Basic Hygiene
Care of the Skin
Lifting & Postioning
Getting someone out of bed
Getting off the bed pan
Positioning a patient in bed
Use of a draw sheet

Basic Hygiene

If your loved one is unable to wash themselves, here are some easy steps to follow.
Gather wash basin, towel, and wash cloth or sponge.  Frequently change water. Water should be warm rather than hot. Use mild soap.   Wash, rinse and completely dry separate areas. Wash the face and neck first. Then bathe the trunk and arms, legs and feet and lastly perineal areas. Always dry each area completely. You may want to add a little powder or deodorant. Look for any reddened areas, especially the bony parts, or pressure areas (elbows, heels, upper buttocks, shoulders, even ears). You can apply lotion to reddened areas.

Include mouth care. If the patient is unable to brush their own teeth, you should provide mouth care at least twice a day. Gently brush natural teeth or remove dentures and clean them. If patient is unresponsive, a mouth swab should be used. Either a lemon glycerin swab or a 4"x4" gauze pad squeezed almost dry with mouth wash can be used to clean and refresh the mouth, (the nurse will supply you with swabs, if needed). Remember, an unresponsive patient may not be able to swallow, so use only a small amount of liquid.

Care of the Skin

Keeping the skin in good condition is very important, especially if the patient is bed-bound or is not able to change their position very often. A good time to check the skin is during the bath.

Dry skin may look flaky and white, may itch or be red and look like a rash. Ask your nurse to check any changes you notice, especially if you see redness over any of the pressure areas. This may be the beginning of a bedsore. Although it is up to your nurse and doctor to decide what treatment will help the area heal, there are several things you can do to lessen the risk of developing bed sores.  Encourage the patient to change position frequently in bed, or shift from side to side in a wheelchair. You can refer to the section in the Caregivers Guide web pages and downloadable documents on turning and positioning if you need to assist the patient in position changes.

Apply lotion gently to the bony areas. Make sure pain medication is given to a patient who has pain. This will make them more willing to move and make it easier for them to do so. Items such as elbow and heel protectors, special mattresses and sheep skin may be necessary to further protect the skin.  Keep the skin clean and dry.  Keep the sheets dry, and smooth out any wrinkles.

Lifting and Positioning

Try to remember the #l rule, always lift with your legs and not your back. Take an extra moment to think about lifting before you do it. It is important to learn how to lift with the least strain on yourself.

Getting Someone Out of Bed

If you have difficulty in performing this procedure, don't hesitate to ask your nurse to demonstrate for you.  Roll the person on their side, facing you.  If you have a hospital bed, raise the bed. If not, place your arms under the patient's underarm and gently pull to a sitting position. Bring the legs around to dangle from the bed.  If the patient can not sit up alone, put one arm around the back of the shoulders, supporting the neck, and with the other arm gently pull forward to the edge of the bed.  Reposition yourself to insure positive balance.  Put both arms around the patient under their arms. Have the patient put their arms around your neck. Brace your knee against the patient's knee by placing one leg between the patient’s legs and gently lift up.   When both of you are standing, turn towards a chair and gently let the patient sit. Remember to have the chair in a nearby position to make moving easier. Also, if lifting to a wheelchair, be sure it is in a locked position.

Getting On and Off the Bedpan

If the patient is not able to get out of bed or if it is easier to use a bedpan at night, use the following steps:

When the patient is on their back, you can begin by crossing their legs. If you are rolling the patient to turn to the left, place the right leg over the left, and cross the right arm over the chest.   The patient may be able to grab the side rail to help you. When their leg and arm is crossed over, place your hands under their back and roll the patient on their side. Place the bedpan as close to the patient's buttocks as possible and then you can roll the patient on to the pan. Fracture pan - place the handle to the front and the flat part against the patient's back. When the patient is finished follow the steps above to remove the pan. Wear protective gloves at this time.  When the pan is removed, keep patient on their side to wash arid dry the area. It is easier to clean the perineum while the patient is still on their side. Then you can roll the patient on their back.

Positioning a Patient in Bed

You can use the same technique as positioning a patient on their side. Use pillows to place behind the patient’s back to prevent them from rolling. You can also use small pillows or soft thin blankets to place between the legs and arms to prevent pressure.  Remember, it is very important to change the patient’s position often.  After positioning, always look and see if the patient is comfortable.  Think of yourself and if you would be comfortable in that position.  Ask if they are comfortable.

Use of a Draw Sheet

If the patient is unable to move, you can use the help   of a draw sheet.  This can be a soft blanket or folded sheet, large enough to reach from shoulders to mid-thigh, with six inches or more on either side for you to hold it. Place the sheet under the patient using the same technique of rolling the patient on their side (see bedpan placement).  Keep the draw sheet wrinkle free under the patient to prevent pressure sores. When the draw sheet is under the patient, you can then lift the patient higher in the bed or roll from side to side using the draw sheet.  Use two people to hold either side of the draw sheet.  Roll the draw sheet up to the patient on either side. On the count of three, move the patient in unison.