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Complete Guide to Bathing for Stroke Survivors

By Caring.com Staff
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The Bed Bath

Bed baths are needed by people who are confined to bed. Baths clean, stimulate, and increase blood flow (circulation) in the skin. However, they can also dry the skin and in some instances cause chapping. Thus, you must decide how often a bed bath is needed. Your decision must be based on the situation of the person in your care. For example, if urinary incontinence (leakage), bowel problems, and heavy perspiration are present, a daily bath may be in order. If not, bathing 2 to 3 times a week might be enough. At bath time, inspect the whole body for pressure sores, swelling, rashes, moles, and other unusual conditions. If baths are given often and the skin is dry, use soap and water one time and lotion and water the next. Cornstarch and powder can cause skin problems in some people. Ask the nurse on your health care team for advice.

To avoid spreading germs, always wash your own hands before and after giving a bath. At each step, tell the person what you are about to do and ask for his help if he is able.

  1. Make sure the room is a comfortable temperature and not too warm.
  2. Gather supplies--disposable gloves, mild soap, washcloth, washbasin, lotion, comb, electric razor, shampoo--and clean clothes.
  3. Use good body mechanics (position)--keep your feet separated, stand firmly, bend your knees, and keep your back in a neutral position.
  4. Offer the bedpan or urinal.
  5. If you have a hospital bed, raise the bed to its highest level and bring the head of the bed to an upright position.
  6. Help with oral hygiene--brushing the teeth or cleansing the mouth.
  7. Test the temperature of the water in the basin with your hand.
  8. Remove the person's clothes, the blanket, and the top sheet. Cover the person with a towel or light blanket. Keep all of the body covered during the bed bath, uncovering only one area at a time while washing it.
  9. Now have the person lie almost flat.
  10. Use one washcloth for soap, one for rinsing, and a dry towel. Have the washcloth very damp, but not dripping.
  11. Very gently wash the face first; pat dry.
  12. Wash the front of the neck; pat dry.
  13. Wash the chest, and for females under the breasts; pat dry.
  14. Wash the stomach and upper thighs; pat dry.
  15. Clean the navel with a little lotion on a cotton swab.
  16. Wash upward from wrist to upper arm to increase circulation; pat dry.
  17. Wash the hands and between the fingers; check the nails; pat dry.
  18. Place a towel under the person's buttocks.
  19. Flex (bend) the person's knees.
  20. Wash the legs; pat dry.
  21. Wash the feet and between the toes and dry well. Use lotion on dry feet. Do not put lotion between toes. This area must be kept dry and clean to prevent fungal infection.
  22. Wash the pubic area. If possible, have the person wash his or her own genitals; if not, do it yourself. (Use PeriWash to prevent a buildup of germs.)
  23. If a male is not circumcised, draw back the foreskin, rinse, dry, and bring the foreskin down over the head of the penis again. For the female, wash the genitals thoroughly by spreading the external folds. (This must be done at least daily.)
  24. Pat the genitals dry.
  25. Watch for unusual tenderness, swelling, or hardness in the testicles.
  26. Change the bath water.
  27. Roll the person away from you.
  28. Tuck a towel under the person.
  29. Wash the back from the neck to the buttocks.
  30. Rinse; dry well.
  31. Give a back rub with lotion to improve circulation.
  32. Dress the person.
  33. Change the bed linens.
  34. Trim the toenails if they are long.

The Basin Bath

If the person in your care can be in a chair or wheelchair, you can give a sponge bath at the sink.

  1. Make sure the room is warm.
  2. Gather supplies--disposable gloves, mild soap, washcloth, washbasin, lotion, comb, electric razor, shampoo--and clean clothes.
  3. Use good body mechanics (position)--keep your feet separated, stand firmly, bend your knees, and keep your back in neutral.
  4. Offer the urinal.
  5. Wash the face first.
  6. Wash the rest of the upper body.
  7. If the person can stand, wash the genitals. If the person is too weak to stand, wash the lower part of the body in the bed.

The Tub Bath

If the person in your care has good mobility and is strong enough to get in and out of the tub, he or she may enjoy a tub bath. Be sure there are grab bars, a bath bench, and a rubber mat so the person doesn't slide. (It may be easier to sit at bench level rather than at the bottom of the tub.) Use the following steps:

  1. Make sure the room is a comfortable temperature.
  2. Gather supplies--disposable gloves for the caregiver, mild soap, washcloth, lotion, comb, electric razor, shampoo--and clean clothes.
  3. Check the water temperature before the person gets in.
  4. Guide the person into the tub. Have the person use the grab bars. (Don't let the person grab you and pull you down.)
  5. Help the person wash.
  6. Empty the tub and then help the person get out.
  7. Guide the person to use the grab bars while getting out. OR you can have the person stand up and then sit on the bath bench. Swing first one leg, then the other leg, over the edge of the tub. Help him stand.
  8. Put a towel on a chair or the toilet lid and have the person sit there to dry off.
  9. Apply lotion to any skin that appears dry.
  10. Help the person dress.

The Shower

Before starting, be sure the shower floor is not slippery. Also make sure there are grab bars, a bath bench, and a rubber mat so the person doesn't slide. A removable shower head is also useful.

  1. Make sure the room is a comfortable temperature.
  2. Explain to the person what you are going to do.
  3. Provide a shower stool in case he or she needs to sit.
  4. Gather supplies--mild soap, washcloth, washbasin, comb, electric razor, shampoo--and clean clothes.
  5. Turn on the cold water and then the hot to prevent burns. Test and adjust the water temperature before the person gets in. Use gentle water pressure.
  6. First, spray and clean the less sensitive parts of the body such as the feet.
  7. For safety, ask the person to hold the grab bar or to sit on the shower stool.
  8. Move the water hose around the person rather than asking the person to move.
  9. Assist in washing as needed.
  10. Guide the person out of the shower and wrap with a towel. Turn the water off.
  11. Apply lotion to skin that appears dry.
  12. If necessary, have the person sit on a stool or on the toilet lid.
  13. Assist in drying and dressing.