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Splish, Splash, I Was Taking A Bath
How well are you meeting your customers’ needs and wants? That is a question successful business leaders ask frequently. The late Sam Walton, founder of Wal-Mart, challenged his employees to exceed their customers’ expectations. “If you do, they’ll come back over and over,” he said. We hope that reading in this issue about the successful services others have tried will spark new ideas to keep adult day services customers coming back to your center—and bringing their friends with them!
When an adult day center offers bathing services, the benefits extend beyond the person being bathed. The caregivers and the center benefit also.
Consider the benefits to the caregiver. Participants may not be able to bathe themselves without assistance. Caregivers have busy schedules with work and caring for their own families. Offering bathing services could add hours every week of free time for caregivers.
Bathing—Why bother? l Skin Care. Staff can better monitor for skin problems, changes in or size of moles. l Range of Motion benefits circulation while staff can monitor for poor circulation such as discolorations and edema in lower extremities. l Personal Hygiene—Nobody wants to be accused of smelling badly. l Infection Control—We all need a little de-germing now and then! l Relaxation.
Bathing Can Generate Revenue for the Center Surveys in the Concord/Charlotte, NC, area showed that home health agencies charge about $15 per hour. Some agencies have a four-hour minimum charge. Most agencies charge $50 or more to come to the home to bathe a client. Coltrane LIFE Center in Concord, NC, charges according to the participant’s Level of Care. Persons who generally require more assistance at the center are charged more. Level 1=$10, Level 2-$15, Levels 3 & 4=$20. This is quite a bargain! Participants are required to supply all special personal toiletries. In August 2002, Coltrane LIFE Center staff gave 53 baths and $1,100 was paid to the center for bathing services. In the past nine months, the center has collected almost $7,500.
Designing the Bathroom J Make sure the bathroom is warm and inviting. J Avoid looking like an institution. J Design the bathroom with a home-like environment. J Hang pictures on the walls. J Use attractive shower curtains and window curtains. J Hang a set of colored or printed towels on a towel bar. J Consider hanging or placing plants in the room to make it more inviting. J Add home-like accessories around the tub or on the counter. J Provide adequate lighting in the bathroom, but not too bright. J Remember that dim lighting can be more calming. J To reduce the “trauma,” consider using a hand-held shower. It is less threatening than an overhead shower and also makes it easier to reach the whole body. J Make sure a temperature valve is used to prevent sudden change in water temperature which could burn the participant.
Bathing equipment should be easily accessible and comfortable with handicap rails. Showers should be shower chair accessible. Tubs, such as Freedom Tubs, allow participants to be seated easily and then filled with water. Water jets in the tub can improve circulation but can be frightening to Alzheimer’s participants. Place the tub in the bathroom so that both sides of the tub are easily accessible. Use heat lamps in the ceiling above the drying and dressing area.
Getting organized for bathing Before 1. Organize towels, wash clothes, staff gloves, toiletries and clean clothes in the bathing and dressing area. 2. Prepare bathing area with bath mat and chair; place a towel on the shower chair. 3. Turn on heat lamps; make sure bathroom is warm, comfortable and free of draft. 4. Turn on some soft background music for a calming effect and to promote relaxation. 5. Use scented oils or bath salts in the tub (if allergies are not a concern) to add aroma and make the bath more enjoyable. An alternative is to just run warm water in the sink and add oil or bath salts to provide aroma. 6. Provide adequate lighting. 7. Inform the participant that you are going to help with his/her bath, assuring privacy.
During 1. Check the temperature of the water, maintaining it at no more than 105°F. 2. Wear gloves to wash the perineal and rectal areas. 3. Assure privacy. Socialize with the participant to keep him or her calm and relaxed.
After 1. Comment to the participant about how he or she enjoyed the bath/shower. 2. Give the participant a hand towel to hold onto while you use two large cotton bath towels to dry them. This prevents them from grabbing or trying to hit. If possible, warm the towels in a dryer right before drying the participant. 3. Clean the tub or shower after the participant is dressed and out of the bathing/dressing area. Sanitize the equipment used.
Bathing when they don’t want to Knowing ahead of time what a person’s routine has been for bathing at home can offer you clues to what may simplify your task at the center. Encourage caregivers to dress participants in clothing that can be easily removed, such as a housedress with snaps or zippers for women and pants with elastic bands and pull-over knit shirts for men.
If a participant refuses to take his/her underclothes off because of modesty, leave them on. Once they are wet, they will likely let you take them off. You could encourage them by saying something like “Let’s put some dry panties on.” If they refuse to disrobe, tell them they can’t wear those clothes to dinner or church. Do not threaten the person who objects to taking a bath. This only causes additional agitation and frustration.
It might help to wait until the participant is in a better mood and try again later. If the participant continues to refuse a bath or is very combative, it would probably be best to try another day. [Include a statement on the bathing authorization form that states, “Staff has the right to refuse bathing of participants who may be combative or resistant to bathing.”] With patience and understanding, you may be able to persuade a reluctant participant to bathe.
How often is enough? Offer bathing services at least three days weekly and allow caregivers or participants to choose how often they are bathed. Frequency of bathing is a personal preference. Some people may not feel the need to shower or wash their hair daily. A sponge bath can be alternated with a more complete bath or shower.
Helms, Regenia, LPN, has served as the Health Care Coordinator at Coltrane LIFE Center in Concord, NC, for more than three years.
Reprinted from The Information Source for Adult Day Centers®, February 2003 |