Dec 18, 2019

Reader question: How do you wash care recipient’s genitalia while seated on shower chairs?

 

Many people who live in residential aged care require help with their personal hygiene, including showering and bathing.

For some, this can be an uncomfortable process. Bathing is one of the most intimate tasks we perform, and so for someone else to perform it does not necessarily come naturally, especially if that person is of the opposite gender.

To avoid embarrassment, carers must take a professional approach and be sensitive to the care recipient’s feelings and wishes when undertaking this important but delicate task.

A question that is sometimes asked is how to clean a care recipient’s genitalia, especially when they are seated in a shower chair.

So we thought we would take a look into the topic, and provide some guidance for our readers.

Respect that this may be awkward for some

Firstly, it’s important to acknowledge that many will find this an awkward subject, including both the carer and the care recipient.

If carers can remain relaxed, upbeat and professional, it can help to alleviate some of the embarrassment.

The task of washing the genitalia of aged care recipients crosses a number of Aged Care Quality Standards, including skin care (2.11), continence management (2.12), privacy and dignity (3.6), and choice and decision making (3.9). How well the task is performed, from the point of view of the care recipient, is an indicator of quality care.

It is absolutely fundamental that those who perform the task preserve the dignity of the care recipient at all times. The care recipient must be able to have their say in how the task is performed. For example, if they don’t want it performed by a person of the opposite gender, then they should be able to request this.

Similarly, if the person does not want to have their genital area washed, then it’s ok to leave it and try another day.

Details about how a person wishes to be bathed might be included in their personal care plan, so ensure you check their plan before proceeding. 

Carers should encourage the care recipient to wash themselves as much as possible to inspire independence and promote self esteem. If the care recipient can hold a hand-held shower, then they may do so, and do much of the showering themselves.

Carers should talk gently to the care recipient along every step of the way, explaining what they are doing. 

It’s important to keep the genital area clean

According to ‘Long-term Caring: Residential, Home and Community Aged Care’ by Karen Scott, Margaret Webb, Sheila Sorrentino, it is particularly important to keep the genital area clean because the warm, moist, dark environment can be an ideal place for microbes to grow.

Cleaning of the genital area and anus is also known as perineal care, but when talking to the care recipient it’s important to use language they will understand, for example, the terms ‘privates’, ‘between your legs’ or ‘genitals’ may be easily understood.

Carers can preserve the person’s dignity by draping a clean towel over their bodies before and after the washing process.

Ensure the room is a comfortable temperature, and free from obstacles.

Cleaning the genital area should be done while the care recipient is showering or when the area becomes soiled with urine for faeces. Those who are incontinent may require more frequent washing of this area.

Use warm water in the shower. Test the water is not too hot. 

When showering, the care recipient may be seated in a chair. To make it easier to wash the genital area, the carer can ask the resident to stand. However, if they are not able to stand, washing the genital area can also be performed when seated. 

Shower chairs have holes in them that allow the water to drain away quickly and easily.

Use wash cloths or moistened towelettes. Do not use soap, but a gentle soap-free cleanser. These details may be included in the care recipients personal care plan.

Use a clean cloth. Use different quarters of the washcloth for each stroke.

Wash from the cleanest area to the dirtiest, which generally means washing from the front, the urethra or vaginal area, to the back, the anal area.

For women, separate the labia with one hand and use a cloth in the other hand to clean between the labia. Use gentle, downward strokes.

For men, use circular motions starting at the urethra. For men who are uncircumcised, pull back the foreskin before washing, and then once washed, return it to the normal position.

Rinse thoroughly.

If the care recipient was standing in the shower, as soon as you’ve finished, the person may wish to be seated again on a shower chair.

Put washcloths in the wash, and dispose of washing materials.

Gently pat the area dry afterwards to wick away moisture, so as to avoid skin breakdown or fungal and bacterial growth.

Document the process. Report any concerns after completing the wash, such as changes in the care recipient’s emotional state, cognitive abilities, or physical health. Note any bleeding, dizziness, pain, or complaints of feeling ill.

Ensuring personal hygiene

Maintaining good personal hygiene for aged care residents is vital to ensuring their health and wellbeing, stopping infection and preserving skin integrity. 

For those new to caring, the task may seem daunting and embarrassing. But with the right information, experience and clear communication it will become easier and more natural over time. 

Showering can be relaxing and a great pleasure for residents. Talking openly about the intricacies can help to make the process go more smoothly and successfully.

 

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  1. U can use a soft nylon toilet brush. That way there is no direct contact. Just don’t use the same brush on the rear. Mark one brown for the rear, yellow for their junk, and blue for the rest of the body. Use a facecloth for between the toes. N scrub the hair n scalp with gloved hands. After use hot water them for a min. N hang to dry. Make sure u rinse the person very well. Towel dry. N let the air help to dry. Make sure they r dry before clothing them. Often humming, eases the tension. .. MAT IN BOSTON

  2. Hi there. As I have a patient who needs a shower chair for showering, I still cannot figure out a practical way to wash the bottom of the patient seated. It would be really helpful if you can share some of your experiences about it because the patient is actually at high risk of falls and I dun recommend the patient to stand up in showering. Thanks a lot!

  3. I would always use a face washer and soap, no brushes as the residents skin is usually very thin due to their age. Unfortunately there is not enough time given to shower a person entirely and thoroughly due to not enough staff, but we do the best we can.

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