Assisting someone with the activities of daily living (ADLs)

Activities of Daily Living (ADLs), such as bathing and toileting, without assistance can be a challenge for many people. Providing practical care and assistance with ADLs is an important element of caregiving. Caregivers report that assisting someone to complete these tasks is easier when they understand how to help.

Bathing/showering

Bathing or showering is often viewed as a personal activity. Try to allow the person you are caring for as much privacy and independence as possible during this activity. Minimizing how physically exposed the person is can help them feel more comfortable. You can wrap a towel around private body parts and clip it with a clothes pin (or Velcro tabs), or the person may prefer to wear a long, plastic apron in the tub or shower for additional privacy.

Keep in mind that even though a specific task may be done more quickly if you do it (for instance, assisting with bathing), you should try to let the person in your care do things for him/herself whenever possible (and when it is safe to do so). For example, the person in your care may still be able to take a bath independently but need your help with washing his or her back. Remember to take your lead from the person you are caring for as to how much or how little to help.

Below are some tips for helping someone with bathing/showering:

• Keep the bathroom as warm as possible and free of drafts.
• Some people may enjoy listening to music. Remember to keep all electronic devices away from any sources of water, especially if you are plugging them in.
• Perhaps a special scented potpourri can help create a comfortable bathing environment. Bath oils should be avoided as they can make the tub slippery. Also, be cautious of any bathing products that may irritate the skin of the person in your care.
• A liquid soap dispenser makes it easy to apply soap with one hand onto a large sponge.
• If the person in your care has sensitive skin, they can use baby shampoo and wash. These are formulated to be mild and gentle on skin.
• Try to prepare the bath or shower with all of the supplies you need before assisting the person to the bathroom.
• Prevent falls by immediately wiping up any water off the floor.
• Test the water temperature with your elbow and ask the person in your care if the depth and temperature of the bath water is okay. Avoid getting shampoo and water in the eyes of the person you’re assisting by covering their eyes with a dry cloth or a bath visor. Bath visors have a large hole at the top of the hat that you can pull the hair through for washing. They are flexible and waterproof and are used to block shampoo and water from seeping onto the face.
• Use a hand-held shower head attached to the faucet to make rinsing and hair washing easier.

Bed baths

A bed bath may be an appropriate option if the person you are caring for is unable to get into a traditional bath or shower. A bed bath is accomplished by filling a large bowl or pail with water. Test the water before using it to make sure it is not too hot. You may actually want to have two basins of water: one which contains some mild liquid soap for washing and another with clean water for rinsing.

It helps to have the wash cloths, soap, and any cream you are using close by along with a comb, brush, and change of clothes. You may want to place towels or incontinence pads on the bed during a bed bath to protect the underlying linens. Remember to remove/replace moistened linens as they can cause skin breakdown and lead to wounds known as pressure injuries. When you are bed bathing the person in your care, wash one body part at a time with a sponge or washcloth and keep the rest of the body covered with a warmed bed sheet or large, warm towel. Make sure to keep the room at a comfortable temperature.

Toileting

Toileting can be a very important part of caregiving. If the person you are caring for requires assistance with toileting, it can be uncomfortable for both of you. Try to be very matter-of-fact when talking about toileting and provide toileting assistance in the same way you would provide any other kind of help.

A person who needs assistance with toileting may feel a big loss of privacy and independence. You can help to keep their dignity intact by allowing as much privacy as possible. For example, if they are able to get to the toilet on their own, help them to do so and then leave the room or wait outside the door, if possible, until you are called to help.

As you become more experienced with toileting assistance, you’ll become more skilled at things such as quick clean-ups, and it will become part of the regular routine, making it easier for you and the person you are caring for.

Below are some tips for using a bedside urinal, bedpan, and various incontinence supplies:

• A bedside urinal

There are different kinds of urinals and it may take a few attempts with different styles until the most comfortable one is identified. Consult with a health care professional for more information on bedside urinals that are available for both men and women.

• A bedpan

To get the person in your care onto a bedpan, ask them to lie on their back with their knees bent and lift their buttocks while you put the bedpan in place. They can also roll to one side while you put the bedpan against the buttocks and then roll onto their back with the bedpan in place. The person in your care may also require assistance with wiping or cleansing the area following the use of a bedpan.

It is important to clean the bedpan regularly with hot water and soap. Rinse the bedpan thoroughly each time you empty the contents (you can keep the bedpan odour-free by rinsing with cold water and baking soda).

TIP

Ensure that any damp skin is cleansed and properly dried after a person has used a bedpan. If not dried properly, damp skin can speed up the development of pressure injuries or bedsores.

Bedsores are caused by constant pressure and/or friction/shear on the skin. This damages the tissues underneath the skin resulting in sores. Watch out for red areas of the skin that do not go away after the pressure has been removed, and if noticed, report them promptly to a health care provider.

• Incontinence bed pads

An incontinence bed pad is a plastic pad you can place on the bed directly under the person’s buttocks. Incontinence bed pads protect the bed and can be easily replaced when soiled. It is important that bed pads are always fresh as soiled pads will be uncomfortable and can cause skin irritation and lead to pressure injuries.

Incontinence bed pads can be disposable or reusable. Reusable bed pads must be washed regularly. You can store the pads in a tightly sealed container or plastic bag until washing time. If you are using disposable bed pads, make sure that when you put the pad in the garbage, it is brought outside immediately as soiled pads will create an unpleasant odour in the living space.

• A plastic bed cover

A plastic bed cover (sometimes called a mattress cover) can be found in many department stores in the bedding section. Plastic bed covers go under the bed sheets to protect the mattress.

• Adult incontinence products

Adult incontinence products such as incontinence pads, adult briefs, and undergarments with pad pockets can help a person stay dry and more comfortable. These products also allow for some increased independence. The person in your care can walk around without having to worry about leaking through cotton undergarments. However, it is very important to change incontinence products promptly after they have been soiled. The choice of products will depend on the amount of incontinence being experienced. Consult with a health care professional about the incontinence product(s) that would be best suited for the person in your care.

Providing assistance with the Activities of Daily Living for someone in your care is one of the most important responsibilities you have as a caregiver. It can be challenging, and you may feel awkward at times, but asking for assistance from health care professionals and becoming informed will help to make these tasks easier.