After reading Adapting Personal Care Activities in the presentation above, I would like to add a few comments below. Most of it will be a review for you as a nurse aide.
Hygiene
Good hygiene is an important part of the care a Home Health Aide provides to a client. Practicing good hygiene is important to maintain skin integrity, prevent infection, as well as to refresh and clean the client. The Home Health Aide may be responsible for providing bathing, oral care, and personal care for the client. It is important for the aide to be sensitive to cultural reactions of clients with regard to providing this type of care. A client's cultural ideas about health, illness, hygiene, and rules for behavior may be different from your own. It will be helpful for you to understand your client's customs, practices, and beliefs so you can provide the best care and be respectful of individual differences. If you are unsure of your client's cultural patterns with regard to personal hygiene, it is a good idea to talk with your case manager.
When bathing a client, don't forget to check the client's skin for any signs of irritation or breakdown. Remember how important a back rub can be!
Shampooing Hair in Bed at the Client's Home
I am sure as a nurse aide you have shampooed hair while a patient is in bed, however, you may not always have what you need in the home. Sometimes we need to find what we need to work with in the home. You may use trash bags under towels to prevent the bed from getting wet. You may need to use a utensil appropriate for the shampooing. Be sure to place a towel under the neck for comfort as well as keeping the bed as dry as possible. Dry shampoos can also be used if the client is too weak to tolerate a wet shampoo. Follow the directions on the package. If you need to shampoo a client's hair and the client is mobile, it is better to do it in the kitchen sink than the bathroom sink. It is easier to bend an older client's head forward rather than backward to the shampoo.
When dressing or undressing a client, do not allow them to remain in nightclothes during the day (unless case manager states it is acceptable). The client needs to know that it is daytime and needs to dress accordingly.
Need for Rehabilitation
Part of the care plan for a client may include rehabilitation, which is the restoring of physical abilities to the highest level possible. Most rehabilitation is planned and carried out by a specialist such as the physical or occupational therapist. When physical ability or skill has been lost, the client must relearn it or adjust to coping without it. In some cases the Home Health Aide will be able to assist in the rehabilitation program.
The Home Health Aide may be expected to assist a client with walking. A physical therapist will determine when the client is ready to begin walking again and what types of assistive devices may be necessary to maintain the client's safety.
A client with a disability may have lost an ability many of us take for granted. However, he or she can be quite capable in other areas. The Home Health Aide should treat every client, no matter his or her ability, with dignity and respect. This enables the client to make decisions to maximize and support his or her existing physical, cognitive, and emotional abilities.
If a client lacks motivation or interest in rehabilitation and daily care activities, the aide should report this to the case manager, nurse, or physical therapist. The case manager may have some tips on ways to motivate this individual or may want to involve family members in supporting and motivating the client.
The care plan is developed to make the client comfortable and to work toward recovery or to regain as much ability as possible. Several factors influence the care that is planned. The case manager and the Home Health Aide must consider the client's age, condition, abilities, areas where assistance is needed, and personal interests before the accident or illness occurred. The personal habits and the client's personality also enter into the total care plan.
The value of activity must not be overlooked. Activities are useful in helping a client relearn skills that may have been lost because of the illness or accident. They also provide meaningful activity to a client who may be depressed due to the illness. An appropriate activity reminds a client of what he or she is still able to do. Activities are not just structured arts and crafts or music, but are also general tasks like sorting socks, washing dishes, planning a meal, dictating a letter, reading a newspaper together, or sorting photos for a photo album. An activity can be used to stimulate memory, to aide in regaining verbal skills after a stroke, or to enhance a relationship.