When a parent becomes bedridden it can hit you hard. If you're providing care, you need to know the basics. Personal Hygiene for Bedridden

When a parent becomes bedridden it can hit you hard. If you're providing care, you need to know the basics.

যখন কোনও বাবা-মা শয্যাশায়ী হয়ে যান তখন এটি আপনাকে প্রচন্ড  আঘাত করতে পারে। যদি আপনি যত্ন ও দেখাশুনার দায়িত্বে থাকেন তবে আপনার প্রাথমিক বিষয়গুলি জানা প্রয়োজন।

Personal  Hygiene for Bedridden.
শয্যাশায়ীর জন্য ব্যক্তিগত স্বাস্থ্যবিধি।

When a parent becomes bedridden, it can hit you hard. Whether you're providing care or just finding someone to help with it, it can take an emotional toll on you. If you're providing care, you need to know the basics, but you'll also need to know when to ask for help from outside sources, such as friends, family members, and professional organizations. 
'Whether you're just supervising or doing the caring yourself, you also need to make sure that you stay healthy, both physically and emotionally.'



Personal hygiene is a preventive health measure that serves a senior's emotional, social, and physical well-being.
Maintaining personal hygiene lowers the risk of social embarrassment and eventual isolation from others.
With regard to emotional health, keeping oneself clean and neat improves morale and lowers the risk of depression.

Personal hygiene includes a number of different activities related to the following general areas of self-care:

washing or bathing, including cleansing oneself after using the toilet; taking proper care of the mouth; grooming and dressing; and keeping clothing clean. Bathing, dressing and undressing, and using the toilet are considered activities of daily living (ADLs), while doing one's laundry is considered an instrumental activity of daily living or IADL.

- Cleanliness protects against the spread of disease from external parasites (such as body or head lice) or from contact with contaminated feces or other body fluids.
- Proper washing and bathing protects the skin against rashes and sores from contact with urine or fecal matter.
- Oral hygiene lowers the risk of malnutrition, swallowing difficulties, or infections caused by bacteria in the mouth getting into the bloodstream and other body tissues.
The senior's loss of capacity is physical or mental ; with arthritis may find it physically awkward or painful to climb into a tub or to open shampoo bottles, whereas a senior with dementia(স্মৃতিভ্রংশ) may completely forget to bathe or shower.

Useful things for  seniors 

The caregiver will need to ask several questions to assess whether and what type of help a senior might need in order to keep him- or herself clean:

* Is the disability temporary or permanent?
* Is it likely to get worse over time or stay at the same level?
* What organ systems or parts of the body are affected? For example, a senior who has arthritis in the hands may need different types of household gadgets or assistive devices than one with arthritis in the hips and knees; similarly, a senior with an ostomy will need a different type of bathroom arrangement from one who is sight- or hearing-impaired.
* Can the senior walk or move to the bathroom or are they completely bedridden?

There are several different physical causes that may lead to incontinence:

- The patient may have structural abnormalities or weak muscles in the area of the bladder or anus; diseases that affect the nerves leading to and from the colon or bladder; may be taking medications that interfere with normal patterns of elimination; or may have difficulty reaching the bathroom quickly because of mobility impairments.
- Urinary incontinence is a particularly important hygienic problem because it is the single most common reason for institutionalizing impaired elderly patients. If a caregiver is helping an incontinent senior with personal hygiene, the caregiver should wash the genital area completely and carefully, and use powder or ointment to protect the skin after washing.

- Seniors with dementia have increased difficulties in maintaining cleanliness because they often lose their ability to control their emotions as well as their thought processes. It is not unusual for a senior with dementia to have what is called a catastrophic reaction
when they are asked or reminded to take a bath or shower.
- A catastrophic reaction is an emotional outburst or overreaction to a situation or event. The senior may be upset about bathing because they are embarrassed by having to take off clothing in front of someone else; because they are disoriented and don't remember the location of the bathroom; because they feel rushed, anxious, or cold; or because they cannot remember all the separate steps involved in taking a bath. If the senior is living with a caregiver, it may make things easier if the caregiver coaches the senior through one step at a time in the process and allows him or her to have as much control as possible over the time of day for bathing and the choice of a bath or shower.
The Alzheimer's Association recommends keeping a large bath towel nearby to cover the senior while they are undressing so that they feel less vulnerable, and keeping the bathroom at a warm temperature.

Oral hygiene

Proper care of the mouth is important to good nutrition as well as preventing tooth decay and the eventual loss of teeth, because seniors with dental pain or sores in the mouth may stop eating foods that require chewing.

If the senior has dementia or some kind of physical impairment that makes it difficult to clean their own teeth or dentures, a caregiver will need to do these things on a daily basis. Some dentists recommend foam applicators instead of brushes for cleaning the teeth of persons with physical impairments. The caregiver should also check the person's mouth and gums for ulcers or irritated areas in between visits to the dentist.
The senior should see a dentist twice a year to make sure the teeth, gums, and other tissues in the mouth are in good condition.

Laundry

Doing one's laundry is an important marker of personal independenceas well as a necessary part of physical cleanliness. Unwashed clothing and bed linens can harbor viruses and bacteria as well as body lice, thus increasing the senior's risk of disease.

Grooming and personal care:

Grooming and personal care concern such matters as shaving, hair care, makeup, and clothing selection as distinct from considerations of cleanliness. Grooming is important,

however, because looking one's best is important to the senior's sense of dignity and morale. Clothing that fits properly, looks attractive, and is easy-care can go a long way to lift a senior's spirits, as is attention to hair styling, eyeglass frames, and other items that contribute to appearance.

Caregivers should consider the following in regard to grooming:

- Check the senior's clothing periodically to make sure it still fits.
- Report Advertisement
-This consideration is particularly important if the senior has swallowing problems or is losing weight for other reasons.

- Simplify the wardrobe so that most articles of clothing can be easily mixed or matched with other items. Seniors with dementia can become confused by too many color choices or too many accessories.
- Choose pants, skirts, and shoes with pull-on styling. Shoes with Velcro fasteners are easier for many seniors to put on and remove than shoes with laces or buckles. There are many dresses and blouses for women that are designed to be pulled over the head without the need for buttons or zippers.
- Small accessories can improve morale, too. A man can wear a clip-on tie or bolo if his fingers can no longer manage a conventional tie. A woman's scarf can be tied ahead of time by the caregiver and simply slipped over the head after dressing.

There is a wide assortment of grooming aids designed for seniors with various impairments, ranging from magnifying mirrors and long-handled sponges for use in the shower to razor holders that attach to the hand, toothpaste and soap dispensers, and many other devices.

For cancer patients, such programs as Look Good … Feel Better offer practical advice about dealing with the effects of cancer treatment on physical appearance like hair loss and weight loss .
With regard to emotional health, keeping oneself clean and neat improves morale and lowers the risk of depression.


Recommended safety measures include:

* Adequate lighting.
* Nonslip surfaces, carefully anchored tub or shower mats, and grab bars or hand rails in shower stalls. In some cases, the purchase of a small stool and a handheld shower extension that will allow the senior to shower sitting down are useful. There are also devices that can be installed to help a senior enter and leave a tub.
* Proper securing of electrical cords and with regard to emotional health, keeping oneself clean and neat improves morale and lowers the risk of depression.hecking the adequacy of existing wiring and outlets.
* Setting the hot water heater at a temperature low enough to prevent accidental scalding.
* Installing a cabinet or other form of storage that will allow the senior to keep bathroom supplies as close as possible to where they are used.
As a care giver 

"Feel their emotions, understand their needs and care them with love.
With regard to emotional health, keeping oneself clean and neat improves morale and lowers the risk of depression."

- Rukshana Sharia  






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Resources
BOOKS
Morris, Virginia. How to Care for Aging Parents, 2nd ed. New York: Workman Publishing Co., 2004.
Beers, Mark H., M. D., and Thomas V. Jones, MD. Merck Manual of Geriatrics, 3rd ed., Chapter 4, “Comprehensive Geriatric Assessment.” Whitehouse Station, NJ: Merck, 2005.
Struyk, Raymond J., and Harold M. Katsura. Aging at Home: How the Elderly Adjust Their Housing without Moving. New York: Haworth Press, 1988.
Mace, Nancy L., and Peter V. Rabins. The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease, Other Dementias, and Memory Loss in Later Life, 4th ed. Baltimore, MD: Johns HopkinsUniversity Press, 2006.
PERIODICALS
Dunn, Joshua C., Brenda Thiru-Chelvam, and Charles H. M. Beck. “Bathing: Pleasure or Pain?” Journal of Gerontological Nursing 28 (November 2002): 6–13.
Cheek, P., L. Nikpour, and H. D. Nowlin. “Aging Well with Smart Technology.” Nursing Administration Quarterly 29 (October-December 2005): 329–338.
Gill, T. M., Z. Guo, and H. G. Allore. “The Epidemiology of Bathing Disability in Older Persons.” Journal of the American Geriatrics Society 54 (October 2006): 1524–1530.
Cohen-Mansfield, J., and B. Jensen. “Dressing and Grooming: Preferences of Community-Dwelling Older Adults.” Journal of Gerontological Nursing 33 (February 2007): 31–39.
ORGANIZATIONS
National Aging in Place Council (NAIPC), 1400 16th Street NW, Suite 420, Washington, DC, 20036, (202) 939-1784, (202) 265-4435, dhicks@dworbell.com, http://www.naipc.org/NAIPCHome/tabid/36/Default.aspx.
American Association of Retired Persons (AARP), 601 E Street NW, Washington, DC, 20049, (800) OUR-AARP (687-2277), http://www.aarp.org/.
Look Good … Feel Better, (800) 395-LOOK (24-hour hotline), http://www.lookgoodfeelbetter.org/general/requests.htm, http://www.lookgoodfeelbetter.org/index.htm.
Administration on Aging (AoA), One Massachusetts Avenue, Washington, DC, 20201, (202) 619-0724, aoainfo@aoa.hhs.gov, http://www.aoa.gov/index.asp.

Alzheimer's Association, 225 North Michigan Ave., Floor 17, Chicago, IL, 60601, (312) 335-8700, (800) 272-3900, (866) 699-1246, info@alz.org, http://www.alz.org/index.asp.


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