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Personal Care

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Title: Personal Care


1
Personal Care
2
Aims
  • To have a knowledge of different aspects of
    personal care
  • To learn practical skills required to deliver
    personal care

3
National Care Standards
  • Dignity
  • Privacy
  • Choice
  • Safety
  • Realising Potential
  • Equality and Diversity

4
  • What does Personal Care Include?

5
Personal Care Includes
  • Bathing, showering, hair washing, oral hygiene
    nail care
  • Toileting, catheter/stoma care, skin care,
    incontinence laundry, bed changing
  • Assistance with the preparation of food and
    assistance with the fulfilment of special dietary
    needs
  • Dealing with the consequences of being immobile
    or substantially immobile

6
Personal Care Includes
  • Behaviour Management, psychological support,
    reminding devices
  • Assistance with medication (including eye drops),
    application of creams and lotions, simple
    dressing, oxygen therapy
  • Assistance with dressing, surgical appliances,
    prostheses, mechanical and manual aids.
    Assistance to get up and go to bed. Transfers
    including the use of a hoist

7
The Skin
8
Functions of the Skin
  • Protective covering for body
  • End organ pain, touch temperature
  • Secretes sebum- oily fluid which keeps skin and
    hair moisturised
  • Absorbs small amounts of oily substances
  • Origin of hair and nails
  • Contains cholesterol, substance converted into
    Vit D by the action of sunlight
  • Secretes sweat removes waste water and salts
    and plays important part in regulating body
    temperature

9
Importance of skin care
  • Keeping skin clean and fresh is essential for
    general health and wellbeing
  • Dirty skin collects dried sweat, dead skin cells
    and secretions from the glands bacteria breeds
    and causes odours and infections
  • It is important to clean the skin at least daily.
  • If a service user is not willing to either have a
    bath or a shower then they should be encouraged
    to have a daily wash. (even using body wash or
    baby wipes) especially to folds of skin
  • If someone has a skin condition, this should be
    noted in their support plan.
  • Older skin loses elasticity and sensation- be
    aware of extreme temperatures and use care when
    drying
  • Pressure problems caused by- unable to move
    position, friction, continence issues, diet etc

10
Infection
  • Bacteria UTI, chest infection
  • Viruses- common cold
  • Fungi- thrush, athletes foot
  • Parasites- scabies, head lice

11
Cross Infection
  • Definition
  • Cross infection is the physical movement or
    transfer of harmful bacteria from one person,
    object, or place to another, or from one part of
    the body to another
  • (Encyclopaedia of Nursing Allied Health)

12
Infection Control
  • Wash hands!!
  • Check washing facilities are clean
  • Use handwashing gel if no suitable facilities
  • Wear gloves and apron where required
  • Wash hands after taking off latex gloves or
    before putting on a new pair
  • Dispose of waste appropriately
  • Seek advice if someone has known infection e.g.
    MRSA, Clostridium

13
Personal Hygiene
  • Maximises a feeling of freshness and comfort
  • Looks after the skin and prevents damage to it
  • Assisting someone with personal hygiene can help
    to identify early signs of injury, rashes, or
    skin dryness or soreness

14
Personal Hygiene
  • Using the bathing/washing period to assess
    individual progress, can identify change of mood
    or ability to co-operate
  • Note any physical signs, e.g pain on movement of
    a limb or bruising. This is important as
    confused or disabled people may be unable to
    recall a fall or knock.

15
Dressing / grooming
  • Helps the person retain an interest in their
    appearance and standard of grooming
  • Consider hair styling, make up etc
  • Respect choices but prompt with appropriate
    clothing e.g. for weather
  • May need to support with sensory aids, prostheses
    and orthoses

16
The Importance of food drink
  • Food drink are basic essentials for human
    beings to survive
  • Food is an important part of social events in
    most cultures and there are often special customs
    associated with eating
  • Meal times are opportunity to spend time with
    family / friends

17
Nutrients required for a balanced diet
  • Proteins
  • Carbohydrates
  • Fats
  • Vitamins

18
Possible Causes of Poor Nutrition in dementia
  • Not recognising that it is time for a meal
    (orientation)
  • Forgetting to eat or drink/thought of having
    eaten already (memory)
  • Difficulties cooking food / Not waiting to cook
    food properly (concentration)
  • Food placed wrongly e.g sausages in cleaning
    cupboard (confusion)
  • Physical causes e.g. sore mouth

19
Things you might try
  • Allow plenty of time to eat
  • Keep noise or activity around the table to a
    minimum
  • Remove distracting items from table
  • Keep crockery simple and a different colour from
    the table cloth
  • Make sure there is adequate lighting

20
Things you might try (cont)
  • Serve one course at a time
  • Serve food that is familiar to the service user
  • Keep eating simple- finger foods
  • Be aware of food temperatures
  • Check sell by dates etc
  • Encourage fluids- may not recognise sensation of
    thirst
  • Find out preferences/choices- use pictures,
    recipe books, TV programmes

21
PEG feeding
  • Percutaneous Endoscopic Gastrostomy
  • Daily nutritional requirements fed directly into
    the stomach
  • Person may still be able to eat and drink small
    amounts

22
Peg Tube
23
Continence Dementia
  • Approximately 50 60 of people with dementia
    are thought to suffer from incontinence. (mostly
    urinary)
  • Rare for someone in earlier stages of dementia to
    suffer from incontinence.
  • More often problems start as dementia progresses
    from moderate to severe stages.
  • Often the incontinence is as a result of
    inappropriate urinating or defeacating rather
    than the person being totally unaware of their
    action

24
General obstacles to continence
  • Infection urine infection (UTI)
  • Poor diet and/or fluid intake
  • Constipation
  • Medication side effects
  • Alcohol

25
Types of Incontinence
  • Stress
  • Urge
  • Overflow
  • Neurogenic
  • Functional

26
Stress Incontinence
  • Weakness of the muscles that support the bladder
    (pelvic floor muscles)
  • Leakage usually happens when coughing, laughing
    etc.
  • Usually affects women
  • Can be caused by multiple pregnancies or
    childbirth

27
Urge Incontinence
  • A sudden need to empty the bladder and not able
    to get to toilet in time
  • Can be caused by caffeine, alcohol, anxiety or a
    neurological disorder such as diabetes or a
    stroke

28
Overflow Incontinence
  • The bladder remains and does not empty properly
    (what is passed is overflow)
  • There is sometimes a poor flow of urine and
    constant dribbling
  • Common in men with enlarged prostate
  • Constipation can cause this by restricting flow
    of urine from bladder

29
Neurogenic Incontinence
  • The bladder loses its sensation and empties with
    no warning
  • Treat with regular toileting and perhaps use
    incontinence pads (these can be supplied by
    community nursing staff)

30
Functional Incontinence
  • The inability to reach the toilet on time due to
    poor mobility, or the inability to interpret the
    signs of a full bladder
  • Common in people with dementia

31
Factors affecting continence in people with
dementia
  • Deterioration in personal hygiene
  • Wandering/agitation/restlessness
  • Anxiety
  • Disturbed behaviour
  • Communication
  • Aggression

32
Factors affecting continence in people with
dementia
  • Memory- may forget what they set out to do
  • Orientation unable to find toilet especially in
    unfamiliar environments
  • Dis-inhibition- where and when appropriate
  • Recognition- unable to recognise facilities or
    recognise sensation of needing toilet
  • Apathy- motivation to get up and go
  • Physical difficulties- unable to remove clothing
    or get on / off toilet due to e.g. arthritis,
    poor eyesight

33
Promoting Continence - general
  • Never accept incontinence as permanent or
    inevitable
  • Overcome your own embarrassment- be aware of your
    facial expressions, body language and tone of
    voice
  • Use language that the person is familiar with
  • Use short simple instructions- dont chatter
  • Consider other factors e.g. diet, fluids (NB-
    never cut down on fluids)

34
Using the Toilet
  • To use the toilet you must be able to
  • Recognise you need to go to the toilet
  • Plan ahead
  • Be motivated to use the toilet
  • Delay onset of passing urine
  • Locate the toilet
  • Possess the physical ability to get there, adjust
    clothing and use the facilities
  • Remember what you set out to do
  • Use the toilet

35
Things you might try - getting to the toilet
  • Establish a routine
  • Tactful reminders- gentle coaxing, not forcing-
    ask if the person wants to go with you
  • Ensure toilet is within easy reach and sight-
    perhaps have vacant toilet door slightly ajar
  • Label toilet clearly, signposts
  • Ensure way to toilet is free from obstacles

36
Things you might try -in the toilet
  • Declutter toilet / bathroom
  • Clear away other receptacles e.g. bins
  • Ensure room is comfortable and not too cold /
    warm
  • Have floor and toilet seats different colours if
    possible
  • Consider aids e.g. handrails, raised seats,
    commodes
  • Be aware of your body position dont stand over
    person
  • Remember correct moving and handling
  • Keep skin clean- avoid too much soap
  • If using barrier creams only thin layer as can
    reduce effectiveness of incontinence pads
  • Remember handwashing prompt/assist person with
    dementia to do so

37
Urinary catheters
  • A tube passed into the bladder usually via the
    urethra, sometimes through the skin above the
    pubic area
  • Used when there is a medical need to drain or
    measure urine. This may include maintaining the
    comfort of a person who is very ill or dying.
  • A catheter stays in place using a small, inflated
    balloon which sits in the bladder
  • You may be asked to empty/change the catheter bag
    and assist in keeping the system clean.

38
Urinary catheters
39
Urinary catheters
  • The main hazard is the introduction of infection
    and trauma
  • Always wash your hands before and after handling
    the catheter
  • Wear disposable gloves when emptying a catheter
    bag
  • Make sure there is no drag or pull on the
    catheter from the bag
  • Keep the drainage bag below the level of the
    bladder
  • Report any signs of redness, swelling or
    discharge
  • Unless otherwise directed, it is important the
    service user has a healthy intake of fluids

40
Stoma Care
  • An ostomy is a surgically made opening, which
    connects part of the internal body to the
    outside.
  • Colostomy is an opening in the colon (bowel) to
    allow the removal of bowel contents.
  • The bowel contents bypass the back passage and
    are collected into a bag (stoma bag) attached to
    the surface of abdomen
  • Ileostomy - opening from the small intestine to
    the abdominal wall

41
Stoma Care
  • You may be asked to assist with emptying bags,
    checking surrounding skin for sores /redness and
    keeping the area clean and dry.
  • Always wash your hands before and after handling
    the stoma
  • Wear gloves when emptying bags
  • Report any signs of redness, swelling or
    discharge

42
Stoma Care
43
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