Helping clients with grooming and dressing is part of the job of a nursing assistant. Do the CNAs at your workplace know how important this everyday task is to their clients? Do they use dressing and grooming activities as an opportunity to observe their clients? By sharing the following information and tips at your next CNA inservice meeting, you may give your aides a different perspective on personal care.Looking Good...and Feeling Better!At first glance, getting ready for the day is so clear-cut and easy that we often don't give it a second thought. We simply get dressed, brush our teeth, comb our hair and perform all the other tasks we need to do to make ourselves presentable. Now, just imagine if:
Your arm was stiff and you couldn't get your shirt on.
You couldn't reach back to close a zipper or hook your bra.
Your legs hurt and you couldn't reach down to put on your socks or shoes.
Your fingers were bent from arthritis and you couldn't tie your shoelaces.
You were unable to remember how to put your clothes on-or in what order.
Your arms shook so badly you couldn't brush your teeth, comb your hair or shave yourself.For people who have physical or mental impairments, dressing and grooming tasks are often difficult to manage alone. Sometimes they might take their frustration out on the people around them.That's where you come in. With your help and encouragement, your clients won't feel discouraged by their appearance or ashamed that they can't dress privately by themselves.A Dozen Benefits of Good Grooming
Letting your clients choose their own clothing gives them feelings of being independent and in charge.
Cheering clients on to do their best while dressing supports a team spirit and gives them a feeling of belonging.
Allowing your clients to do as much as they can by themselves helps their self- reliance grow.
Voicing your approval during dressing and grooming gives clients a sense of being valued.
Looking good boosts each client's self esteem and may even help a bad mood disappear!
Dressing your clients helps protect the skin from injury and maintain proper body temperature.
Making sure your clients' clothing fits properly keeps all of their body systems unrestricted.
Brushing your clients' hair promotes a healthy scalp and strong hair.
Providing daily mouth care prevents the onset of painful mouth conditions and protects the mouth from oral diseases.
Keeping your clients' fingernails trimmed with no ragged edges prevents scratches and cuts that can cause infection.
Reporting toenail changes helps your clients get care from a podiatrist as needed. This can prevent complications for people with diabetes, heart conditions or poor circulation.
Moving your clients' joints and muscles during the grooming process helps maintain body movement and prevents contractures.Clues That MatterDressing and grooming tasks give you daily opportunities to look for clues that trouble may be brewing. For example:
Be aware of clients' facial expressions. Clients may tell you that they have no pain, but their faces may reveal the real story.
Clients get in and out of clothes several times a day. While assisting them, look over the whole body, making note of any areas of redness, rashes, bed sores or other changes in the skin.
Report any unusual body odors. A strange odor may be a symptom of an illness.
Some health conditions cause the body to swell. Watch for signs of swollen hands (such as tight rings) and swollen feet (such as shoes and socks suddenly being too small).
As you brush or comb your client's hair, check for head lice. (Lice can happen to anyone-no matter how young or old, dirty or clean, rich or poor.) Look for white eggs known as "nits". They look like small bits of dandruff, but do not wash or flake off. Instead, they stick firmly to strands of hair.
If you provide nail care, look for white or yellow areas on finger and toe nails. Your client may have a nail fungus.Dressing & Grooming ChallengesFor confused clients, grooming and getting dressed involves a lot of steps and the use of many different skills. It can be a very confusing time. Clients with dementia may be more cooperative if you give them something to do. Let them help by putting toothpaste on a toothbrush, holding a sock while you put on a shoe or folding some washcloths as you brush their hair.Consider using a "mirroring technique" when assisting confused clients. For example, hold a toothbrush and pretend to brush your teeth to help a client understand how to perform the task himself.When clients have shaky limbs, sit and talk to them for a few minutes before starting care since certain types of tremors improve when clients are feeling relaxed. Encourage them to support one arm with the other when performing tasks such as shaving or brushing teeth.To help vision-impaired clients feel in charge, tell them about the styles and/or colors of clothing items and guide their hands to where grooming supplies are kept. Speak up when you are coming and going to keep them aware of their surroundings and to let them know whether they are alone or with others.
Keep in mind that many people with arthritis suffer from "morning stiffness". Their joints may be especially swollen and painful during morning grooming and dressing tasks. Encourage your arthritic clients to dress their legs and feet first as this requires the most energy. Have them sit down for as much of the dressing and grooming process as possible-to save energy and to keep them from having to bend over so far.If a client asks you for a pain pill prior to going through the motions of getting dressed, let a nurse or family member know that the client is in pain and needs attention.Remember that some of your clients may keep quiet about their pain due to fear, their beliefs or their cultural heritage. Be sure to look for non-verbal signs of pain such as:
Clenching or grinding the teeth.
Rubbing or holding a body part.
Crying.
Losing interest in their appearance.
Changes in blood pressure (usually higher).
Sweating.As you assist your clients with personal care, remember that it is your duty to notify your supervisor when you know-or suspect-that a client is in pain. Every client has the right to feel relief from pain!Safety IssuesKeep in mind that some of your clients may find it safer and easier to dress while lying down-especially when it comes to pulling up pants. If a client is weak on one side, encourage him or her to dress the weaker side first.Report frayed wires on grooming devices like hair dryers or electric shavers to keep you and your clients safe.
Consider using a "buddy system" when caring for clients who have a history of being combative. This isn't so you can "gang up" on the client, but so that you can remain safe as you perform client care.Remember that some people feel lightheaded when their body temperature drops. Help your clients maintain an even body temperature by dressing them appropriately for the weather and keeping them away from drafts.Be sure to adjust your clients' clothing when they are seated in wheelchairs to keep the clothes from being pulled into the wheels.The Bottom LineRemember that everyone has the right to participate in his or her own care. So, encourage your clients to get involved in their personal care. Even if they aren't strong enough to get dressed by themselves, they can probably wash their faces or comb their hair.It takes patience and understanding to stand back and let your clients "do for themselves". However, allowing your clients to maintain as much independence as possible when it comes to dressing and grooming can affect their health in a positive way-and enhance their overall quality of life.
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