BASIC CARE
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SKIN CARE • Keep skin clean by washing with warm water and mild soap and rinse thoroughly. • Keep skin dry as much as possible. • Keep skin well hydrated by drinking as much wa- ter as can be tolerated. • Avoid friction or rubbing. You can use cornstarch to reduce friction. • Use alcohol free lotions for moisturizing. • Do not massage reddened areas. • Sitting for long periods of time can damage the skin that covers the tailbone. Move patient around to take pressure off skin. • Keep heels off bed with pillows under calves. • Change bed position at least every two hours, every hour if in a chair. • Have the patient shift their weight every fifteen minutes while they are awake if possible. • Your Care Team can recommend special pads and mattress overlays to help protect skin.
CALL YOUR CARE TEAM IF: • You have questions or con cerns about bathing or grooming, or if you need more help with bathing the patient. • You see a white coating on the tongue or inside the mouth, which can be in - dicative of a yeast infection. • You notice reddened areas that do not fade, open areas, or blisters on the skin. • Changes occur in the ability to turn or change the patient’s position. • You have any other questions or concerns about giving care.
CARING FOR THE PATIENT
BASIC CARE
BATHING • During shower or bath time, provide privacy and warmth by partially covering the patient with a light towel or blanket and washing one small area at a time.
• Make sure to wash face, hands, back, underarms and genitals at least once a day. • Wash the face first and work down to the feet. Genitals and buttocks are always last. • Be gentle when soaping, rinsing and drying the skin. • Apply moisturizing lotion to all areas, as it helps to protect the skin. • Take time to shave, comb, brush or style hair. Grooming can provide an emotional lift.
• Nutrition is important in skin care but sometimes even normal amounts of food may overwhelm a patient. Offer protein rich drinks and snacks during the day if the patient can tolerate them. See the section on nutrition below. • Even when giving extremely attentive care to the patient, the skin can break down because of the physi- cal changes that occur near the end of life. NUTRITION Appetite changes are often attributed to illness or medications that treat the illness. Food often tastes different, and discomfort or nausea with eating can occur. Weight loss is common with serious illness. A patient may not necessarily be able to gain weight and feel better just by eating more. You and your Care Team can focus on ways to make eating and drinking as pleasant as possible. • Arrange meals and snacks when energy is higher. • Reduce pain when offering food. Sometimes medications for pain about an hour before a meal may help. Your nurse will help guide you. • Try smaller, more frequent meals with favorite foods. • Use smaller portions and smaller plates as they are less overwhelming. • Avoid foods with strong odors and coarse textures. • Light foods such as rice and vegetables may be easier to digest than meats, pastas, potatoes and bread. • Choose soft foods if there is difficulty with chewing or swallowing. • Ask your Care Team about thickeners that can help with swallowing drinks. • Avoid foods that are excessively cold or hot. • Consider larger-handled utensils and “sipper” cups. • Check with your Care Team or medical provider to be sure that wine or other alcoholic beverages will not interfere with other medications.
• Choose loose-fitting, comfortable clothes. If dressing and undressing become more difficult, consider cutting old t-shirts and nightgowns down the back and sewing ties or velcro to make them easier to remove. Clothing that is tight, has buttons, or has thick seams can actually injure the skin if the patient is in bed or in a chair most of the time. • A sponge bath in bed may become necessary when the patient has great difficulty getting to the tub or shower, or if slipping or falling are possible. Ask your Care Team for instructions on giving sponge baths. • A hospice aide can come to help with the bathing and grooming. • Your nurse will help arrange additional equipment to make bathing safe and more comfortable. MOUTH CARE AND CLEANING • Be sure the patient is in an upright position to prevent choking. • Moisten the mouth first with sips of water or a damp cloth. • Gently brush teeth and gums with a mild toothpaste or small cloth wet with diluted mouthwash using a washcloth, towel, or bowl under the chin can help catch fluids. • If rinsing and spitting is difficult, use a washcloth, a “toothette” (disposable foam stick), or a gauze pad mois- tened with water or diluted mouthwash. • If the patient wears dentures, remove and clean them after eating. Make sure to clean the mouth gently with a soft toothbrush or cloth before replacing dentures. • For dry mouth, use ice chips, ice pops, or lollipops to suck on. Hard candy can be a choking hazard, so lol- lipops are preferred. A saliva substitute, an item found at most drug stores, may also be helpful. • Apply lip balm several times daily for chapped lips. If the patient is using oxygen, only use lip balms that do not have petroleum.
866.466.9734
FourSeasonsCare.org
FourSeasonsCare.org
866.466.9734
Four Seasons
Four Seasons
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