Personal Care Activities
Personal care activities include: Eating, bathing, shaving, caring
for the skin, hair and mouth, and transferring (moving from chairs,
toilets or bed). During the course of our daily lives these
activities are taken for granted until weakness or a disability
makes them difficult to accomplish independently or safely.
Providing assistance requires knowledge, patience, skill and
Bathing: Bathing an older person
may require strength, special equipment and skills. It is advised
that caregivers ask the elderly person's doctor and/or physical
therapist for special instructions on how to safely bathe the
Shampooing and Shaving: Visits to a
barber or hairdresser are very positive experiences. Individuals who
provide this service will often come to the home. Wetting hair with
alcohol or cream rinse helps to remove the snarls.
Dry shampoos are
available if your family member is bed bound. People who are
diabetic or on medication to thin the blood (anti-coagulants, i.e.,
Coumadin) should use an electric shaver to reduce the risk of cuts.
It is much easier and safer to shave another person with an electric
- Keep skin clean and dry,
especially when people are having problems with bowel and
bladder control. When washing, use a mild soap, rinse well, and
- Keep bed linens clean, dry and
free of wrinkles. Disposable bed pads can be purchased at a drug
store and can keep sheets dry so that the caregiver does not
have to change sheets so often.
- Massage skin gently using a
light, circular motion. Change the position of older people at
least every two hours, particularly for those confined to a bed
or wheelchair. Encourage them to shift their weight between
position changes to redistribute pressure onto other areas.
- Encourage good nutrition and
adequate fluid intake. As a supplement to your family member's
diet, give a multi-vitamin every day to ensure proper nutrition.
Check with the physician as to the appropriate supplement.
- Use mattress and chairs that are
soft and form-fitting rather than rigid and hard. (Example: egg
crate mattress and sheep skin). This spreads the weight over a
larger skin area, decreasing the pressure under the bones.
- Encourage movement or mild
exercise; this helps stimulate circulation which is good for the
skin. Combing hair and helping with bathing and dressing are
good ways for frail people to get exercise and be more
- Watch for possible sources of
pressure on anything that would interfere with good circulation,
such as tight shoes, elastic cuffed socks or tight
- Bony prominences are prone to
skin breakdown. They are heels, feet, behind the knees, hips,
buttocks, sacrum, elbows and shoulder blades. A special air
mattress may be ordered by the doctor to prevent skin breakdown.
- Watch for any redness or a break
in the skin and report it immediately to the doctor or nurse,
and keep the care-receiver off the affected side.
Constipation or Irregularity:
Many elderly become constipated due to medications and inactivity.
If your care-receiver is experiencing this problem the doctor or
nurse can suggest a stool softener. Other important factors are:
- Safety features in the bathroom,
such as grab bars and raised toilet seats, make using the
- A commode or urinal may be
necessary when flexibility and distance to the bathroom are a
problem. They may be especially helpful at night.
- Lack of control over bowel or
bladder functions can be embarrassing and older people may try
to hide it from caregivers and professionals. Be sensitive to
the older person's feelings, and mention this to the doctor.
Loss of bowel and bladder control is not a part of normal aging
and often can be controlled.
- For the care-receiver with bowel
and/or bladder problems it may help to take them to the bathroom
every 2 hours. Specialized programs exist to retrain a bladder
and bowel function. Check with your doctor or nurse for a
program in your area.
Assisting with Eating:
- Eat plenty of fresh fruit,
vegetables and foods high in fibers.
- Drink at least 8 glasses of
water a day.
- Avoid constipating foods like
cheese, rice, bananas, etc.
- Exercise as much as is
- Be sure your doctor is aware of
all the medications being taken.
Eating can be very time-consuming,
especially if the older person must be fed. Encouraging independent
eating saves time for caregivers, and promotes the independence and
self-worth of the older person. Try to relax yourself and enjoy the
time spent with your care-receiver. Here are some suggestions for
Transferring: Moving people who cannot
move safely by themselves requires skill, knowledge, and some
strength. For every type of disability, there is a specific
technique to use. Ask a doctor, therapist or attend caregiver
training for specific techniques. In all cases, remember:
- Check gums for areas of redness.
Dentures may not fit correctly and cause the family member pain
- Provide adaptive equipment such
as plate guards or special silverware with built-up handles.
These can be purchased from medical supply houses (listed under
Hospital Equipment and Supplies in the Yellow Pages). An
occupational therapy evaluation can recommend the best for each
- Prepare finger foods which may
be easier to eat than those requiring utensils.
- Encourage older people to use a
straw, cups with 2 handles, or a glass with ribbed surface for
- If the older adult has limited
vision, consistent place setting of food and utensils helps to
know where to find silverware, beverage, etc. Using the clock
method to locate food may be helpful; for example, Your meat
is at 9 o'clock, your potato is at 12 o'clock and your carrots
are at 3 o'clock.
- Reminder: Treat older people who
are being fed as adults, not children. Disciplining poor eating
habits should be avoided. When they lack interest in food, try
to learn the reason. For example, ask if they are thirsty or not
feeling well, or if the food in not appetizing on this occasion.
Rest and Sleep: As we age, our sleep
patterns change. The elderly require less sleep time. It takes
longer for them to fall asleep. Also, awakenings during the night
increase. Scheduled rest times are important.
- When lifting, do not add your
own weight to whatever you are lifting -- get close and keep
- Do not use weak back muscles to
lift - use your leg muscles because they are much stronger.
- Do not twist when you are
lifting - instead, change the position of your feet so that you
face the older person, keeping your spine straight.
- Balance is vital - spread your
feet to serve as a base for support.
- Your doctor can refer you to a
physical therapist who can teach you to transfer safely.
A few naps during the
day can refresh and revitalize the care-receiver. However, if you
notice that your care-receiver is sleeping for brief periods during
the night, it could indicate a problem. Notify your doctor and
discuss your concerns.
Tips for Encouraging Self Care:
Be aware of changes in the
care-receiver's health and abilities. Your plans for care will
change as the care receiver changes.
- Allow the care-receiver to do as
much as possible; provide only as much help as needed. When
older people do all or part of their own personal care, it is a
form of exercise that will help maintain strength as well as
promote independence. No matter how small the activity (holding
the soap, combing the front of the hair, etc.) it is important
that the person be able to participate.
- Adapt the home to allow the
care-receiver to do more things. Install equipment such as grab
rails in the bathroom, wheelchair-accessible sinks and mirrors,
bath bench for the shower or tub, and lights with switches that
can be easily reached.
- Seek the aid of therapists or
nurses to teach you how to perform personal care tasks safely
- Learn about the care-receiver's
disability and what you and others can do to help him/her
function as independently as possible. If the older person
cannot perform a certain activity, see if there is a part that
can be done. For example, one might be able to independently
dress the upper body if sitting, but require help dressing the
- Whenever possible, include the
care-receiver in making plans for his/her care. Take suggestions
and feelings into consideration and encourage involvement in
his/her own care. Sometimes, slowing the pace of an activity
allows older people to do more for themselves.