Assisted Sponge Bath or Shower.

        Bathing assistance is provided to those clients who cannot be independent in self­ care due to either physical or mental limitations.

Purposes of bathing:
  • To clean and deodorize the skin
  • To stimulate circulation
  • To produce a sense of well-being
  • To promote relaxation and comfort
  • To prevent and eliminate unpleasant body odors

        Clients require varying degrees of help with bathing. Typically, clients can wash with just a little assistance, like rinsing and wringing out the washcloth or washing their backs and feet. In those cases, the aide’s job includes:

  • Reading the care plan,
  • Organizing the equipment,
  • Anticipating what will be needed for this procedure,
  • Providing privacy and safety,
  • Offering a helping hand,
  • Observing the condition of the skin,
  • Doing the cleanup of the bathroom afterward.
Reading the Care Plan:
  • Pay attention to the amount of help the client needs with the bath and make sure the care plan matches what the client needs.
  • If the care plan says the client needs only a stand-by assist into the shower, but you find that she
  • Cannot get into the shower at all due to her weakness, call the office and report this to the supervisor.
  • The supervisor needs to know about any changes in the client’s condition, which may change the plan of care.
Organizing the equipment (wash hands first):
  • Washcloth 1 or 2 bath towels, soap and shampoo if is part of the shower routine.
  • Lotion, powder, and deodorant.
  • Clean clothing, slippers or shoes.
  • (Basin for soaking feet, if this is sponge bath)
Anticipating what the client will need:

        Think about your own daily routine and the things you need in order to complete your own personal care. Proceed in an organized manner.

  • Check out client preferences, like when to brush teeth – before or after a shower?
  • Remind the client, if necessary, to use the toilet or urinal before bathing.
Providing Privacy and Taking Safety Precautions:
  • Assist the client as necessary with removing clothing.
  • As clothing is removed, offer a towel to drape the client.
    • Ladies may need 2 towels: one around the neck and down the front of the chest, another around hips – or one bath towel around her torso and underarms.
    • Men should be draped with one towel around the waist.
  • safety precautions should be taken to avoid wet surfaces and to offer stability during the step into the shower, etc.
  • Always make sure the floor of the tub or shower has a non-skid surface.
  • Have a small skid-resistant bath mat, rug, or dry towel for stepping out after showering.
  • Checking water temperature is a very important part of helping with bathing.
  • Test it as you would for your own shower or bath.
  • Have a stool or chair just outside the shower, in case the client becomes weak while bathing.
  • Have the client use the grab bars on the wall to assist sitting on the bath bench – if available.
Offer a helping hand:
  • Some clients might need minor guidance in the shower.
  • Check the water temp. Help direct the shower spray or hand the shower extension to the client.
  • Remove the privacy drapes discreetly.
  • The client may need assistance rinsing and wringing out the washcloth.
  • Offer to wash the client’s back, lower legs, and feet, if necessary.
  • If steady and not confused, the client can be left alone for a few minutes to complete the bath.
  • Stay within earshot and announce your re-entry to the bathroom.
  • Offer towels again and help to drape the client if necessary.
  • Help to dry the skin in hard-to-reach areas (back, feet, lower legs).
  • Offer deodorant, lotion, powder, etc.
  • Help the client get dressed, but encourage independence as much as possible.
  • Provide hairbrush or comb, make-up, etc.
Observing the condition of the skin:
  • During the bathing process, it is important to notice the condition of the skin.
  • Report anything unusual: rashes, wounds, redness, swelling, tenderness, or bruises to the supervisor.
Bathroom cleanup:
  • After the shower, ease the client into a comfortable chair or bed.
  • Clean the tub or shower (or basin) with the client’s household or bathroom cleaner.
  • Hang towels to dry.
  • Put away all supplies.
  • Wash your hands.
Giving a Partial Bath
  • Partial baths involve _bathing face, hands, underarms, genitals, back, and buttocks. These body parts develop odors or become uncomfortable if not clean.
  • Partial bed baths are given to clients who cannot bathe themselves independently and are given on days when a complete bath or shower is not given.
  • Partial baths can be given at the bathroom sink or at the bedside, depending on the client’s condition or preference.
  • Follow the general guidelines for the complete bed bath.
Complete Bed Bath:
  • Are ordered for persons confined to bed for medical reasons like illness and paralysis.
  • Are ordered for bed-bound persons who can help with their bathing procedures and should be encouraged to participate.
  • Should be done at the bedside.
The purposes of bathing, as stated previously, are:
  • To clean and deodorize the skin
  • To stimulate circulation
  • To promote a sense of well-being
  • To promote relaxation and comfort
  • To prevent and eliminate unpleasant body odors

Steps in performing the Complete Bed Bath:

        Read the care plan. If you find the client’s condition requires a bed bath when he/she usually receives less assistance, report this to the supervisor because your care will not match the care plan established by the supervisor.

The client may be going through significant changes, which the supervisor should know about.
  • Prepare the client and the surroundings.
  • Close windows and doors to eliminate drafts.
  • Provide privacy.
  • Assist the client to use the bedpan, urinal, or commode.
  • Wash hands after handling toilet equipment.
  • Offer oral care assistance at this time.
  • (This can be done when the bath is finished.)
  • Remove heavy blankets from the bed.
  • Help the client to undress.
  • A cover client with a light sheet, blanket, or towels. I 0. Privacy drape.
  • Bath towels can be warmed in the dryer to provide additional comfort.
  • If using the bedsheet as a cover, loosen the ends from the bottom of the bed.
  • If the client has a soiled incontinence pad, give peri-care and replace the pad before proceeding with the bath.
  • Make a bath “mitt” by folding the washcloth over your hand to form either a triangle or a rectangle. The mitt retains heat and moisture better than a washcloth that is loosely held.
 Face, Head, and Neck
  • Wash the client’s face. Use warm water – not soap – for eyes-only.
  • Use a separate corner of the washcloth for each eye.
  • Wash eyes from the inside corner toward the outside corner.
  • Do cleaner areas first to prevent infecting tear ducts with secretions from the eyes.
  • Ask whether the client wants soap used on the rest of the face.
  • Wash, rinse, and dry the client’s face, ears, and neck.
Arms and Hands
  • Place the bath towel the long way under the client’s arm.
  • Wash, rinse, and dry the arm using long, firm strokes from the wrist to shoulder. This helps to stimulate circulation.
  • Move the towel under the hand.
  • Place the basin of water under the client’s hand.
  • Place the hand directly into the wam1water.
  • Assist client to wash, rinse, and dry the hand.
  • Repeat the above for the other arm and hand.
Chest and Abdomen
  • Fold the cover sheet down to the lower abdominal area.
  • Cover the chest with the towel.
  • Wash, rinse, and dry the chest, and abdomen.
  • Pay special attention to any skin folds of the belly or breasts.
  • Replace the cover sheet when all areas have been dried.
  • Check water and change if cloudy or cool.
Legs and Feet
  • Fold back the cover sheet to expose one leg and foot, keeping the client’s genitals covered.
  • Place the towel lengthwise under the leg.
  • Wash, rinse, and dry the leg from ankle to knee, then a knee to thigh, with long, firm strokes.
  • Work from the ankle upwards to help promote circulation.
  • Move basin and protective towel to the foot.
  • Place the foot in the warm water.
  • Wash between toes and check feet for breaks in the skin or reddened areas.
  • Dry the foot carefully.
  • Repeat the above for the other foot and leg.
  • Discard the water and start with fresh water. Use another dry towel if necessary.
Back and Perineum
  • Assist the client to tum on her side, away from you.
  • Cover her back with the towel.
  • Wash and dry the back, buttocks, and back of thighs, using long, firm strokes.
  • Clean creases well.
  • Apply lotion and give the client a back rub at this time, if desired.
  • Keep the client covered as much as possible.
  • Pay close attention to the condition of the skin.

        Report to the supervisor areas that are reddened and remain reddened even after pressure is relieved.