Posted elsewhere:no response. Tub bath info pls!

flyingchange · Oct 19, 2010

I used to work in home health and have given lots of in-home tub baths; the most dangerous part of them is always transferring into/out of the tub. If her home is set up properly then there should be plenty of things to grab onto and anti-slip mats in the tub and on the floor. If she can't sit properly in the tub she should have a bench. If her house is not set up properly, proceed with caution, and I agree with just keeping her on the toilet for a sitting bath if necessary.

The water temperature should be no more than 40*C (Not sure F, sorry). Lots of risks of overheating and burns to people who can't tell you they're too hot. Make sure you bring lots of towels and washcloths. Encourage independent washing if at all possible. Even if she can't really wash herself, let her try, and then follow up. Give her a towel in the tub (my preference would be one of the dishtowel-sized ones but you get what you get in home care) to cover her shoulders.

My preferred order is body-axillae-groin. Wash her feet if you can access them, a lot of elderly have terrible feet. Then wash her hair last. Might want fresh water from the tap to rinse. Depends if she's cooperative.

When she gets out of the tub dry her feet really well and let her step down. Towels are a slip risk. Get her into slippers asap. This is the worst part IMO because it requires a lot of body strength and bracing because often you are the only thing to hang onto. Then cover her in towels and get her dried off asap .

Hope this helps :)

rn/writer, RN · Oct 19, 2010

RN/Writer: My concern is proper draping of towels. The rest of what you mentioned is purely common sense.

I included the common sense items, because you said you did not know what to do. Sometimes when people are anxious about doing a task that is new, the common sense things may not occur.

Here is a link to a very detailed site on bathing an adult:

http://cas.umkc.edu/casww/tubshowr.htm

Feel free to ignore anything that is not worth your time.

As far as draping goes, if you have her sitting on a toilet or a bath chair, you can put one towel over her lap and another around her shoulders. Lift each one to wash and rinse the area beneath. Replace a towel if it becomes too wet. (Have a towel beneath her if she is sitting on the toilet lid. Otherwise, wet skin can stick to the surface and become irritated when she pulls to a standing position.)

When you are finished, use the towels to dry her off and help her into a robe.

Hope this helps.

Saralynelle · Oct 19, 2010

I used to work in home health and have given lots of in-home tub baths; the most dangerous part of them is always transferring into/out of the tub. If her home is set up properly then there should be plenty of things to grab onto and anti-slip mats in the tub and on the floor. If she can't sit properly in the tub she should have a bench. If her house is not set up properly, proceed with caution, and I agree with just keeping her on the toilet for a sitting bath if necessary.
The water temperature should be no more than 40*C (Not sure F, sorry). Lots of risks of overheating and burns to people who can't tell you they're too hot. Make sure you bring lots of towels and washcloths. Encourage independent washing if at all possible. Even if she can't really wash herself, let her try, and then follow up. Give her a towel in the tub (my preference would be one of the dishtowel-sized ones but you get what you get in home care) to cover her shoulders.
My preferred order is body-axillae-groin. Wash her feet if you can access them, a lot of elderly have terrible feet. Then wash her hair last. Might want fresh water from the tap to rinse. Depends if she's cooperative.
When she gets out of the tub dry her feet really well and let her step down. Towels are a slip risk. Get her into slippers asap. This is the worst part IMO because it requires a lot of body strength and bracing because often you are the only thing to hang onto. Then cover her in towels and get her dried off asap .
Hope this helps :)

This is pretty much how I handled things this morning. The only thing I didn't do is get her into slippers! I will remember this next time. She has issues with her right arm/shoulder. I treat it as her "weak side." There aren't any bath rails. There is a slip resistant pad in her shower. After the bath I helped her by getting dressed and putting on some body lotion on her back, arms, hands and legs.

Her feet are cracking and dry around the tops of her toes and her heels. The RN suggested she use Vaseline around those areas so I applied that to her toes and heel areas.

My next step is to try to find an CNA course to get into if I'm going to be doing these things I want to feel secure in knowing I am doing them the correct way. Thanks again for all your positive and supportive comments.

Thank you so much for all your support and help.

Saralynelle · Oct 19, 2010

I included the common sense items, because you said you did not know what to do. Sometimes when people are anxious about doing a task that is new, the common sense things may not occur.
Here is a link to a very detailed site on bathing an adult:
http://cas.umkc.edu/casww/tubshowr.htm
Feel free to ignore anything that is not worth your time.
As far as draping goes, if you have her sitting on a toilet or a bath chair, you can put one towel over her lap and another around her shoulders. Lift each one to wash and rinse the area beneath. Replace a towel if it becomes too wet. (Have a towel beneath her if she is sitting on the toilet lid. Otherwise, wet skin can stick to the surface and become irritated when she pulls to a standing position.)
When you are finished, use the towels to dry her off and help her into a robe.
Hope this helps.

Thank you so very much, Rn/Writer! This was an awesome find! I will be printing it out and studying it like a hawk. :)

Nothing any of you here have to say is a waste. I soak up and absorb all information I possibly can. I greatly enjoy reading posts and learning new things.

We all have a voice, thoughts, minds and opinions. So yes, thanks again to all of you for your helpfulness!

CrunchRN, ADN, RN · Oct 19, 2010

See if the family will not buy a "grab bar". We put one up in the guest bathroom for my mother in law when she steps over the lip of the tub. They are about 10 bucks at Bed, Bath, Beyond and stick right up and handle tons of weight.

Esme12, ASN, BSN, RN · Oct 19, 2010

Flatbelly, again I will agree with what you and the others have said here. I'm not denying this at all.
I didn't go straight for number 4. My employer said you are taking on a new client and this is what we need from you. Riding on thin ice because of being removed from a case for not administering a narcotic a client a caregiver was strike one. Having to take off three shifts due to dealing with my own personal life (my children beyond my control) was strike two.
This is me now trying to CYA and keep my job. I don't have a license to lose at this point. That doesn't make me any less nervous about giving a bath to someone when I've not been through the process. Hence, my post on these forums asking for help.
RN/Writer: My concern is proper draping of towels. The rest of what you mentioned is purely common sense.
At least when you look up bed bathing you can find several step by steps on how this is done.
Thank you again :)

I would not refuse I would be sure the proper things are in place first. Frist....is there a bath chair in the tub. It is extremely hard to get a slippery wet patient out of a tub. Be sure there is a non slip bath mat in the tub to help with footing is she wants to sit in the tub instead of being on a chair (rubbermaid type). If she wishes to sit in the tub to "have a bubble bath so to speak" and she is ambulatory here's what to do. I give this advice as a daughter for my parent from a daughter who happends to be a nurse

1) get everything you need first. Towels,soap,wash rags(seperate face pits and privates), a portable heater for the bathroom is nice (they are always cold) non slip bath mat inside and outside of tub. Have enough towels to section the body. one for her hair,one for shoulders,one midsection, one privates and one for each leg (providing maximum coverage)and one for drying the tub to get them out, plus a glass or shower hose for rinsing hair. Get their clothes,underware ect and bring in to the room. NEVER LEAVE THEM any where for a length of time my parents were/are stubborn to the extreme and would be foolish when our backs were turned!

2) Have a cell phone or the cordless land line in the bathroom with you in case they do fall and you need to call for help and can't leave them!

3) set the water temperature prior to placing them in the tub to save your ears! :) dry the tub, put them in the tub and fill the water. Let them wash what they can it is awsome range of motion and physical therapy.

NEVER GO FAR! They can and will get ointo trouble! They think they can do more that they can and will fall!

4) finish with rinsing, begin draining the tub place a towel on their head. This is where they WILL COMPLAIN BITTERLY OF THE COLD! Sometimes if the dryer is close by throw the towels in the dryer to make them hot while they bathe........FEELS GREAT! Now, place a towel around their shoulders to dry and keep warm, as the water drains slowly, add the other towels drying as you go middle, right leg, left leg, privates. Dry the tub before trying to get them out! have a chair on the bathroom for them to sit on if the toilet is not secure or close enough.

ONCE they are DRY! and the tub dried, you can get them out.

5) clean up the towels so they don't slip throw the towels directly in to the washer to limit the mess (or at least offer). and pray they don't fall! :) do teeth (if you have to)

CONGRATULATIONS! they are clean and dry!

If they agree to do the tub with a shpwer chair same principles apply. Do everything as above with a few moderations

1) all of step 1.

2) NEVER FORGET THE PHONE!

3) set the temp, dry tub,get them in and hose em down,soap em up and rinse em off. (just a little humor no disrespect meant) :lol2:

4) again with the towels one for the hair,chest,each leg and privates. They are covered for privacy and warmth. all the towels expedites the adventure! Make sure the tub is dry whenever attempting to move them in or out!

5) clean up dress and go!

with a little luck they are clean and tired and want a nap!

:ancong!:

All done as safely and effectively as you possibly can! Go slow, be patient. If they object to your presence explain that it is their saftey the is your upmost concern! Tell them you will turn your back while they wash if they insist you "leave" tell them you will go only as far as the outside door, NO LOCKS ALLOWED!, and you will right outside the door so you can hear if they need help!

Good luch and let us know how it goes!