Personal hygiene (NHS) The person you care for may be physically or mentally unable to maintain their own personal hygiene. Keeping clean is essential for good health. Poor hygiene can cause skin complaints, unpleasant smells and bacterial or parasitic infections. General hygiene The daily personal hygiene of the person you care for is very important, so make sure: • their hands are washed after they’ve used the toilet • their genitals and anal area are washed every day • their face is washed daily they’re fully bathed or showered at least twice a week • their teeth are brushed twice a day, preferably after each meal. It is also important that they have regular dental checks. Find out more about dental treatment for people with special needs. Washing and bathing For most people, washing is a very private activity. When helping someone to wash or bathe, be sensitive and help maintain their dignity. You’ll both probably feel awkward and embarrassed, especially at first. To make bathing as pleasant and comfortable as possible: • use pleasant-smelling shampoo, bubble bath or soap play music that the person you care for likes and is familiar with • if the person is confused, explain what’s happening as you go along • be sensitive to the mood of the person Carer’s tip from Netbuddy “If you are caring for someone who won’t wash, get involved with activities that are followed by showers, for example, swimming. It may help if they see other people showering. My son only started using the shower and wetting his head because he saw it in a film he was watching”. Personal preference and emotional state
Be aware of the emotional state of the person you care for when helping them wash. For example, some people can be anxious about deep bath water. Adaptations, such as seats or recliners, can help with anxiety. Reassure the person that you won’t let them be hurt. Overhead showers can be frightening to some people. If you have no bath or there is a good reason for using a shower rather than a bath, use a hand-held shower unit. Ask the person how they would prefer to be helped and allow them as much independence as you think is safe.
If they had a routine before you began caring for them, find out what it was and stick to it as much as you can. Find out which shampoo, shower gel or soap they prefer to make the experience more familiar to them. Many people become self-conscious when undressed in front of others. Be sensitive to the situation and approach it in the way you think is most appropriate. The person you care for may feel isolated if you leave them alone. How you handle this depends on your relationship with them. Have clothes and towels with you so you don’t have to leave them alone in the bathroom if they don’t want you to.
Safety If the person you’re looking after has limited mobility or has problems balancing, make sure that: • the floor is not slippery (dry it if necessary), • the room is a comfortable temperature, • the water is comfortably warm (older people particularly feel the cold, so bear this in mind when adjusting the temperature), • the locks are removed from the door (the person you care for may want privacy, but in an emergency you will need to get into the bathroom), and • you look out for your own safety, for example by making sure you can manage if you have to lift the person in and out of the bath.
Toileting Toileting is an important part of personal hygiene, regardless of whether the person you’re looking after is continent (able to control their bladder and bowels) or not. Incontinence can create feelings of shame or embarrassment for both the carer and the person being cared for. Sometimes, they may be in denial about their incontinence or refuse to accept help. Reassure them that it’s not their fault and approach the issue in a calm, reassuring way if they’re in denial. Bed baths If the person you care for cannot move or has extremely limited mobility, you may have to give them a bed bath.
You will need to be extra careful, for your own safety, when moving or lifting them. Specialist disposable baths are available if they need a proper immersive bath (to be put fully in the water). Getting help If you’re finding it difficult to cope with toileting, washing or general hygiene, contact your local authority or a local carers organisation (see Services near you, above right). Cleanliness and infection control 12. —(1) The registered person must, so far as reasonably practicable, ensure that— (a) service users; (b) persons employed for the purpose of the carrying on of the regulated activity; and c) others who may be at risk of exposure to a health care associated infection arising from the carrying on of the regulated activity, are protected against identifiable risks of acquiring such an infection by the means specified in paragraph (2). (2) The means referred to in paragraph (1) are— (a) the effective operation of systems designed to assess the risk of and to prevent, detect and control the spread of a health care associated infection; (b) where applicable, the provision of appropriate treatment for those who are affected by a health care associated infection; and c) the maintenance of appropriate standards of cleanliness and hygiene in relation to— (i) premises occupied for the purpose of carrying on the regulated activity, (ii) equipment and reusable medical devices used for the purpose of carrying on the regulated activity, and (iii) materials to be used in the treatment of service users where such materials are at risk of being contaminated with a health care associated infection. Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010