Life with MS

Those who require assistance with the intimate task of bathing may experience a myriad of feelings such as modesty, shame, vulnerability, sadness, or low self-esteem. As a caregiver, you can empower your care-receiver to overcome these negative feelings by learning all the right moves. By knowing what to do and how to do it, you can make bathing a positive experience.
 
When done properly, bathing provides so many benefits. Not only does it stimulate circulation and provide physical activity for the patient, but it is also the ideal time for you to examine the patient from head to toe for any physical changes that should be brought to the attention of the primary care doctor. 
 
Preparing for the bath
 
Whether you are preparing for a bed bath, a tub bath, or a shower with a shower chair, preliminary preparations are similar.
 

• Plan the bath or shower for the time of day when the patient is most calm and cooperative.
• Make sure you have ample time so you will not feel rushed.
• Strive to be gentle, respectful, patient, and calm.
• Talk to the patient by name.
• In your approach to hygiene, be flexible. Discover together what methods work best.
• Allow the patient to use the toilet before you begin.
• Always explain what you are going to do beforehand.
• Remove all jewelry and watches to avoid injury.
• To avoid scratching, trim your nails as well as the nails of the patient.
• Choose a convenient location for all supplies, such as a chair or bedside table. Make sure you have everything you need before you begin.
• Make sure the room is at a comfortable temperature, and free from drafts.
• Ensure privacy for the care-receiver by closing blinds or curtains. Let other family members know it is bath time to avoid embarrassing interruptions. 
• Leave clean clothes nearby, but not so close as to get wet.
• If you experience difficulty with moving, lifting, or transferring, don't panic. Dry the care-receiver off and wrap in a fresh towel or robe. Make sure they are okay, and call for help. Don’t get hurt, get help! 

 
Bed bathing basics
 

• Spread a large towel under the body parts being washed to keep bed dry.
• Use gloves.
• Undress or uncover only the part of the patient that is being bathed.
• If patient is in a hospital bed, raise the head, or even the entire bed, to eliminate back strain.
• If patient is unable to sit up, help them roll to the side. Don’t forget to use side rails!
• Dress the patient as you go, avoiding chills and unnecessary motion that can result in fatigue.
• Use one washcloth for soaping, the other for rinsing. Wash gently, yet thoroughly.
• Change water frequently.
• Rinse and dry with a medium-sized towel, which is easier to handle than the larger ones. 

 
Skin care
 

• As you wash, look for red, blistered, or broken areas on the skin. These may be bedsores and should be promptly treated by a medical professional. Do not rub or massage these areas.
• Use powder, cornstarch, deodorant and perfume, if the patient desires, but don’t sprinkle powder on. Instead, use a powder puff or your hand to avoid getting it in the patient’s eyes, nose or mouth. Powder also helps clothing to slide on more easily.
• Place lotion container in a basin of warm water or rub it between your hands before applying to prevent shocking the patient with cold lotion.
• Hair is softened by bath water, so if shaving is needed, now is the time.
• Use extra care on the navel and beneath breasts, behind ears, and in between folds of skin. Vulnerable to trapped perspiration, these areas are especially susceptible to infection.
• Pay special attention to any skin folds around the genital area.
• Dry gently by blotting. Do not rub.

 
Remember: If the care-receiver seems particularly needy or is making more requests than usual, ask yourself what the underlying need might be. Most importantly, always consider the dignity of the care-receiver.
 
(Last reviewed 8/2009)