The Resident's Unit

1. The Resident’s Unit
Chapter 12
 Importance of comfortable environment
 Controlling noise level – enhancing sleep
 Controlling odors
 Promptly answering call lights
 Changing briefs and proper disposal
 Temperature of room
 Listening
 Ask what they would like

2. Standard Resident Unit
 Bed – Electric
 Bedside stand
 Personal items kept in stand
 Overbed table
 Call light
 Privacy curtain
 Keep tidy

3. Cleaning the equipment
 Bedpans
 BSC
 Urinals
 Use facility protocol for cleaning these
 Dirty utility room
 Clean utility room

4. Bedmaking
 Linens always changed after baths, when damp or
soiled
 3 other reasons to change linens…
 Wrinkled, bunched up linens may prevent good sleep
 May cause infection or disease (moisture - breeding
ground for bacteria)
 Increase risk for pressure sores

5. Bed making guidelines
 Keep linens wrinkle-free, tidy
 Wash hands before handling clean linen
 Hold soiled linen away from body
 Do not shake
 Gloves for dirty linen (not in test, but in real life)

6. Occupied bed
 Review from learned skill
 Make resident comfortable
 Bed in low position
 Call light within reach

7. Definitions
 Closed bed – Completely made with bedspread and
blankets in place
 Open bed – Blankets folded down ready to receive
resident who has been out of bed or day or being
admitted to facility
 Surgical bed – linens are folded to the side to receive
resident from gurney, returning from procedure or test
(hospital setting)

8. Personal Care Skills
Chapter 13
 Hygiene – practices to keep our bodies clean
 Bathing
 Brushing teeth
 Grooming – fingernails, hair
 Both, along with eating, transferring, and toileting are
called ADLs (Activities of Daily Living)

9. Personal Care (continued)
 Encourage independence when possible
 Be professional at all times
 Always explain procedure
 Provide privacy
 Promotes dignity and respect
 Helping with personal care gives the opportunity to
observe for changes:
 Skin, mood, pain, always make note and tell nurse

10. Personal Care (continued)
 Other things to observe for changes and report
 Skin color, temp, mobility issues, ability to perform own
care (stand-by assist, 1 person assist, 2 person assist, etc)
 Complaints
 Mental and emotional state

11. Why do residents need help with
ADLs?
 Chronic illness
 Frail – old age
 Disabled
 Dying
 What kind of help and with what?
 Bathing, peri care, toileting, mouth care, shampooing,
combing-brushing hair, nail care, shaving,dressing,
eating, walking, transferring.
 Often called a.m or p.m care. Why?

12. a.m. and p.m. care
 a.m. care
 Offering bedpan/urinal/trip to BR
 Wash face and hands
 Mouth care/denture care, before or after breakfast
 Dressing, deodorant, hair, make-up? Sometimes
 p.m. care
 Offering bedpan/urinal/trip to BR
 Wash face and hands
 Giving snack
 Mouth care
 Back rub…sometimes

13. Skin care
 Prevention is the key!
 Be aware of why and where skin breakdown can occur.
 Bony prominences and pressure
 Under breasts and scrotum (moisture)
 Ears
 Change position q 2h. (every two hours)
 Inspect areas of body at this time.
 If breakdown starting, inform nurse and place pillows,
wash and dry area that is moist
 Place barrier cream

14. Signs of skin breakdown
 Pale, white, reddened
 Darker skin may look purple
 Tingling, burning
 If pressure allowed to continue, will become a
“pressure sore”, “bed sore”, or “decubitus ulcer”
 Rash (under breast, scrotum, peri area)

15. Pressure Sores
 If left unattended, will get bigger, deeper, and infected
 Most pressure sores occur within a few weeks of
admission to LTC
 Painful, difficult to heal.
 Can lead to life-threatening infections…so…
 PREVENTION IS THE KEY!!

16. 4 stages – See pg 196
 Stage 1: Skin intact, but reddened, does not blanch or
go away within 15 to 30 minutes
 Stage 2: Superficial ulcer. Blister or shallow
crater…partial skin loss…outer or inner layer
 Stage 3: Full skin loss…death of tissue..extends down
to tissue that covers muscle
 Stage 4: full skin loss, major destruction, damage to
muscle, bone, or ligaments
 Takes a long time to heal…

17. Basic skin care
 Clean and dry
 Reposition at least every 2 hours
 Change soiled briefs often or at least every 2 hours,
give good peri care
 Be careful during dressing or transfers especially with…
 People that are stiff and cannot move limbs well
 People who are on blood-thinning medications
 Encourage good nutrition and hydration

18. When moving in bed…
 Use draw sheet
 Do not slide resident – causes “shearing” using
friction…can damage skin
 Use pressure relieving devices:
 Heel protectors
 Pillows
 Alternating pressure mattress
 Bed cradle ( toe pleat helps, too)

19. Pressure-relieving devices
(continued)
 Also called “Positioning Devices”
 Hand rolls
 Orthotic devices:
 Splint
 Brace
 Knee pillows
 Other pillows (behind back, under arm, etc)

20. Bathing guidelines
 Complete bed bath
 Use mitt or 4 corners for face
 Provide privacy
 Cover with bath blanket
 Only uncover part being washed
 Place towel under limb being washed
 When washing face, wash from inner aspect to outer
aspect of eyes
 Review steps on pg 200, 201, & 202

21. Modified Bed bath
 One of your skills
 Will wash face, one arm, and one hand
 Always place towel under part being washed (with the
exception of face
 Wash, rinse, and pat dry for all bathing skills

22. More skills…
 Fingernail Care
 Foot care
 Mouth Care
 Cleaning dentures
 Peri-care – female and male
 Dressing affected side
 With all of these…provide privacy!

23. Other grooming skills…
 Shaving – always wear gloves!
 Electric
 disposable razor
 Flossing
 Shampooing hair
 Dandruff
 Lice
 Combing, brushing hair
 Review whole chapter thoroughly!