Bathing and Toileting Elderly Parents

Bathing and toileting elderly parents can be an incredibly awkward topic, especially if it is your mother or father’s hygiene habits you are talking about. Keeping your loved ones clean and safe is important though, as it directly contributes to their well-being, and helps keep them safe from infection.

Why does this have to be addressed?

Personal care and hygiene means more than just being clean. Good hygiene includes washing the hands, hair and body regularly and thoroughly, brushing and flossing teeth, and caring for gums. These grooming habits will reduce the threat of posed by the bacteria that reside on the body. To ensure optimum general hygiene, it is important to wash clothes, towels and linen on a regular basis.

Good hygiene leads to better health. Keeping your body clean keeps away bacteria and viruses, which can cause illness or infection. The simple act of washing your hands regularly is an effective way to prevent germs from spreading.

How to assist with showering and bathing

When bathing, it is important to feel safe and secure. Many older people have experienced slips and falls in the bathroom, and may, as a result, be reluctant to receive assistance. When assisting them with showering or bathing, it is important to approach them with sensitivity and compassion.

First, make sure the bathroom is fitted with any necessary bathing aids before use. You may need to consult with a carer or occupational therapist to get the room up-to-scratch. You can usually do this through your GP.

Ensure that all aids and equipment, such as bath seats, mobile showers or commodes, are charged and working correctly. Check that the room is warm enough, that the towels and floors are dry, and that all soaps, creams and clean clothes are to hand.

When escorting them to the bathroom, be sure to take it at their pace. Before undressing and assisting them into the bath or shower, be sure to check the water temperature. To help preserve their dignity, encourage them to wash themselves wash where possible.

Gentle encouragement may be needed to establish a regular washing routine. One great technique is to remind them of their former washing habits.

Toileting – This gets a little more complex

As time passes, they may require the assistance of urinal aids such as catheters, pads, or urinal bottles. Again, these can be accessed by an occupational therapist via your GP. Your district nurse or carer will also be able to advise you on the most suitable assistance for your loved one. Many of these aids can also be purchased cheaply and easily online.

These aids should be checked regularly to make sure they are functioning properly. Left unattended, these aids may give off an odour, which may go unnoticed if the user is losing their sense of smell. Body odour is a very sensitive issue, and it’s important that these matters are discussed with sensitivity to reduce embarrassment.

For more information, visit the care shop they also have a great article on this.

Dignity

Helping a friend, family member to use the toilet or bedpan can be a difficult and sometimes embarrassing process. It is important to consider the user’s dignity and privacy at all times. Talking to and reassuring them as you help them through this process can make all the difference. Remember to ask for permission to assist them at each step before proceeding.

If you are just dropping by, it may be helpful to ask if they need to use the toilet, as your presence may reduce the risk of any accidents. This is especially advisable if the suffer from dementia.

Direct assistance:

If your loved one gets to the point of requiring this kind of assistance, it is best to employ a carer, or train yourself up. See our article on what type of care you need to help you judge what point you are at. We also offer some strong guidance on how you can train yourself to help on a more regular basis with these quite complex and sometimes embarrassing tasks.

If you are living with them and need to provide help in a more direct way, we have some further information:

If they are still physically active:

If they are not bedridden, they may be able to use the toilet or a commode. However, they may still require support from to walk, sit and stand. If they are bedridden or cannot stand easily, contact the district nurse or GP, who may be able to advise an alternative. Other methods and options include:

• a bedpan or urinal container
• a removable raised toilet seat
• handrails near to the toilet
• bed or chair raisers
• hoist, or commode 

They may require help with undoing buttons or removing items of clothing before using the toilet. If so, ensure they have something to hold on to, such as a support rail. If using a commode, ensure the breaks are on at all times while in use.

While they are using the toilet or commode, make sure to give them as much privacy as possible: close the curtains or pull the door to, so nobody can see in. Ask them to tell you when they are finished and ready for your help again.

They may be able or prefer to attempt cleaning themselves. However, even in these cases, they may require some assistance, such as passing them the toilet paper. If they are unable to clean themselves, you may need to help them more directly. Consider the following guidance:

• Firstly, help them stand or lean into an accessible position.
• Clean them with toilet paper, followed by wet wipes or dry wipes if necessary. Your client may also wish to be washed with clean water. Be sure to dispose of wipes in a biodegradable nappy sack, rather than flushing them down the toilet.
• For ladies, wiping front to back will help prevent infections such as UTIs.
• Once they have finished, assist your client back to the chair or bed. If a commode is used, be sure to clean it afterwards, and wash your hands thoroughly with soap after removing your gloves.

Making it easier to use the toilet:

• If they have poor eyesight or dementia, they may struggle to make out objects. Having a brightly coloured toilet seat, or lights that go around the toilet itself can make it much easier for them to use.
• When going to the toilet, some people prefer a regular routine. Allow them plenty of time, and make sure they do not feel rushed.
• If there’s a long hallway leading to the toilet, consider placing a chair halfway. This will allow your client to rest if necessary.
• Keep the route to the toilet free from clutter to prevent trips or falls.
• Keep a hallway light on at night so your client can safely reach the toilet.
• Where they have communication difficulties, consider putting pictures or arrows on doors, indicating where to go and what to do.

If they are bedridden:

If they struggle to get out of bed, they may need to use a bedpan. Be sure to talk them through the process as you go along, and always ask their permission. Ask them to sit up in bed if possible. Support them with plenty of pillows to ensure their back is in an upright position. If their bed is adjustable, adjust it so that their head and back are raised.

• If they are able to lift their back and bottom from the bed (sometimes called ‘making a bridge’), ask them to do so. Slide a waterproof pad underneath them to catch any spills.
• Supporting their lower back with one hand, place the curved edge of the bedpan underneath their buttocks. Then ask them to rest their weight on the pan. Cover them with a towel to maintain their dignity.
• If they can not lift their back, you may need to roll them on to their side. With the bedpan and waterproof pad in place, roll them back onto the bedpan.
• Once they are finished, ask them to raise their buttocks again and slide the pan out gently while supporting their lower back. If they are not able to do so, you may need to roll them onto their side.
• Cover the bedpan with a paper towel, and put it to one side while you clean them.

To clean:

• Wipe the client with toilet paper, then wet wipes if required. Dry the area gently.
• Roll them into a comfortable position and cover them with a sheet so they are less exposed.
• Offer them some wet wipes and antibacterial gel to wash their hand. Alternatively, use soap, water and a dry wipe.
• Replace their clothing and duvet. Empty the bedpan in the toilet, and wash with hot water. Ensure the bedpan is dry before it is reused. If you are using a bedpan, make sure you dispose of it correctly.

For more information and guidance, visit:

• Alzheimer’s society guidance
• Caregiver guidance
• Marie Curie Guidance
• Daily Caring guidance
• Aged Care Hub Guidance
• And find aids at the care shop

As always, you can get in touch with us by hitting the chat icon in the bottom right-hand corner of your screen.