Hand care:

        The nails of an older adult tend to be ridged, grooved, thick and brittle. They grow at about half the rate than those of younger adults. Weekly attention to an older adult’s hands keeps nails attractive and in good condition. This should include:

• Wash hands under running water and clean under the nails using the pointed end of an orangewood stick (a kind of wooden stick with a rough surface that is used in manicuring nails). After cleaning, be sure to rinse the orangewood stick off or dispose of it. The use of a metal instrument may roughen the nail and make it easier to collect dirt.
• Massage the nails and cuticles with a lotion. Make sure to massage the sides of nails and the areas where the nail extends over the finger. This massage stimulates circulation, and this helps strengthen nails and prevent thickened nails. Lotion massaged on cuticles helps to prevent hangnails.
• Soak the nails in warm, soapy water for 3-5 minutes. This will make the cuticles and nails softer and easier to manipulate.
• Push cuticles back gently. Harsh rubbing or poking at the cuticles can cause them to split into hangnails and could cause infection.
• Shape nails into an oval using the fine side of an emery board, making sure not to file too close to the sides of the fingers. Filing too close to the side of the finger could cause injury to the cuticle and skin around the nail. Cutting the nail tends to make them brittle. Move the emery board in one direction rather than using a sawing motion that can leave rough edges.

        The general health of the care recipient is often reflected in the nails’ appearance. Nails that are broken or brittle may be the result of an improper diet. However, they can also be the result of improper care. Improperly cared for nails can be a health hazard. Nails that are broken, brittle, or have cuticles that are torn can permit microorganisms to enter the body. Dirty nails also carry germs which can spread infection when handling food or scratching the skin. As people get older, their nails’ physical appearance and growth rate changes. Nails should be cared for daily by cleaning beneath them and pushing back the cuticle. The best time to do this is right after bathing. Soap and water will loosen dirt and soften the cuticle. Extreme caution must be taken when clipping and trimming nails to prevent any damage to surrounding tissues. If the care recipient has diabetes, or circulation problems, do not cut the nails unless directed to do so.

Giving Finger Nail Care procedure:

1. Assemble equipment

             a)      Towel;

             b)      Washbasin;

             c)      Nail clipper;

             d)      Orange stick;

             e)      Nail file or emery board

1. Wash your hands.
2. Explain to the care recipient what you are going to do.
3. Help care recipient to a chair close to table, if possible. If in bed, raise the bed to a comfortable working height.
4. Place a towel under a half-full basin of water. Water temperature should be warm, but not too hot.
5. Soak care recipient’s fingernails for 20 minutes.
6. Clean under fingernails. Push cuticles back gently. Rinse and dry fingernails.
7. Place hand on a towel. Shape into an oval or rounded shape with the nail file or emery board.
8. Properly dispose of nail clippings by putting them in a sealed trash container.
9. Clean and put away equipment.

Wash your hands.

NAIL AND FOOT CARE

• Nails and feet need special attention to prevent infection ·injury and odor.
• Many older clients cannot see well enough, or cannot reach their feet, to do thorough self-care.
• Cleaning and filing nails is easier if nails are soft, like after soaking in water.
• (Remember: PCW do  not cut or trim fingernails or  toenails).

Procedure for Foot Soaks:

1. Explain the procedure.
2. Assist the client to remove shoes and stockings as necessary. Wash your hands.
3. Gather equipment:

              a)       Basin (large enough for feet);

              b)      Towel;

              c)       Washcloth;

              d)      Emery board or nail file;

              e)       Lotion;

               f)       Bath mat or plastic cover (trash bag) to protect the floor from spilled water

1. Cover the floor with waterproof protector
2. Fill the basin with warm – NOT HOT – water.
3. Direct or help the client to place feet into basin of water.
4. Wash all surfaces of the feet and between the toes.
5. Soak the feet for 15-20 minutes.
6. Remove feet from water and dry thoroughly.
   1. Pay special attention to areas between the toes.
   2. Apply lotion to feet and legs as directed. (Avoid deep massage of the legs)
   3. Re-apply stockings and shoes.
   4. Clean up the area.
   5. Wash hands.

Note:

Report any of the following observations:

• Swollen puffy feet;
• Any breaks or cracks in the skin;
• Reddened areas;
• Pain.