2. CCA Study Notes: Safe, Client-Centred Bathing Procedures

The Big Picture

Bathing helps keep the skin, genital area, and anal area clean. It removes microbes, dead skin, perspiration, and excess oils. Bathing also gives the CCA time to observe the client and get to know the person.

Safe bathing involves more than washing. You need to respect the client’s choices, privacy, dignity, comfort, independence, and right to refuse. You also need to follow the care plan, watch for changes, protect the client from falls and burns, and report and record your actions and observations.

Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.

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Course Notes: Key Ideas You Need to Know

What Bathing Does

Bathing keeps the skin and the genital and anal areas clean. It removes microbes, dead skin, perspiration, and extra oils.

Bathing also has other supported effects. It is refreshing and relaxing, stimulates circulation, and exercises body parts. A bath also gives you an opportunity to observe the client.

Choosing the Type of Bath

The type of bath depends on the client’s condition, ability to care for themselves, and personal choice.

Bathing methods include:

• Complete bed bath
• Partial bed bath
• Tub bath
• Shower
• Towel bath
• Bag bath

In facilities, bathing often takes place after breakfast or after the evening meal. Respect the client’s preferred bathing time whenever possible.

How Often a Client Bathes

Bathing frequency depends on personal choice or employer policy. Weather, physical activity, illness, perspiration, and dry skin also affect how often bathing takes place.

Some clients living at home prefer a daily bath. In long-term care, legislation ⓘ might call for a complete bath once or twice each week, with a partial bath daily and as needed.

Hot environmental temperatures or fever increase perspiration, so more frequent bathing might be needed. Some illnesses and dry skin limit bathing to once every 2 or 3 days.

Culture also matters. In some cultures, only a family member is permitted to bathe the person.

Water Temperature and Scald Prevention

Water that is too hot creates a scalding risk, especially for a frail or thin person.

Many agencies require two people to check bathwater temperature with a digital thermometer. The temperature is then recorded in the client’s chart.

For an adult complete bed bath, water is usually 43.3°C to 46.1°C, or 110°F to 115°F. Older people might need lower temperatures. Follow the care plan.

For tub baths and showers, the usual optimal temperature is 40.5°C, or 105°F. Check with the supervisor and care plan for the correct temperature for the individual client.

Always test the water before bathing a client.

Observe the Client During Every Bath

Bathing gives you an important opportunity to observe the client’s skin.

Report and record:

• Skin temperature
• Complaints of pain or discomfort
• Colour of the skin
• Colour of the lips
• Colour of the nail beds
• Colour of the sclera, the whites of the eyes

Also check for:

• Rashes, including their location and description
• Dry skin, including its location
• Bruises or open skin areas, including size, colour, and location
• Pale or reddened areas, especially over bony areas
• Drainage or bleeding from wounds or body openings
• Swelling of the feet and legs, including the size, colour, and circulation of the feet
• Corns or calluses on the feet

Complete Bed Bath

A complete bed bath means washing the client’s entire body while the client remains in bed.

It is used for clients who do not bathe themselves, including clients who are unconscious, paralyzed, in casts or traction, or weak after illness or surgery.

Before starting, ask the supervisor about:

• How much the client is able to do during the bath
• Activity limitations
• Position limitations

Follow Standard Practices and allow the client to make choices during the bath.

Privacy needs special attention. Some clients feel embarrassed when another person sees their body or fear being exposed. Explain how the bath will take place and tell the client that the body will remain covered for privacy.

Use the adult complete bed bath procedure for toddlers and older children.

Infants, young children, and older people have fragile skin and need lower water temperatures. Ask the supervisor or check the care plan for the correct temperature.

Towel Bath

A towel bath usually uses one oversized towel that covers the client from the neck to the feet.

The towel is saturated with a cleaning solution containing:

• Water
• A cleaning agent
• A skin-softening agent
• A drying agent

The drying agent helps the body dry quickly.

Towel baths are quick, soothing, and relaxing. Clients living with dementia often accept this bathing method well.

Use a towel bath when the supervisor and care plan direct it. Follow employer policies and procedures.

Bag Bath

A bag bath uses 8 to 10 washcloths that have been moistened with a no-rinse cleaning agent. The bag bath is commercially prepared or prepared by the employer.

The washcloths are warmed in a microwave before use. Ask the supervisor and follow the manufacturer’s instructions for the correct microwave setting.

Use a fresh washcloth for each body part. Let the skin air-dry. Towels are not required for drying.

Partial Bath

A partial bath focuses on body areas that develop odour or discomfort when they are not clean.

The partial bath includes:

• Face
• Hands
• Axillae, or underarms
• Back
• Buttocks
• Perineal area

Perineal care, or pericare, means cleaning the genital and anal areas.

A partial bed bath is given to a client who does not bathe independently. Some clients wash themselves in bed or at the bathroom sink and need help only with areas they do not reach, especially the back.

The general bathing guidelines also apply to partial bed baths.

Tub Baths and Showers

Some clients prefer a tub bath. Others prefer a shower.

Both involve risks from falls and hot water. Protect the client from:

• Slipping
• Falls
• Chilling
• Burns

Give a tub bath or shower only when the care plan specifies it. Check with the supervisor and care plan for special instructions.

Tub Bath Safety

Tub baths often feel relaxing. They also leave some clients feeling faint, weak, or tired.

Clients on bed rest have greater risk of these effects. A bath for these clients should last no longer than 20 minutes.

In facilities, clean the tub before and after use to reduce the spread of microbes and infection. Follow Workplace Hazardous Materials Information System, or WHMIS, requirements.

Portable tubs have sides that lower for transfers and rise again afterward. Cover the client with a blanket during transfer and transport to protect privacy and warmth.

Some whirlpool tubs use hydraulic lifts. A special wheelchair or stretcher moves the client to the tub and is lifted into place. Whirlpool action cleans the lower body while the upper body is washed. Clean carefully under the breasts, between skin folds, and in the perineal area.

Dry the client after the bath. Clean whirlpool jets after each use according to agency policy.

Bathroom Safety in the Client’s Home

Keep the bathroom as safe as possible.

Use a rubber bath mat or nonskid strips on the tub or shower floor. Some clients use safety equipment such as:

• Grab bars
• Transfer boards
• Bath chairs
• Shower chairs

The case manager and other health care team members arrange this equipment as needed.

Make sure required safety equipment is in place and used. A straight chair in the bathroom gives the client somewhere to sit while you prepare the bath or shower.

The bathroom should be warm and well-lit. Keep the floor free of clutter and water spills.

Never leave a client unattended in the bathroom. Organize the necessary supplies before care begins.

Shower Safety

Facilities use different shower arrangements. Some clients shower in their rooms. Others use shared shower areas.

A shower chair gives support and also transports some clients to and from the shower room. Lock the wheels during the shower.

Protect privacy in shared shower areas. Screen and cover the client properly. Close the door and shower curtain.

If the client steps into a bathtub to use the shower, make sure safety bars are available. Assist the client when entering and leaving as needed.

Before using a shower chair, make sure the chair is steady and does not slide.

Turn on the water and test its temperature before the client enters.

A client who stands in the shower should use grab bars when they are available. Shower floors should have nonskid surfaces. If a rubber bath mat is needed, position it so it does not cover the drain.

Never allow a weak or unsteady client to stand in the shower. The client must use a shower chair.

Contact the supervisor when you have concerns about the client’s safety.

For an older child, follow the supervisor’s direction about how much help and supervision to provide. Remember that independence and privacy are important.

When the Client Refuses a Bath

The client has the right to refuse a bath.

A bathing procedure requires the client’s informed consent. Do not bathe a client against the client’s wishes.

Clients refuse baths for different supported reasons. A person might:

• Feel ill or weak
• Fear falling
• Fear getting chilled
• Feel embarrassed
• Believe a bath is unnecessary

Listen carefully to find out what is bothering the client.

If the client was cold during the previous bath, offer to raise the room temperature. Use a heat lamp for additional warmth when the bathing area has one.

If the client thinks bathing is unnecessary, remind the client that bathing promotes hygiene, comfort, and relaxation.

When the client refuses, offer the bath again later. If the client continues to refuse, speak with the supervisor.

Bathing a Client Living With Dementia

A client living with dementia might feel frightened during bathing because the person does not understand what is happening or why it is happening.

The client might resist care, become agitated or combative, shout, or cry for help.

Follow the care plan. Supported measures include:

• Do not rush the client.
• Use a calm, pleasant voice.
• Divert the client’s attention.
• Help the client become calm and try the bath again later.

When the Client Does Not Tolerate the Position

Some clients do not tolerate sitting or lying on their back or side for long periods. Disease, injury, surgery, or shortness of breath are supported reasons.

Some clients also do not tolerate repositioning of the legs for perineal care.

Adapt the procedure to the client’s needs. Supported options include:

• Use a position the client finds more comfortable.
• Change to a partial bath.
• Ask for help so the bath takes less time.

Follow the supervisor’s directions and the care plan.

When the Client Urinates or Defecates During a Bath

To reduce the chance of urinary or fecal incontinence during bathing, toilet the client before every bed bath or tub bath.

During a Bed Bath

If the client urinates or defecates:

1. Put on gloves if you are not already wearing them.
2. Turn the client away from you.
3. Clean the client with toilet tissue.
4. Discard the tissue into a bedpan.
5. Change the soiled linen.
6. Clean the bedpan.
7. Remove your gloves.
8. Wash your hands.
9. Put on clean gloves.
10. Replace the bathwater and washcloths to prevent contamination of other body areas.

During a Tub Bath

If the client urinates or defecates:

1. Drain the tub.
2. Cover the client with a towel to prevent chilling.
3. Help the client out of the tub.
4. Remove stool with toilet tissue.
5. Dispose of the tissue in the toilet.
6. Clean the tub.
7. Refill the tub.
8. Help the client return to the tub.
9. Use a clean washcloth.

Control both verbal and nonverbal reactions. Do not embarrass the client.

Removing Hardened Secretions or Stool

Use unscented lotion, petroleum jelly, or peri-wash spray to soften hardened secretions or stool before wiping.

Place the product on a clean, damp washcloth or disposable cloth according to agency policy.

Gently clean the area and repeat as needed.

Do not rub or scratch. Rubbing or scratching can irritate the skin and cause skin breakdown.

When a Client Has an Erection During Bathing

Protect the client’s privacy and stay professional and calm.

A client living with dementia might not have conscious knowledge of the erection.

You have two supported options:

• Continue the bath calmly.
• Offer the client some private time.

If you feel uncomfortable, first provide for safety. Leave the room and close the door. When you return, knock before entering, identify yourself, and ask whether you have permission to enter. Then continue the bath.

An erection is a normal response to physical contact, especially contact with the genital area. Avoid showing embarrassment and maintain a professional manner.

Bathing and Older Clients

Aging and soap contribute to dry skin, which becomes damaged easily.

Older people usually need a complete bath or shower two times each week, with partial baths on other days.

Many facilities do not use soap when bathing clients because soap dries the skin. If the facility uses soap, rinse the skin thoroughly afterward.

Rinse bar soap after use and place it somewhere that allows the bar to dry.

Some older clients bathe every day without using soap each time. Some find bath gels easier to use.

Never add bath oil to a tub bath. Bath oil can increase the risk of slipping and falling. It can also irritate the delicate mucous membranes of the urethra and vagina.

Some skin-cleansing products do not require rinsing. Follow the manufacturer’s directions.

Lotion after bathing helps keep the skin soft and moisturized.

General Guidelines for Bathing Clients

These principles apply across bathing procedures when relevant:

Follow the Plan and Prepare

• Follow the care plan for the bathing method and skin-care products.
• Allow the client to make personal choices whenever possible.
• Follow Standard Practices.
• Make sure the client understands the procedure before starting.
• Speak with the supervisor when you are unsure whether the client understands and agrees.
• Gather all supplies before starting.
• Do not leave the client alone in the bathroom while collecting forgotten equipment.

Protect Privacy, Warmth, and Safety

• Protect privacy by closing doors, shades, drapes, or privacy curtains.
• Cover the client for warmth and privacy.
• Close doors and windows to prevent drafts.
• Protect the client from falls.
• Use good body mechanics.
• Protect the client from burns and scalds.
• Check bathwater temperature with a bath thermometer, the inside of your wrist, or your elbow. Follow the care plan.

Wash and Dry Safely

• Keep bar soap in the soap dish between uses.
• Wash from the cleanest areas toward the dirtiest areas.
• Encourage the client to do as much as safely possible.
• Rinse soap completely from the skin.
• Pat skin dry. Never rub the skin.
• Dry carefully under the breasts, between skin folds, in the perineal area, and between the fingers and toes.
• Thoroughly clean skin soiled with stool or urine and follow Standard Practices.

Giving a Complete Bed Bath

A complete bed bath promotes dignity, independence, individualized care, preferences, privacy, and safety.

Before the Bath

1. Identify the client according to employer policy.
2. Explain the procedure.
3. Offer the bedpan or urinal and provide privacy.
4. Perform hand hygiene.
5. Gather the supplies:
   • Wash basin
   • Soap
   • Bath thermometer, if available
   • Orange stick, nail file, or soft nail brush
   • Washcloth
   • Two bath towels
   • Two face towels
   • Flat sheet
   • Clean gown, pyjamas, or clothing chosen by the client
   • Oral hygiene supplies. Oral hygiene means care that keeps the mouth and teeth clean.
   • Lotion
   • Powder
   • Deodorant or antiperspirant
   • Brush and comb
   • Other grooming items requested by the client
   • Paper towels
   • Gloves when contact with blood, body fluids, secretions, or excretions is likely, or when bathing the genital and rectal areas
6. Cover the overbed table or work area with paper towels and arrange supplies within easy reach.
7. Close doors and windows to prevent drafts.
8. Provide privacy.
9. Raise the bed to a comfortable working height to reduce back strain.

Begin the Procedure

10. Lower the bed rail nearest you if it is raised. Remove the call bell. This step might not apply in community settings.
11. Provide oral hygiene when needed.
12. Cover the client with the top sheet for warmth and privacy.
13. Lower the head of the bed until flat if the client tolerates the position. Make sure the client has at least one pillow. This step might not apply in community settings.
14. If bed rails are used, raise the rail beside you. Fill the basin about two thirds full. Use a bath thermometer to make sure the water is safe and comfortable.
15. Place the basin on the overbed table or work area.
16. Lower the bed rail if it is raised.
17. Help the client move toward the side of the bed nearest you.
18. Place a bath towel over the client’s chest.
19. Fold the washcloth into a mitt and use it throughout the bath.

Wash the Eyes, Face, Ears, and Neck

20. Wash around the eyes using water only. Do not use soap. Wipe gently from the inner part of the eye toward the outer part. Clean the far eye first, then the near eye with a clean part of the mitt. This reduces transfer of possible microbes from one eye to the other.
21. Ask whether the client wants soap used on the face. Some clients avoid facial soap because it dries the skin.
22. Wash the face, ears, and neck. Rinse and pat dry with the towel over the chest.
23. Remove the client’s clothing without exposing the body. Keep every area covered except the area being washed.

Wash the Arms and Hands

24. Place a bath towel lengthwise under the far arm to protect the linen.
25. Support the arm with your palm under the elbow and the client’s forearm resting on your forearm.
26. Wash the arm, shoulder, and underarm with long, firm strokes. Work from the distal area toward the proximal area. Rinse and pat dry.
27. If dried food or feces visibly soil the hands or nails, place the client’s hand in the basin to soak. Follow employer policy because some facilities do not allow the basin on the bed. Soaking is the only way to soften dried food or feces on the hands and nails. Wash the hand and clean under the fingernails with the client’s own orange stick, nail file, or soft nail brush. Clean the basin thoroughly afterward according to agency policy.
28. Ask the client to exercise the hand and fingers.
29. Remove the basin. Dry the hand well and cover the arm.
30. Replace the water when it becomes cool, overly soapy, or soiled. Repeat steps 24 through 29 for the near arm.

Wash the Chest and Abdomen

31. Place a bath towel across the chest. Hold it in place while pulling the sheet down to the waist.
32. Lift the towel enough to wash the chest without exposing the client. Observe the skin under the breasts, in abdominal folds, and in the groin. Rinse and pat dry, especially under the breasts. Report changes in skin condition.
33. Turn the towel lengthwise over the chest and abdomen. Pull the sheet down to the pubic area without exposing the client.
34. Lift the towel enough to wash the abdomen. Rinse and pat dry.
35. Pull the sheet back to the shoulders and cover both arms. Remove the towel.
36. If bed rails are used, raise the rail. Replace water that is soapy, soiled, or cool. Measure the new water temperature. Lower the rail after returning.

Wash the Legs and Feet

37. Uncover the far leg without exposing the genital area. Place a towel lengthwise under the leg and foot.
38. Bend the client’s knee when the client is comfortable with this position. Support the leg with your arm. Wash with long, firm strokes. Rinse and pat dry.
39. Place the towel under the feet and wash the feet. If the feet are visibly dirty and need soaking, washing them during a tub bath is usually safer and easier.
40. Clean under toenails with an orange stick, nail file, or soft nail brush when needed. If the knee does not bend, wash the foot and carefully clean between the toes. Rinse and dry thoroughly. Poor drying between the toes allows bacteria to grow.
41. Repeat steps 37 through 40 for the near leg.
42. If bed rails are used, raise the rail beside you. Replace the water and measure the temperature. Lower the rail when you return.

Wash the Back and Buttocks

43. Turn the client onto the side facing away from you. Keep the client covered with a sheet or bath towel.
44. Uncover the back and buttocks only. Place a towel lengthwise along the back.
45. Wash from the back of the neck down to the lower buttocks using long, firm, continuous strokes. Rinse and dry well.
46. Offer a back massage after the bath if the client wants one.
47. Turn the client onto the back and cover the body with the sheet.

Provide Perineal Care and Finish Grooming

48. If bed rails are used, raise the rail. Replace the water for perineal care and measure its temperature. Lower the rail when you return.
49. Let the client wash the genital area independently when able. Put the basin, soap, towels, and call bell within reach. Make sure the client understands what to do. Ask the client to call when finished and respond promptly.
50. If the client does not perform perineal self-care, put on gloves and provide perineal care.
51. Apply deodorant or antiperspirant and lotion according to the care plan or the client’s direction.
52. Help the client into clean clothing.
53. Comb and brush the client’s hair.
54. Make the occupied bed.

After the Bath

55. Provide for safety and comfort.
56. Lower the bed to its lowest position. Attach the call bell and follow the care plan for bed rail use. Some parts of this step might not apply in community settings.
57. Empty and clean the wash basin. Return supplies to their proper places.
58. Wipe the overbed table or work area with paper towels and discard the towels.
59. Remove privacy measures.
60. Follow employer policy for dirty linen.
61. Perform hand hygiene.

Report and record your actions and observations according to employer policy. Reporting and recording keep the health care team informed and are required for legal reasons.

Giving a Partial Bath

A partial bath also promotes dignity, independence, individualized care, preferences, privacy, and safety.

Before the Partial Bath

1. Follow complete bed bath steps 1 through 8. Put on gloves when employer policy requires them.

Partial Bath Procedure

2. Place the bed in its lowest position for client safety.
3. Assist with oral hygiene.
4. Remove the bedspread and cover the client with the top sheet for privacy.
5. Put paper towels on the overbed table or work area within the client’s reach.
6. Fill the basin. Water should be 43.3°C to 46.1°C, or 110°F to 115°F, or the temperature directed by the supervisor and care plan. Measure it with a bath thermometer.
7. Place the basin on the overbed table or work area.
8. Position the client in Fowler’s position or help the client sit at the bedside.
9. Adjust the overbed table so the client reaches the basin and supplies without reaching too far.
10. Help the client undress. Respect cultural diversity.
11. Ask the client to wash the body parts that are easy to reach. Explain that you will help with the back and other areas that are difficult to reach.
12. Put the call bell within reach in a facility and ask the client to call for help or when finished. In community care, tell the client that you will remain outside the door and ask the client to call when help is needed.
13. Perform hand hygiene.
14. Leave the room only when it is safe. Stay within hearing distance. Return when the client calls. Knock before entering.
15. Replace the bathwater and measure the new temperature.
16. Raise the bed to a comfortable working height and adjust the overbed table.
17. Ask which body areas the client already washed. Wash and dry areas the client did not reach. A partial bath includes the face, hands, underarms, back, buttocks, and perineal area. Wear gloves for perineal care.
18. Offer a back massage if the client agrees.
19. Apply deodorant or antiperspirant when requested.
20. Help the client put on clean clothing.
21. Assist with hair care.
22. Help the client into a chair. If the client remains in bed, turn the client onto the side away from you.
23. Make the bed.
24. Return the bed to its lowest position.

After the Partial Bath

25. Provide for safety and comfort.
26. Put the call bell within reach.
27. Follow the care plan for bed rail use.
28. Empty and clean the basin. Return the basin and other supplies.
29. Wipe the work surface with paper towels and discard them.
30. Remove privacy measures.
31. Follow employer policy for dirty linen.
32. Perform hand hygiene.

Report and record your actions and observations according to employer policy.

Safety Guidelines for Tub Baths and Showers

Tub and shower care requires careful attention to water temperature, falls, equipment, warmth, privacy, and supervision.

• Follow agency policies about observation. Most agencies require a client in a tub to remain under observation at all times.
• Gather all equipment before starting the tub bath.
• Check the supervisor and care plan for the correct water temperature.
• The usual optimal temperature is 40.5°C, or 105°F.
• Many agencies require two people to check bathwater temperature with a digital thermometer and record the bath or shower temperature in the chart.
• Clean the tub or shower before and after use according to WHMIS.
• Dry the bathroom or shower-room floor.
• Check handrails, grab bars, hydraulic lifts, and other safety equipment. They must work properly.
• Use a bath mat unless the tub or shower already has nonskid strips or a nonskid surface.
• Keep the client covered during transport for privacy and warmth.
• Keep an undressed client covered and warm whenever the client is outside the tub or shower.
• Put needed items within the client’s reach.
• In facilities, put the call bell within reach and show the client how to use it.
• Have the client use safety bars while entering and leaving.
• The client must not use towel bars for support.
• Use good body mechanics during transfers.
• Ask for help before the transfer when help is needed.
• Turn on the cold water first, then the hot water.
• When turning water off, turn off the hot water first, then the cold water.
• Before the client enters a shower, adjust the temperature and pressure.
• Position a shower or bath chair before the client enters.
• Fill a tub before the client gets into it.
• Measure water temperature with a bath thermometer or the facility’s digital display.
• Keep shower spray directed toward the client to help maintain warmth.
• Avoid bubble bath products and bath oils because they make surfaces slippery and contribute to skin irritation and rashes.
• Keep bar soap in the soap dish to reduce soapy water and slipping risk.
• Do not leave weak or unsteady clients unattended in a tub or shower.
• If a client is safe to remain alone, stay within hearing distance outside the door or shower curtain.
• Drain the tub before the client gets out.

Assisting With a Tub Bath or Shower

This procedure promotes dignity, independence, individualized care, preferences, privacy, and safety.

Before the Tub Bath or Shower

1. Reserve the bathtub or shower according to employer policy. This step might not apply in community settings.
2. Identify the client according to employer policy.
3. Explain the procedure.
4. Perform hand hygiene.
5. Gather:
   • Washcloth
   • Two bath towels
   • Soap
   • Bath thermometer for a tub bath, if available
   • Straight chair, if needed
   • Bath or shower chair, when needed
   • Transfer board, when needed
   • Clean clothing
   • Grooming items requested by the client
   • Robe
   • Nonskid footwear
   • Rubber bath mat, if needed
   • Disposable floor mat, if needed
   • Gloves

Prepare the Bathing Area

6. Put all needed items in the bathroom or shower room before starting. Gathering supplies first helps you remain with the client.
7. Clean the tub or shower according to employer policy. This step might not apply in community settings.
8. Put a rubber bath mat in the tub or shower when needed. Do not cover the drain.
9. Put a bath mat on the floor in front of the tub or shower.
10. Position the bath or shower chair and lock its wheels. Position the transfer board when one is used.
11. Place the Occupied sign on the door when required. This step might not apply in community settings.
12. Return to the client and provide privacy.
13. Help the client sit on the side of the bed.
14. Help the client put on a robe and nonskid footwear.
15. Assist the client to the bathroom or shower room. Use a wheelchair when needed.

Prepare the Water

16. For a tub bath: For a shower:
    • Have the client sit on the chair beside the tub and keep the client covered.
    • Fill the tub halfway with warm water at 40.5°C, or 105°F, or another temperature the client tolerates.
    • Measure the water temperature with a bath thermometer or check the digital display.
    • Turn on the shower.
    • Adjust the water temperature and pressure.

Help With Bathing

17. Help the client undress and remove footwear.
18. Assist the client into the tub or shower. Have the client use grab bars for support.
19. Help with washing as needed. A bath should last no longer than 20 minutes.
20. Put a towel across the chair.
21. Turn off the shower or drain the tub. Keep the client covered while the tub drains.
22. Help the client out of the tub or shower and onto the chair. Encourage use of the grab bars.
23. Help the client pat the skin dry. Dry carefully under the breasts, between skin folds, around the perineal area, and between the toes.
24. Help apply lotion and other grooming products as needed.
25. Help the client dress and put on footwear.
26. Help the client return to the room and settle into the bed or a chair.
27. Provide privacy.
28. Offer a back massage if the client returns to bed.
29. Assist with hair care and other grooming needs.

After the Tub Bath or Shower

30. Provide for safety and comfort.
31. Put the call bell within reach when used in the setting.
32. Follow the care plan for bed rail use when applicable.
33. Return to the bathroom or shower room. Put on gloves, remove soiled linen, discard disposable items, and clean the tub or shower according to WHMIS.
34. Change the door sign to Unoccupied when the setting uses one.
35. Return supplies to their proper places.
36. Follow employer policy for dirty linen.
37. Perform hand hygiene.

Report and record your actions and observations according to employer policy.