Showering and bathing is a personal experience, but many people will require help with this daily task as they grow older.

Bathing is important for older people. It helps with personal hygiene and can be an important part of continence management and managing skin integrity.

But bathing is also pleasurable, it makes people feel both refreshed and relaxed, and can greatly benefit a person’s sense of wellbeing.

Home care workers can talk to clients who need assistance with bathing about the best ways to help them. Helping clients maintain their bathing routines can help them hold onto a sense of normalcy and routine in their lives. 

Together, home care staff and their clients can discuss how often the client will be bathed and at what time of day. Some people like to shower twice a day, whereas for others, showering every few days is enough. Some like to bathe in the evening, others prefer the morning. 

Some older people become reluctant to shower at all, and carers never have to feel the need to force someone to bathe against their wishes. If you are having trouble at first, leave it until the next visit, and if the problem persists, speak to their loved ones.

Bathing is an intimate task, and every effort must be taken to preserve the dignity of the client and ensure they feel comfortable and respected at all times. Some clients will prefer to have someone of the same gender to bathe them. It is key that carers understand their client’s wishes, and do their best to provide care in line with those requests.

Assessing the situation

First, see if the client’s care plan includes information about bathing. If guidelines aren’t in place, sit down with the client, perhaps with a loved one too, and talk to them about how they wish to proceed.

Does the client prefer to have a shower, or is a bed bath necessary? How often do they like to bathe? Are they comfortable with you helping them?

As always, work with the client to ensure you understand their preferences and help them design their own care.

Modifications to the home

Next you will have to determine the equipment that is available to you, and if any modifications are needed to the home. 

Are there handrails in the bathroom? Do you need a shower chair? Are there the appropriate non-slip surfaces in the bathing areas? Would the client benefit from a shower hose rather than a fixed shower head?

If modifications are required, talk to the client or their family about how to get these measures taken care of. They may be covered as part of the client’s home care package.

Always encourage the client to bathe themselves as much as they can. This will help them maintain skills and boost their confidence in their ability to look after themselves.

Preparation for bathing

  • Ensure the room is a comfortable temperature. Ask the client if they are comfortable with the temperature.
  • Ensure windows and doors are closed to prevent drafts. 
  • Ensure the room is free from clutter, especially on the floor.
  • Make sure everything the clients needs is easily within their and your reach.
  • Remove any jewellery you are wearing to prevent causing injuries to the client’s skin.

What you will need

  • Three washcloths
  • Two towels 
  • Soap or soap-free cleanser, such as QV Wash
  • Tear-free shampoo or dry shampoo
  • Body lotion for dry skin, such as sorbolene

Showering the home care client

  • Encourage the client to do as much of the showering on their own as possible.
  • Talk them through every step of the way. Provide reassurance. Being given a shower by another person can be uncomfortable for some people. Try to adopt a relaxed and happy countenance.
  • The client might like to sit in a shower chair.
  • Place soap on the washcloth and wash the face and any other easily reached places.
  • With the second washcloth, wash the body from the top down to the feet, including the back. Help with any areas the client is unable to reach. 
  • Use the third washcloth to wash the genital areas moving from the front to the back. The client will have to stand for this process. Once done, the client can sit down again.
  • Rise off all the soap, including from the genital area. The client may be able to help with the hand held shower head.
  • Turn off the water.
  • Place a towel over the client’s lap and one around their shoulders.
  • Dry the client with the towels, using a circular, massaging motion. It is important to ensure all the skin is dry, including skin folds such as under the breasts or the genital area. Skin left damp is more vulnerable to fungal or bacterial growth or skin breakdown.
  • Apply lotion if the client has asked for it.
  • Check the skin for signs of skin breakdown, rashes or sores. If you see any red areas, don’t rub them. Protect the skin from further damange.
  • Dry any supports, and ask the client to stand and move slowly out of the shower area.
  • Help the client to dress.
  • Dry hair.
  • Shave or help apply makeup, as needed.

Giving a home care client a bed bath

  • If possible, adjust the client’s bed so it’s at a comfortable height for you to bathe them. This is usually considered to be waist height.
  • Place a waterproof sheet or towels under the client to prevent the bed from getting wet.
  • As with showering, talk the client through every step of what you are doing, and adopt a happy, relaxed attitude.
  • Allow the client to undress themselves as much as possible, but help them where needed. 
  • As they remove their clothes, place a sheet over their body to preserve their dignity and privacy.
  • Have the client lying on their back, with their legs slightly apart.
  • As you wash each section of the body, fold a small section of the sheet back. This will preserve the client’s dignity and prevent them from getting cold.
  • Allow the client to wash as much of their own body as they can.
  • Start by washing the face, and move down the body, to the neck, armpits, torso and so on.
  • Use a gentle massaging motion with the washcloths.
  • Make sure you wash in skin creases.
  • Check the skin for signs of skin breakdown, rashes or sores.
  • Gently dry the client with the first towel, again in sections.
  • Roll the client onto their back. If the client can’t help, a second person will be needed.
  • Again, clean the client’s back starting at the top and working your way down.
  • Use the third washcloth to wash the client’s genitals, from the front to the back.
  • Dry the client’s back and genitals with the second towel.
  • Gently roll the client onto their back.
  • Wash the client’s hair with dry shampoo.
  • Apply body lotion.
  • Help the client to get dressed.
  • Help the client with shaving or makeup, according to their directions.

Many home care staff recommend Dermalux bed baths. Refer to HelloCare’s article ‘How to give an elderly person a bed bath’ for more information.

Bathing can be an extremely pleasurable experience, and is both relaxing and invigorating at the same time. It has both physical and psychological benefits. It can mark either the start of a new day, or time for bed, depending on each person’s background and routine. 

Helping residents continue bathing at home helps them hold onto normalcy in their lives. It helps them continue a routine often maintained over a lifetime, and can provide clients with one of life’s simple pleasures. 

When done with dignity and respect, helping a home care client bathe, a task many of us take for granted, is something to be proud of.

 

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