Helping clients groom and dress is part of the job of a nursing assistant. Do the CNAs in your workplace know how important this daily task is to their clients? Do you use dressing and grooming activities as an opportunity to observe your customers? By sharing the following information and tips at your next CNA training meeting, you can give your attendees a different perspective on self-care.
Look Good… and Feel Better!
At first glance, getting ready for the day is so clear and easy that we often don’t think twice. We just get dressed, brush our teeth, comb our hair, and do all the other things we need to do to look presentable. Now imagine if:
- Your arm was stiff and you couldn’t put your shirt on.
- You couldn’t reach back to close a zipper or hook your bra.
- Her legs ached and she couldn’t bend down to put on her socks or shoes.
- Your fingers were bent from arthritis and you couldn’t tie your shoelaces.
- You couldn’t remember how to put your clothes on, or in what order.
- Your arms were shaking so much that you couldn’t brush your teeth, comb your hair, or shave.
For people who have physical or mental disabilities, dressing and grooming tasks are often difficult to perform alone. Sometimes they can take their frustration out on the people around them.
That’s where you come in. With your help and encouragement, your clients won’t be discouraged by their appearance or embarrassed that they can’t dress themselves in private.
A dozen benefits of good preparation
- Letting your customers choose their own clothes gives them a feeling of being independent and in charge.
- Encouraging customers to do their best while getting dressed builds team spirit and gives them a feeling of belonging.
- Allowing your clients to do as much as they can for themselves helps increase their self-sufficiency.
- Expressing your approval by dressing and grooming gives customers a sense of being valued.
- Looking good boosts each client’s self-esteem and can even help a bad mood disappear!
- Dressing your clients helps to protect the skin from injury and to maintain the proper body temperature.
- Making sure your clients’ clothes fit properly keeps all of their bodily systems unrestricted.
- Brushing your clients’ hair promotes a healthy scalp and strong hair.
- Daily mouth care prevents the onset of painful oral conditions and protects the mouth from oral diseases.
- Keeping your clients’ nails trimmed with no jagged edges prevents nicks 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.
keys that matter
Dressing and grooming tasks give you daily opportunities to look for clues that trouble may be brewing. For example:
- Be aware of customers’ facial expressions. Clients may tell you they are not in pain, but their faces can tell the real story.
- Clients put on and take off their clothes several times a day. As you help them, look at their entire body and take note of any areas of redness, rashes, bed sores, or other skin changes.
- Report any unusual body odor. A strange smell can be a symptom of a disease.
- Some health conditions cause the body to swell. Watch for signs of swollen hands (like tight rings) and swollen feet (like shoes and socks that are suddenly too small).
- As you brush or comb your client’s hair, check for 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 little bits of dandruff, but they don’t wash off or come off. Instead, they stick firmly to the hair strands.
- If you do nail care, look for white or yellow areas on your fingernails and toenails. Your client may have a nail fungus.
Challenges of dressing and grooming
For confused customers, getting ready and dressed involves many 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 you by putting toothpaste on a toothbrush, holding onto a sock while putting on a shoe, or folding a few wipes while brushing your hair.
Consider using a “mirror technique” when helping confused customers. For example, hold a toothbrush and pretend to brush your teeth to help a client understand how to do the task on their own.
When clients have shaky limbs, sit and talk to them for a few minutes before beginning care, as certain types of tremors improve when clients feel relaxed. Encourage them to support one arm with the other when doing tasks like shaving or brushing their teeth.
To help vision-impaired customers feel in charge, inform them of clothing styles and/or colors and guide their hands to where toiletries are stored. Talk when you are coming and going to keep them aware of their surroundings and so they know if 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. Ask them to sit through most of the dressing and grooming process to save energy and less bending.
If a client asks for a pain pill before you start dressing, let the nurse or a family member know that the client is in pain and needs care.
Remember that some of your clients may remain silent about their pain due to fear, their beliefs, or their cultural heritage. Be sure to look for nonverbal signs of pain such as:
- Clenching or grinding your teeth.
- Rub or hold a part of the body.
- Crying.
- Losing interest in your appearance.
- Changes in blood pressure (usually higher).
- Perspiration.
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 pain relief!
Security issues
Keep 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 their pants. If a client is weak on one side, encourage him to wear the weaker side first.
Report frayed cords on grooming devices like hair dryers or electric razors to keep you and your customers safe.
Consider using a “buddy system” when serving customers who have a history of being combative. This is not so that you can “group” with the customer, but rather so that you can remain safe while performing customer service.
Remember that some people feel dizzy when their body temperature drops. Help your clients maintain an even body temperature by dressing them appropriately for the weather and keeping them out of drafts.
Be sure to adjust your clients’ clothing when they are seated in wheelchairs to prevent the wheels from pulling on their clothing.
The bottom line
Remember that everyone has the right to participate in their own care. Therefore, encourage your clients to get involved in their personal care. Even if they are not strong enough to dress themselves, they can probably wash their faces or comb their hair.
It takes patience and understanding to step back and let your customers “do it themselves.” However, allowing your clients to maintain themselves as much as possible when it comes to dressing and grooming independently can positively affect their health and improve their overall quality of life.
