5.3.5 Providing a Bed Bath

Each of the care processes below can take place separately for individuals, but are completed together for a complete bed bath. A bed bath is the cleaning of a person while they are in bed. A partial bed bath cleans only areas which need daily cleaning to maintain good health. Complete bed baths include the entire surface of the body as well as hair, nails, and mouth care.

Prepare for the bed bath

To prepare to complete a bed bath, complete the following steps:

1. Prepare the supplies. For a bed bath you will need:
   • a basin filed with warm water
   • a second basin filled with warm water with soap in it
   • soap
   • a large pitcher filled with warm water
   • a bath thermometer
   • bed shampoo board
   • pail
   • shampoo/conditioner
   • washcloths (4)
   • bath towels (3)
   • face cloths (2)
   • bath sheet or top sheet
   • clean pajamas or clothing for the client to wear after the bath
   • toothbrush, toothpaste or denture cleaner, dental floss (if needed)
   • kidney basin
   • mouthwash
   • glass of water
   • face towel
   • gloves
   • lotion
   • brush/comb
   • hair dryer, if needed
   • deodorant
   • electric razor if needed
   • nail brush and file
2. Greet your client and let them know what you’re there to do.
3. Place the bed at a height that is comfortable with you. Remember: you should avoid stooping in order to practice good body mechanics.
4. Lower the rail on your side.
5. Draw the curtain or close the door for privacy.
6. Wash hands and don appropriate PPE. You are now ready to assist the client with their bathing and personal care needs.

Provide oral care

You will begin a bed bath by providing all necessary oral care. Please note that oral care will be discussed at length in the following chapter. We will not cover the same ground here, so please refer to that chapter for explanation.

Note: you will remove your soiled gloves after oral care is complete.

Wash hair

To complete the hair washing procedure for your client, progress through the following steps in order:

1. Explain the hair-washing procedure to the client.
2. Place a large plastic bag on the bed under the client’s head, cover the plastic bag with a towel, place the shampoo board directly under the client’s head, and place a rolled washcloth at the client’s neck. Place a pail (if needed) under the spout of the shampoo board.
3. Don gloves
4. Ask the client to hold a washcloth over their eyes while the water is poured from the pitcher onto their hair, if they are able to assist. If they cannot assist, you may wish to request another staff member, or just do your best to avoid their eyes. Wet all of the hair.
5. Apply shampoo and massage into scalp. Then, rinse the shampoo from the hair completely.
6. Apply conditioner and rinse well.
7. Fold the hair snugly in a towel.
8. Remove the shampoo board after emptying the used water into the pail. Remove the plastic and the towel in one piece to avoid wetting the sheets.
9. Replace the towel around their hair with another dry towel.
10. Dry and style the hair using the client’s choices for styles.

Bathe the client

To bathe the client’s body while in bed, complete the following steps in order.

1. Explain the bath process to the client.
2. Place the basins on the bedside table.
3. Assist the client to be lying on the side of the bed near you.
4. Cover the client with a bath sheet.
5. Fold the washcloth into a mitt to prepare to wash the client’s face. Then, wash the eyes first without soap, starting at the inside corner; rinse, and pat them dry. Wash the face with soap if the client agrees then, rinse and pat dry.
6. Roll the bed sheets down under the bath sheet.
7. Remove the client’s garment under the bath sheet.
8. Put a towel under the arm closest to you. Wash the shoulder, underarm, arm and hand, including using the nail brush to clean the nails. Then, rinse and pat dry. Apply deodorant to the underarm area. Repeat with the opposite arm.
9. Slightly lift the sheet, and wash the chest and abdomen of the client. Then, rinse and pat dry.
10. Put a towel under one leg, wash the leg and foot. Rinse and pat dry. Repeat with the other leg.
11. This is a good time to change the water for clean warm water. Explain what you are going to do. Put the side rails up and place the bed in the low position while you are not present at bedside. When you return, lift the bed, lower the side rail and continue the bed bath.
12. Turn the client onto their side, place a towel behind the back, and wash the back from the neck to the lower buttocks. Then, rinse and pat dry.
13. Turn the client onto their back. Place a waterproof pad under the client’s hips to the knees.
14. Allow the client to complete perineal care if able, washing front to back. Assist, if needed, with a separate washcloth, or complete perineal care yourself if the client is unable to complete this task. Here are the steps of perineal care:
    • For females: ask them to flex their knees and separate their legs. Then, wash the perineal area down one side of the labia, down the other side, and down the middle. Rinse, and pat dry. Assist the client onto their side, and using a clean washcloth, clean the rectum, wiping from the vagina to the rectum. Rinse, and pat dry. Assist the client to their back.
    • For males: retract the foreskin if uncircumcised, hold the penis, and wash around the tip in a circle. Rinse with a clean cloth and pat dry. Then, have the client flex his knees, wash under the scrotum, rinse and pat dry. Assist the client to turn onto their side, wash the rectal area, rinse, and pat dry. Assist the client to lay onto their back.
15. To soak the client’s feet, fill a basin with warm water, place the foot in the basin, gently wash the foot, remove the foot and pat dry. Then, place the other foot into the basin, wash the foot, and remove the foot and pat dry. File the toenails.
16. Pull the side rail up, assist the client to put their clothes/pajamas on, remove the bath sheet, and cover the client.
17. Lower the bed to the low position. Place the call light with the client before leaving the bedside.
18. Empty and clean the basins, place the soiled linen in the hamper, and put away supplies.

Now that all parts of the complete bed bath are finished, or just the parts that you were required to complete, always report the cares and record them in the client’s chart.