or wet, it must be changed.
 1\ DRESSING AND UNDRESSING cont..
Many people will be able to dress and undress with minimal
assistance from you.
 Assistive devices such as shoehorns, buttoning aids and zipper pulls
can help a person function more independently with dressing and
undressing.
 So can choosing clothing that is easier for the person to put on and
take off.
For example, pants with elastic waistbands may be easier for a person
to manage than pants with zippers, buttons or ties.
Shoehorns buttoning aids
 1\ DRESSING AND UNDRESSING cont..
For some people who are receiving health care, it can be very difficult
to make the effort required to get dressed each day.
However, it is important to encourage them to do so, unless they are
very ill.
Getting dressed every day helps people to maintain their sense of
identity and purpose.
Encourage the person to do as much as he can, and provide help as
needed.
 1\ DRESSING AND UNDRESSING cont..
It is also important to allow people to make their own decisions about
what they want to wear .
If the person has trouble making decisions, limit the number of
choices, but still allow the person to choose.
When helping a person select clothing, consider:
■ The person’s preferences.
■ The person’s physical capabilities.
■ What the person will be doing that day.
■ The weather and the season.
 1\ DRESSING AND UNDRESSING cont..
Clothing should fi t properly and be in good condition.
If you notice that an article of clothing is stained, ripped, torn,
missing buttons or in need of alterations to make it fi t properly, talk to
the nurse so that arrangements can be made to have the clothing
cleaned, altered, repaired or replaced.
 1\ DRESSING AND UNDRESSING cont..
When helping a person with a weak, paralyzed or injured arm or leg
to dress, put the garment on the affected arm or leg first.
Then, do the opposite when you are helping the person to undress:
Remove the garment from the affected arm or leg last.
 1\ DRESSING AND UNDRESSING cont..
Some people will be required to wear compression stockings.
These stockings, which are made of tightfitting elastic, compress
(squeeze) the veins in the legs.

Compressing the veins in the legs helps to return blood to the heart,
preventing complications such as blood clots.
 1\ DRESSING AND UNDRESSING cont..
These stockings must be put on before the person gets out of bed in
the morning.
If the person has been standing, have her sit in a chair with the legs
elevated for 15 minutes before putting on the stockings.
 Compression stockings usually have an opening across the top of the
toes.
This opening is so that you can check the person’s toes for changes
that might suggest poor circulation to the toes, such as a bluish color
or coldness
 1\ DRESSING AND UNDRESSING cont..
Check the person’s circulation hourly.
 If you note that the toes are pale, blue or cold, or the person
complains of numbness or tingling in the feet, report these
signs and symptoms to the nurse
 2\ VISION AND HEARING AIDS
♠ Many of the people in your care will use vision aids (such as
eyeglasses or contact lenses), hearing aids or both.
♠ These devices help the person interact with others and are therefore
important to the person’s overall quality of life.
♠ Although prosthetic (false) eyes do not help the person to see, they
are important for helping the person maintain his or her appearance,
and in that respect are important to the person’s self-esteem and
quality of life.
 2\ VISION AND HEARING AIDS cont…
Eyeglasses:
♠ Eyeglasses are worn to correct vision problems.
♠ Encourage the people in your care who have glasses to wear them,
especially when they are out of bed. This is important for safety.
♠ Eyeglasses are expensive and it can be inconvenient to replace them if
they become broken or lost, so always handle them carefully.
♠ When the person is not wearing them, they should be stored in their
case.
♠ The person may need help keeping the glasses clean
 2\ VISION AND HEARING AIDS cont…
♠ Clean the glasses with soap and water or eyeglass-cleaning wipes,
which are moistened with a cleansing agent meant specifically for
cleaning eyeglasses.
♠ If soap and water are used to clean the glasses, dry them with a soft,
clean cloth to avoid scratching the lenses.
2\ VISION AND HEARING AIDS cont…
 2\ VISION AND HEARING AIDS cont…
Contact Lenses
Contact lenses are placed directly on the eye to correct vision.
Some contact lenses are worn once and discarded, while others need to be cleaned
daily.
The solutions used to clean and store contact lenses vary, depending on the type of lens.
 If you need to help a person maintain his contact lenses, be sure you know what
products to use.
 Because contact lenses are placed directly on the eye, it is very important to maintain
them properly.
A damaged or dirty contact lens can scratch the eye or cause an infection.
 Always wash your hands before handling a person’s contact lenses.
 2\ VISION AND HEARING AIDS cont…
Prosthetic (False) Eyes
A person who has had an eye removed due to illness or disease may
choose to wear a prosthetic (false) eye.
Prosthetic eyes are custom-made for the person and can be very
expensive to replace.
If a person in your care has a prosthetic eye and needs help caring for
it, the nurse will show you how to assist the person with removing,
cleaning and re-inserting the prosthesis.
As with contact lenses, it is important to care for the prosthetic eye
properly to prevent injury to the eye socket and eyelid.
Always handle a prosthetic eye carefully, and with clean hands.
 2\ VISION AND HEARING AIDS cont…
Hearing Aids
A person with impaired hearing may use a hearing aid.
Hearing aids are battery-operated devices worn in or behind the ear to make
sounds louder.
Some of the people in your care may need help inserting or removing their
hearing aids, and keeping them clean.
You may also need to help the person to keep the hearing aid clean.
Follow the manufacturer’s instructions for cleaning.
Make sure the person keeps an extra battery on hand, so that the battery can
be replaced promptly when necessary.
 2\ VISION AND HEARING AIDS cont…
♣Like other assistive devices, hearing aids are expensive to replace if
they are lost or damaged.
♣ Moisture and hair care products (such as hair spray) can damage a
hearing aid, so help the person to insert the hearing aid after providing
hair care.
♣Store the hearing aid in its case, and out of reach of children, pets and
confused adults who might mistake the battery for something that can
be swallowed.
 3\ HAND AND FOOT CARE
Hand and foot care involves cleaning and caring for the skin of the
hands and feet, and keeping the nails trimmed and smooth.

Many people who are receiving health care need help caring for their
hands and feet.
 3\ HAND AND FOOT CARE cont…
Caring for the Hands
You will help the people in your care to wash their hands before
meals, after using the bathroom and whenever else it may seem
necessary.
Assisting with care for the fingernails is done as needed.

Keeping the fingernails trimmed and smooth helps to prevent the

person from accidentally scratching herself.
 3\ HAND AND FOOT CARE cont…
Caring for the Hands cont…
Keeping the skin of the hands moisturized promotes comfort and
helps to keep the cuticles (the skin along the edges of the nails) from
becoming ragged and torn.
Hangnails (ragged and torn cuticles) are painful and unsightly, and
can become infected.
Soaking the nails in warm water softens them and makes them easier
to trim.
For this reason, nail care is often done following a bath or shower.
 3\ HAND AND FOOT CARE cont…
Caring for the Hands cont…
Equipment used when providing nail care includes:
■ Nail clippers (used to trim the nails).
■ An emery board (used to smooth rough edges).
■ An orange stick (a wooden stick with an angled edge that is used to
push the cuticles back and clean underneath the nails).
 3\ HAND AND FOOT CARE cont…
Even if trimming the fingernails is within your scope of practice, it
may not be permitted with certain people (such as those who have
diabetes or other conditions that can impair circulation and sensation).
 Check with the nurse or consult the person’s care plan to make sure
that you are allowed to trim the person’s fingernails before doing so.
If you are allowed to trim the nails, cut them straight across so that
the edge of the nail extends slightly beyond the tip of the finger
3\ HAND AND FOOT CARE cont…
 3\ HAND AND FOOT CARE cont…
Caring for the Feet
The feet have a large number of sweat glands.
Washing and drying the feet and changing the socks regularly are
important for comfort and to control odor.
Keeping the nails trimmed and the edges smooth makes wearing
footwear more comfortable.
 3\ HAND AND FOOT CARE cont…
Many of the people in your care will not be mobile enough to care for
their own feet.
In addition, many will have conditions such as diabetes that affect
circulation and sensation in the feet.
In a person with poor circulation and sensation in the feet, a small
injury such as a blister or an ingrown toenail can lead to a serious
infection.
 3\ HAND AND FOOT CARE cont…
With age, the toenails become thicker and more difficult to cut.
In addition, many people have conditions such as diabetes that can
make even a small injury to the foot very dangerous.
 Because it is easy to injure the person by trimming the toenails too
short or nicking the skin around the toenail, and because such injuries
can have serious consequences, trimming a person’s toenails is usually
outside of the scope of practice for a nursing assistant
Instead, a doctor who specializes in care of the feet (called a
podiatrist) or a nurse is usually responsible for trimming the person’s
toenails
 3\ HAND AND FOOT CARE cont…
Your responsibilities with regard to foot care include caring for the
skin of the feet by washing the feet, drying them well, and applying
lotion to avoid dryness and cracking.
Foot care is often carried out during bath time, but it may also be
done independent of a bath.
While you are providing foot care, you will have an opportunity to
inspect the feet for injuries or other problems.
Report any unusual conditions to the nurse.
 4\ SKIN CARE
Bathing does a lot for a person: It refreshes and relaxes; eliminates
body odor; removes dirt, oils and dead skin cells; and stimulates blood
flow (circulation) through the body.
Good blood flow to the skin helps to keep the skin healthy.
 A back rub, which is often provided as part of the bath, stimulates
blood flow to the skin as well.
When and how a person chooses to bathe can be influenced by factors
such as the person’s culture, religious beliefs or long-standing habits.
 4\ SKIN CARE cont…
Bathing
When you are assisting a person to bathe, be aware that the person may
be embarrassed about needing help.
 Encourage the person to complete as much of the bath as he or she can
independently, and take measures to keep the person warm and protect
his or her modesty.
When you are scheduling bath times, take into account the person’s
preferences as well as your employer’s policies.
 Be aware that the people in your care do have the right to refuse a bath.
 4\ SKIN CARE cont…
Close attention is needed to prevent accidents when bathing.
Water on hard bathroom surfaces can be very slippery.
 Make sure that showers and tubs have nonskid mats and surfaces and
that grab bars are tightly fastened to the wall.
To prevent burns, check the temperature of shower or bath water by
using a bath thermometer
The temperature should be between 105° F and 115° F. If a
thermometer is not available, use the inside of your wrist to check the
temperature of the water.
 4\ SKIN CARE cont…
Assisting a person with a bed bath
A complete bed bath involves bathing all parts of a person’s body
while she is in bed.
A partial bed bath involves bathing only the face, hands, axillae
(armpits), perineal area, back and buttocks.
A partial bath may be given on days when a complete bath is not
scheduled.
A partial bath can also be a useful compromise when the person
refuses a complete bath.
 4\ SKIN CARE cont…
Assisting a person with a shower or tub bath
People who are able to get out of bed will take a shower or a tub bath.
Shower stalls in health care facilities are usually large enough to
accommodate a shower chair, so that the person can sit down while
showering
A shower chair should be used if the person is not reliably steady on
his feet.
 4\ SKIN CARE cont…
You may see several different types of bathtubs in use in a health care
facility.
If using a standard bathtub (for example, in a person’s home), make sure that
the person can get in and out of the tub safely.
The person should be:
■ Predictable.
■ Able to bear all or most of his own weight.
■ Able to stand on one foot and lift the other foot over the edge of the tub with
minimal assistance.
■ Able to lower his body into the tub.
 4\ SKIN CARE cont…
Back Rub
Back rubs promote blood flow to the skin and can be very relaxing for the
person.
 Often a back rub is provided as part of the bed bath.
 Alternatively, you may give a person a back rub before bed to help the
person relax and sleep better.
 During a back rub, you can also check the person’s skin for reddened
areas or other changes that could signal the beginning of a pressure ulcer.
Before giving a back rub, consult with the nurse or check the person’s care
plan.
Back rubs are not allowed for people with certain conditions, such as those
who are recovering from back surgery.
Thank You!
 Chapter 13: Assisting with Personal
Cleanliness and Grooming
Mouth Care and Hair Care and Shaving
1:00 pm – 3:00 pm

Prepared by:
Dr. Ibrahim Abbakr
Dr. Badria Alfaki
Outline
1. Mouth Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
2. Hair Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
3. Shaving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Objectives
■ Explain why mouth care is important, and describe when mouth care
should be provided.

■ Explain how to maintain the hair.

■ Explain how to assist a person with shaving, and describe safety

measures that should be observed.
Assisting with Personal Cleanliness and Grooming
When you help a person with personal hygiene and grooming
activities, you help the person feel confident and attractive.

A person who feels confident and attractive is more likely to

socialize with others and feel better about himself or herself in
general.

Think about how you felt on a day when you knew you looked
your best, versus how you felt on a day when you had to rush
through your normal personal care activities!
 MOUTH CARE
oPart of your responsibility in assisting with personal care is
to help provide mouth care, also called oral hygiene.
oMouth care includes care of the teeth, gums, tongue, lips and
soft parts of the inside of the mouth, such as the cheeks and
the roof of the mouth.
 MOUTH CARE cont…
oGood oral hygiene is necessary to keep the mouth and the
body healthy.
oRegular brushing and flossing helps to remove plaque, a
sticky, colorless layer of bacteria that forms on the teeth.
oSugars and starches in the food we eat cause the bacteria in
plaque to grow.
oThese bacteria can cause bad breath odors.
oIn addition, they produce acids, which destroy the outer
surface of the tooth, leading to tooth decay.
 MOUTH CARE cont…
oIf plaque is not removed by brushing the teeth, it hardens
into tartar.
o Tartar can cause gum irritation and infection, as well as
tooth decay and loss.
 MOUTH CARE cont…

o The same bacteria that cause gum inflammation and infection can
also cause inflammation and infection in other parts of the body,
putting the person at risk for heart disease, stroke and other serious
conditions.

o In addition to removing harmful bacteria, regular mouth care also

helps to keep the tissues of the oral cavity moist.

o A dry mouth is uncomfortable and can alter the taste of food and
beverages, making them less appealing.
 MOUTH CARE cont…
At minimum, assist those in your care with mouth care:
■ Every morning
■ Every evening
■ After each meal
■ Every 2 hours, if the person is unconscious, on “nothing by mouth”
(NPO) status, on oxygen therapy or breathes through the mouth (all of
these conditions can cause the mouth to become dry and uncomfortable)
■ After the person vomits
• Assistive devices, such as toothbrushes with built-up handles or
electric toothbrushes, may enable some people to provide for their own
mouth care independently
 MOUTH CARE cont…
ELDER CARE NOTE.
o Good mouth care is important for people of all ages, but it is especially
important for older people.
oSaliva helps to keep bacteria from sticking to the surfaces of the teeth.
oHowever, as we age, saliva production decreases, leading to a dry
mouth.
oMedications that older people commonly take, such as those used to
treat high blood pressure, can also decrease saliva production.
oIn addition to allowing plaque to build up faster, a dry mouth is
uncomfortable and can make food less appealing.
o For these reasons, regular mouth care is particularly important for the
older people in your care.
 Mouth Care for a Person with Natural Teeth
o Natural teeth are cared for using a soft-bristled toothbrush, toothpaste
and dental floss.
o The soft bristles of the toothbrush remove plaque and food particles
from the teeth and tongue and stimulate circulation in the gums, which
helps keep them healthy.
o The toothbrush should be replaced every 3 to 4 months, or when it
begins to show wear.
o Unless instructed otherwise, use a toothpaste that contains fluoride (a
chemical that helps to strengthen the tooth enamel and prevent tooth
decay).
Mouth Care for a Person with Natural Teeth continue…
oAfter brushing, dental floss is used to remove plaque and food
particles from between the teeth.
oWaxed dental floss slides between the teeth more easily than
unwaxed dental floss does.
oBefore flossing a person’s teeth, check with the nurse or review
the person’s care plan to see whether there are any restrictions
or special precautions to be considered
oFor example, some people taking certain medications may
bleed excessively if their teeth are flossed.
Mouth Care for a Person with Dentures

• Many people have dentures (false teeth).

• Complete (full) dentures replace all of the top teeth
or all of the bottom teeth.
• Partial dentures replace only a few teeth.
• Wearing dentures decreases gum shrinkage after
teeth have been removed and maintains the shape
of the mouth.
Mouth Care for a Person with Dentures continue…

oDentures are cleaned by brushing them with a special

toothpaste made for dentures.
oSome people may also soak their dentures in a denture-
cleansing solution as part of their denture-cleaning routine
oA soft mouth sponge is used to clean the soft tissues of the
mouth after the dentures are removed for cleaning.
oDentures are removed for cleaning and, ideally, for at least 8
hours every day (usually overnight) to rest the gums.
 Mouth Care for a Person Who Is Unconscious

oAn unconscious person is not able to respond to her

environment and will be totally reliant on you for mouth care.
oPeople who are unconscious breathe through their mouths,
which causes drying of the soft tissues of the mouth and leads to
the build-up of mucus and other secretions on the teeth and
tongue.
oYou must provide mouth care for an unconscious person every
2 hours throughout the day and night to remove these
secretions and prevent the mouth from becoming excessively
dry
Mouth Care for a Person Who Is Unconscious continue…

oWhen providing mouth care for a person who is

unconscious, elevate the head of the bed (if allowed) and
turn the person’s head to the side to allow fluids to run out
of the mouth instead of down the person’s throat.
oThis is important to prevent aspiration
oAspiration can lead to pneumonia
oUse a mouth sponge to clean the soft tissues of the person’s
mouth and a soft-bristled toothbrush moistened with water
or a mixture of mouthwash and water to clean the person’s
teeth.
 Mouth Care for a Person Who Is Unconscious continue…

oRemember to tell the person what you are doing as you are
doing it.
o Even though the person cannot respond to you, he may be
aware that something is being done to him.
 HAIR CARE

oHair care, which includes washing, brushing, combing

and styling the hair, is necessary to keep the hair and
scalp healthy, and to maintain a neat appearance.
oWashing the hair (shampooing) removes dirt, oil and
bacteria from the hair and scalp.
oMany long-term care facilities have salons where
residents can go to have their hair professionally cut,
washed and styled
 Brushing, Combing and Styling the Hair

oA comb with widely spaced, blunt teeth is used to remove

tangles from wet or dry hair.
oA brush is used on dry hair to neaten the appearance of the
hair.
oTo prevent hair from breaking and to detangle the ends, start
brushing or combing from the ends of the hair, working
toward the scalp, and work in small sections.
oRemember to comb and brush hair gently so that you do not
pull it out
oask about the person’s preferences
 Shampooing the Hair
oShampooing cleans the scalp and hair and stimulates blood
flow to the scalp.
oMany people find it very relaxing to have the head and scalp
gently massaged as part of the shampoo, and having clean
hair can help a person to feel better in general.
oHow often the hair is washed varies from person to person.
oOlder people tend to have drier skin and hair and are
usually less active than younger people, so they may only
need to wash their hair once or twice a week.
Shampooing the Hair continue…

oPeople with oily skin and hair or people who are very
active may need to wash their hair every day.
oShampooing is often accomplished in the shower or tub
while bathing.
o If the person is unable to get out of bed, his hair can be
washed while he is in the bed using a shampoo tray
 SHAVING

Shaving is done to remove unwanted hair from the body.

A safety razor is used with warm water and shaving
cream, gel or soap. An electric razor is used after applying
a pre-shave lotion.
 Men who have very curly beards may prefer not to
shave, but to use a depilatory cream (hair removal cream)
or powder to chemically dissolve and remove facial hair.
Many women also use a depilatory product to remove
unwanted leg, underarm or facial hair.
 Shaving with a Safety Razor
When using a safety razor, it is easy to nick the skin,
causing bleeding.
Because people with certain medical disorders or who are
taking certain medications can bleed excessively if they are
cut, check the person’s care plan or ask the nurse before
assisting a person to shave with a safety razor.
For people with conditions that can cause them to bleed
excessively, an electric razor is usually preferred
Shaving with a Safety Razor continue…
Before helping a person to shave using a safety razor, inspect the
skin for moles‫امات‬II‫ ش‬or other raised areas.
 Shave carefully around these areas to avoid scraping‫ا‬I‫شطه‬I‫ ك‬or
cutting them, which could cause bleeding. Apply shaving cream, gel
or soap to soften the hair and help the razor glide over the skin.
Many men will prefer to finish the shave by applying aftershave
lotion, which has a nice scent and helps to soothe the skin.
The alcohol in most aftershave lotions also acts as an antiseptic and
can help to stop bleeding from small nicks or cuts.
 If a nick or cut does occur while shaving, report this to the nurse.
Always take standard precautions when helping a person to shave with a
safety razor.
 Because blood particles may be left on the razor blade and can spread
infection, make sure each person has his own safety razor.
 When the blade on a safety razor becomes dull, it is more likely to nick
the person’s skin.
Depending on the type of safety razor, the entire unit may be disposable,
or you may just need to replace the blade.
Always handle razors and blades carefully to avoid nicking yourself and
dispose of them properly in a sharp's container.
To store a safety razor between uses, place it blade-end down in a
container without recapping it.
You may accidentally cut yourself if you attempt to recap the razor.
 Shaving with an Electric Razor

An electric razor lifts the hair away from the skin before
slicing it off with the blade.
Thus, an electric razor carries a lower risk of cutting or
nicking the skin and is preferred for people with blood-
clotting disorders and those who are taking medications
that affect the blood’s ability to clot
Applying a pre-shave lotion can help to soften the hairs
and may result in a smoother shave when using an electric
razor.
Shaving with an Electric Razor continue…
Electric razors are small appliances, so remember to take the same
precautions when using them that you would with any electrical appliance.
Inspect the razor before using it to make sure that the cord is not frayed
and that it is operating normally. If the razor is malfunctioning (for
example, it stops and starts, or is making a strange sound), do not use it.
 Check with the nurse before using an electric razor in a room where a
person is receiving oxygen therapy, because an electrical spark could ignite
a fire.
 (It may be safe to use a battery-operated or rechargeable electrical razor
in these circumstances but check with the nurse first.)
To keep the razor in good working order, take it apart and clean it after
each use.
Thank You!