Spot Light: Face, Hands & Butts?

Much of the work we do is aimed at keeping our residents clean, dry, fed, toileted and hydrated. We focus on these things because it is OUR job. There are other things though, that often get lost in the daily shuffle. I work for an agency as a part time job (as well as a full time job at a rehab facility) and through my experiences here, I’ve seen a lot of rushed care and the results of it.

When working short, there’s a saying among aides: Face, Hands and Butts. FHB. This means that our time should be spent washing faces, hands and butts and the rest can go unattended. This isn’t ideal but it is the reality when we’re pressed for time.

Even when our units are well staffed I have seen some pretty poor quality cares that leave me wondering if some of us cannot put ourselves in our residents’ shoes…

No matter how short staffed, we must always consider resident dignity.

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Complete bed baths, whirlpools and showers can be postponed.

Washing faces doesn’t mean simply wetting a wash cloth and wiping it over a face. It means using gentle soaps/cleansers. It means using another wash cloth dampened with water, to rinse off the soap. It means paying close attention to the eye areas, removing the residue and drainage we often see. It means making sure noses are clean and the area around mouths is clean as well. Shave the men.

Oral care MUST always happen- how would YOU feel if your teeth weren’t brushed???

Care must be given to underarms. They need to be washed, rinsed, dried. If needed, a light coat of deodorant is called for. Body odor is a major dignity issue for our residents.

Hands have to be washed. Period. Several times each shift. Nail care can wait, unless they are long and ragged or dirty.

Incontinent care has to happen. Buts and other areas MUST be cleaned. Period. No skimping here.

I can’t count the times I have witnessed residents being brought out with messy hair, or worse, with hair dos that are not becoming to them. Ladies like to look presentable. Imagine how you would feel with greasy, slicked back hair…it’s up to US to make hair look nice. Hair should be combed/brushed no matter what; if ladies’ hair is permed, a little spritz with some water often works wonders to bring back some curl.

Clothing choices? It usually doesn’t matter when it comes to staffing issues. Residents have clothes and we assist them with dressing. BUT what does matter is matching colors at best and avoiding clashes at worst: Striped shirts do not go with plaid pants! Just like an elegant fluffy blouse doesn’t go with sweatpants. Some of our male residents prefer to wear t shirts under their tops; and MOST of our ladies like to wear bras. Don’t skimp on this.

A quick note about briefs: For the residents who use them, we have to ensure they are correctly applied. The right size is paramount. Too big a brief is not only wasteful but a major cause of discomfort. Small briefs often lead to nasty red marks in the groin areas. Make sure the brief is centered, and the front portions are pulled up enough to allow for movement. Don’t let the brief bunch up anywhere.

Residents who use wheelchairs need special attention for comfort AND skin issues. This is a no brainer but I have seen countless times, bunched up shirts in the back and sides. Pants that are wedged up in front. We need to make sure these things don’t happen. Take the time to pull down tops once a resident is positioned in their W/C; fix the wedgies and pull down the lower parts of pants. Make sure the resident is seated properly and is comfortable.

As much as most of us don’t like providing less than ideal care, we can do so on shifts where we just don’t have time. Assignments are often increased with two or three residents when there’s been a call out. Always check with the charge nurse about your priorities when staffing is an issue. Better yet, ask the nurse for a meeting with all the aides on the shift, to plan ahead for those times.

Always consider safety, comfort and dignity. Some will say not always in that order, either.

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