This is a multi-part series to help professional eldercare givers learn how to assist adults with their personal care. Activities of Daily Living, or ADLs, are basic eldercare self-care tasks. In Part II, we will focus on assisting an older adult with grooming and dressing.
Assisting with Personal Eldercare: Grooming
Helping with nail care
Nail care should be performed every week. The nails of an older adult are often thick but also brittle, and grow more slowly than those of younger adults. After washing the older adult’s hands, clean under the nails using the pointed end of an orangewood stick. An orangewood stick is preferred to a metal stick. Then either rinse the stick or dispose of it.
Massage the nails and cuticles with a moisturizing lotion. This helps to prevent hangnails. Soak the nails in warm, soapy water for 3-5 minutes. This will make the cuticles and nails softer. Push cuticles back gently. Too rough may lead to skin breakdown and infection.Cut nails with a nailcutter; or, if nails are brittle, file them down instead. Move the emery board in one direction and don’t file too close to the sides of the fingers.
Helping with shaving
Make sure you are working in a well lit area and sit the older adult upright if possible. Place a towel under his chin to protect his clothes. Spread a warm (not hot), damp towel over the lower face and chin to soften the hairs, or have him take a shower before the shave. This makes shaving much easier.
Using a circular motion, apply a thin, even layer of shaving cream on the lower face and chin, and leave it on for a minute to soften the hairs. Warm a razor with a sharp blade in a tub of warm water. Stretch the older adult’s skin as taut as possible while shaving. Shave in the direction of hair growth. Usually the beard hairs grow downward toward the neck, but neck hair usually grows toward the chin.
Use short strokes, starting with sideburns, cheeks and neck. Finish with the upper lip and chin. Wipe the razor on a clean towel or tissue, and rinse it in a tub of warm water frequently. When you are done, rinse the person’s face thoroughly with cool water and pat dry with a towel. Do not rub. Finally, apply non-sting after-shaving moisturizer.
Helping with routine skin care
Skin changes with increasing age: it begins to thin, dry and becomes easier to damage. The normal fat layer under the skin begins to disappear, making it easier for pressure sores to develop. For proper dermatology and eldercare, keep the person's skin clean and moisturize it regularly. Use a moisturizer that is free of fragrance and unnecessary ingredients that may cause skin irritation or allergy. Eucerin is often a good choice. Even the massaging motion of applying moisturizer can help keep an older adult’s skin healthy.
Assisting with Personal Care: Dressing
Assisting with clothing - including adaptive clothing
First, gather necessary items; for example, towel/blanket, older adult’s choice of clothes, gloves. Start dressing the older adult’s weaker side. Pull the shirt over the head or around the back. Finally, assist older adult with stronger side
The goal is for the older adult to do as much of the dressing as possible themselves. One way to encourage this is to use adaptive clothing, which is widely available. Adaptive clothing, or ‘easy access clothing’ is easier to change and remove than regular clothing, and is specially made for older adults or people with disabilities. It has simple closures, helps an older adult retain dignity and provide some level of self-care.
Some examples of adaptive clothing include Velcro shoe closures, Velcro or snap closures rather than buttons, front closing bras, and designs which allow a person to get dressed from a seated position.
Assisting with support stockings
Support stockings by definition are snug-fitting and can be difficult for an older adult to apply themselves. They can even be difficult for caregivers to apply, but a few simple strategies can make their application much easier.
First, have the older adult sit while applying stockings. Make sure there is no skin breakdown. Apply the stockings before the older adult gets out of bed in the morning (before any swelling starts), and take them off after they get in bed at night. This can make application much easier. There are various devices that can make the application of compression stockings much easier, such as an E-Z slide applicator. Ask at the medical supply store where the stocking was purchased for what they have available and for any instruction on using their applicators.
If the stockings are open-toed, place a plastic bag over the foot, and put support stocking over. Then remove plastic bag by pulling it through the open toe area. Do not fold the top edge of support stocking, this can cause tourniquet effect.
If the older adult won’t wear the stockings because they feel too tight, speak to the doctor or therapist who prescribed them. Stockings are available in very light strengths, and often some compression is better than no compression at all. Support stockings usually only need to be knee high, any higher and they are more difficult to pull on.
Put any creams or moisturizers on the legs at night and then stockings on in the daytime. Moisturizers can damage the elastic in stockings. Always remember to apply footwear with a rubber sole, as support stockings are slippery and have no traction when walked on.
Assisting with personal care is important, but remember to let the older adult do as much as possible themselves. Professional eldercare is about helping someone enjoy their lives.