When it comes to assisting clients with showering, they will each require varying amounts of support.
Although it is important to refer to personalised care plans to establish the level of support necessary, we must also ask what the client’s preferences are on the day to ensure they feel safe, and empowered.
In different healthcare facilities and homes, the shower room will contain different safety features to support Healthcare Assistants and clients.
These features may include; a removable shower head allowing more control over the water for the client; grab bars on surrounding walls to provide stability while the client is standing or transferring between chairs; a shower chair for the client to sit on throughout; non-slip rubber mats and; curtains or screen dividers for privacy (Scott, Webb, & Sorrentino, 2015).
Healthcare Assistants are responsible for supporting clients to shower in a way that is safe, personalised, coordinated, enabling and dignified for them.
Complete the reading below for best practice instructions on how to safely shower a client.
Watch the video below for a demonstration of the correct process for showering a client. If it helps, work through the reading as you watch to reinforce your learning!
INSERT VIDEO
Identify one aspect of the showering process that aligns with the person-centred care principle of personalised.
Bed bathing is most commonly used with clients who are less mobile, paralysed, or in an unconscious state. The process involves washing the person with water, soap and a facecloth while they are lying on their bed (Scott, Webb, & Sorrentino, 2015).
Bed bathing can be an uncomfortable experience for some clients as they are moved and repositioned to accommodate the washing process. When this is the case, it is important to look for any signs of distress or pain before you commence and throughout the process. If the client is in pain, ask the attending Nurse to address this before proceeding.
Complete the reading below for best practice instructions on how to bed bath a client.
Identify one aspect of the bed bathing process that aligns with the person-centred care principle of coordinated.
Shaving and nail care are small but meaningful activities which not only prevent infection, but also promote feelings of good health and wellness (Hoy, Wagner, & Hall, 2007, & Lezwijn et al., 2011).
These grooming activities are most commonly completed during or after showering or bed bathing a client, and is an aspect of your client’s routine that should be completed with sensitivity.
Complete the reading below for best practice instructions on how to shave a client and provide nail care.
Watch the video below for a demonstration of the correct processes for undertaking personal cares with a client. If it helps, work through the reading as you watch to re-enforce your learning!
INSERT VIDEO HERE
Identify one aspect of one of the grooming processes that aligns with the person-centred care principle of enabling.
Oral hygiene consists of caring for both dentures and teeth (Weening-Verbree et al., 2013).
The primary intentions behind good oral hygiene are to prevent infection, and facilitate good nutrition (Burns, 2012). Mouth sores or infections that develop from poor oral care can lead to lowered food intake causing nutritional issues (Burns, 2012).
Oral care can be grouped accordingly:
Complete the reading below for best practice instructions on how to provide oral care to a client.
Watch the video below for a demonstration of the correct process for providing oral hygiene with a client. If it helps, work through the reading as you watch to reinforce your learning
INSERT VIDEO HERE
Identify one aspect of one of the oral care processes that aligns with the person-centred care principle of dignified, compassionate and respectful care.
Good nutrition is essential to maintain and work towards positive health outcomes. As Healthcare Assistants, it is our responsibility to ensure that our clients are getting the nutrition they need for a healthy lifestyle and good recovery prospects (Age Concern, 2006).
Below are some considerations we should make when supporting a client to eat their meals:
- Allow clients ample time to eat and finish their food. They should not be rushed at any point
- The meals which clients are given are based on their nutritional needs and ability to tolerate food
- Specifications could include cultural or allergenic food restrictions, gluten-free, lactose free or whether clients eat a soft or normal diet. Always ensure you are providing clients with the correct and most suitable meal
- The process of being assisted with feeding can have emotional and psychological implications. Be sensitive with your clients and the gestures you present.
Complete the reading below for best practice instructions on how to support a client with their meal.
Watch the video below for a demonstration of the correct process for spoon feeding a client. If it helps, work through the reading as you watch to reinforce your learning!
INSERT VIDEO HERE
Yes, we eat to fuel our bodies, but it’s also a time for community, laughing, celebrating, and remembering. It is part of our role to recreate some of these feelings associated with meal times.
With this in mind, read through the article below and consider whether there is anything you could apply to improve the dining experience for your clients.
Having read the article above, identify one action that you as a Healthcare Assistant could take to improve the dining experience for your clients.
Complete the reading below for best practice instructions on how to support a client with their meal.
Toileting independently is an important part of maintaining self-esteem, hygiene, and ongoing continence (control of bladder and bowel functions) (Resnick, 2004).
Unfortunately, there is often shame and embarrassment associated with incontinence (loss of control of bladder and bowel functions), and the use of continence protective pads (Resnick, 2004). Even though protective pads play an essential role in supporting incontinence, it is important to provide regular opportunities and prompts for clients to go to the toilet every few hours to prevent accidents (Resnick, 2004).
There are many assistive devices which when used in conjunction with an appropriate level of support, can enhance and promote toileting independence, in turn boosting client morale:
Bed pans are for bladder and bowel movements and must be cleaned regularly to prevent any odour.
The following video provides further details on how to use a bed pan:
INSERT VIDEO HERE
Urinals are for bladder movements only and must be cleaned regularly to prevent any odour.
For safety purposes, it is important to ensure the height is adjusted suitably and the brakes are on when transferring.
Commodes are for bladder and bowel movements and must be cleaned regularly to prevent any odour.
For safety purposes, the raised toilet seat must be carefully secured to prevent falls.
When supporting a client to use the toilet, you must make the following considerations:
- Remember the mobility status of the client before supporting them to use the toilet
- There may be times when urine output is monitored and measured. When this is the case, you will need to report this data to relevant staff and/or document it in the client’s file
Complete the reading below for best practice instructions on how to support a client with toileting.
Mobility does not only include walking, but also movement in bed such as turning or changing position, movement while seated and transfers from one position or place to another. Transfers can include moving from a bed to a chair, into or out of the car, into or out of a shower or bath, and moving from sitting to standing.
As part of the personal care planning process, the Nurse and/or Physiotherapist conduct assessments that determine the level of support required to mobilise a client. If assistance is necessary, the care plan will include information regarding the number of people required to do this safely. A care plan will also state whether supportive equipment such as a bed lever, hoist, walker, or wheelchair is required.
Some factors that may impact a client’s mobility include existing conditions such as Parkinson’s or a stroke, limited range of motion for example someone with a cast or hip replacement, imbalance and instability, muscle weakness or fatigue.
When supporting a client to mobilise, it is important to make the following care considerations:
Consistently adhere to all manual handling guidelines for your safety as well as the clients
Be flexible in your approach. The personal care plan may indicate that one person should support a client, but if they have taken a turn in their health or slept badly, you may need to ask an additional staff member to support you
Identify one aspect of supporting a client to mobilise that aligns with each of the four person-centred care principles.
- Personalised
- Coordinated
- Enabling
- Dignified, compassionate and respectful care
Caring for the needs of clients goes far beyond the day to day management of physical care needs. When clients enter care, they come to the caring relationship, having lived full and productive lives where they have contributed to those around them and to the wider community. Growing older should not imply that people spend their golden years sitting quietly due to frailty of body and mind. In fact, for many older people leading active physical and social lives helps to maintain physical wellbeing and valued social roles such as grandparent, partner, volunteer or friend, and this contributes toward overall quality of life. Furthermore, according to Bernoth & Winkler (2017) preventing social isolation is recognised as being a key factor in reducing a client’s vulnerability to abuse.
Therefore, encouraging clients to participate in a schedule of meaningful activities gives them something to look forward to, helps to maintain physical and psychological wellbeing, prevents mobility decline and reduces the risk of abuse (Scott, Webb & Sorrentino, 2015).
There is an enormous array of activities that may interest clients. These range from social events, exercise groups and music through to cooking, gardening and trips to the cinema. Healthcare Assistants need to be ever mindful that clients must be actively involved in the planning of activities, as these activities must meet client’s individual level of ability and be something that the client actually enjoys. Choice is an important element in the maintenance of client wellbeing. While many Healthcare Assistants will encourage client participation in activities with the client’s best interests at heart, they must be careful not to pressure clients to participate in activities that do not hold any interest to them (Scott, Webb & Sorrentino, 2015).
Some clients may require assistance to participate in activities that they enjoy. As the body ages, there are natural changes to vision, hearing, dexterity, agility and stamina that can impact a client’s ability to take part in the things they enjoy. Cognitive disorders, such as dementia and stroke can also make participation in activities difficult due to issues with physical and mental agility. Given this, when it comes to activity planning, healthcare professionals such as diversional therapists, GPs, nurses, physiotherapists or occupational therapists will be involved in order to assess and manage risk, as well as access appropriate resources like mobility aids, rails or ramps.
Healthcare Assistants can assist greatly by helping clients to find alternative methods to doing the things that make them happy. Structuring activities so that they are well-paced, simplifying tasks or using equipment or aids as per the care plan can all be good ways of encouraging clients to engage in tasks and activities that are both purposeful and meaningful to them (Williams, 2016).
Below are some considerations we should make when supporting clients with activities:
- Follow the client care plan, in particular, risk management strategies.
- Encourage and support but do not pressure clients to participate in activities that do not interest them.
- Pace activities at a speed that best suits the client’s physical and mental abilities.
- Simplify activities by breaking them down into smaller tasks if needed.
- Report and record any information about client preferences or concerns regarding activity intolerance.
By following care plans and sharing information about client preferences and adaptions with the wider healthcare team, Healthcare Assistants are able to contribute to the planning of client care which gives thought to and promotes holistic person-centred care and continuity.
Take a look at the reading below to see how one organisation is encouraging intergenerational connection as an activity to support client health and wellbeing.
Having read the article above, reflect on one activity that you believe may benefit someone you care for. What is the activity? What are the likely benefits?
