Showers & Personal Hygiene

Showers & Personal Hygiene

Personal Assistance ranges from being present for safety during a shower to lifts, transfers and full assistance with showers or bathing, toileting and peri-care. Providing support that respects individual privacy and dignity is central to how caregivers operate. This is especially true when providing intimate personal support.

• Standby presence for safety
• Mobility assistance to the shower and transfer assist to shower chair or bench
• Assistance during shower
• Assistance getting dry
• Application of creams and lotions
• Sponge bathing in bed when mobility is impaired and transfers are not possible

• Oral Care
• Skin Care & Shaving (Must be pre-approved and only using a mechanical shaver)
• Simple Haircuts (Not all caregivers provide)
• Filing Hand & Foot Nails**
• Brief changes
• Peri-care and washing
• Toileting
• Transfers to a bed or chair
• Repositioning in bed or a chair

**Please Note** Caregivers cannot clip or trim hand and foot nails.

This must be done by a Foot Care professional. Cuts on fingers and toes can lead to serious infections and worse for individuals with peripheral neuropathy, peripheral vascular disorders, diabetes and other conditions.

Mechanical Lifts, Wheelchairs and Transfers require Skilled Caregivers

educated in Safe Patient Handling.

• Having the right equipment and setup can make all the difference. Check out the Vancouver Island Resource Guide: Medical Equipment Suppliers

Resistance to Personal Care and Showers

Most of us are resistant to the idea of any help; let alone help while naked! When there is a degree of dementia, paranoia or cognitive decline this resistance can be a serious problem. 

• The right approach to the individual and continuity in who comes are critical to success.
• Caregivers do not force people to do things they will not consent to. Forcing anyone increases the odds of aggression and the likelihood that someone gets injured.
• Caregivers learn the language and approach that can build positive routines. Caregivers ask, bargain, cajole, provide choices, seek to build trust and look for the path to success.
• Especially when a service is brand new, it can take several visits before an individual feels comfortable accepting personal care from a new caregiver.

It’s not uncommon for clients with dementia to react aggressively when showers or personal care are suggested. Finding the right approach can be critical to success. Examples:

Asking a client with dementia if they wanted a ‘shower’ always received an aggressive response and they would try to send the caregiver away. 

• When someone familiar to the individual used the words ‘wash-up’ instead this was often accepted. (Language that didn't insult their dignity)
• When the individual expressed back pain, suggesting warm water on their back for relief was almost always accepted. (Framed in terms of pain relief)
• This individual also had bowel incontinence and we would frequently come in to find some sort of disaster that the individual tried to sort out themself. We never asked if they needed help because they would always decline.

Asking a client with dementia if they wanted a ‘brief change’ was always tersely refused and made them upset.

• The bathroom was upstairs so caregivers would suggest going upstairs for an unrelated activity, perhaps to lie down for a nap. (Proposing an activity they would accept that got us closer to the desired location)
• Climbing stairs was difficult for the client so when they passed by the bathroom they would suggest sitting down. (Framed in terms of pain relief)
• Once the person was sitting on the toilet the caregivers said something like “Oh while we’re here we’ll get you tidied up”, not quite asking and not quite telling and then they accepted the brief change.
• It’s very important that caregivers vocalize what they are doing before they do it with an individual who has dementia with a calm soothing tone. Sometimes knowing helps people to accept and sometimes it’s less what we say and more how we say it.