The bed bath, or sponge bath, has important health benefits: in addition to maintaining hygiene, it improves circulation and eases some of the discomfort and stress associated with prolonged immobility. It acts as a minor form of exercise too.
Bathing also provides an opportunity for the caregiver to observe the person’s general wellbeing, and note any changes or concerns that may need medical attention.
In particular, bathing is a good time to check for reddening of the skin that may indicate that a pressure sore (bed sore) is developing. Pressure points such as the buttocks, spine, elbows and hips are likely areas for bed sores to occur.
Before the bath:
Find out the patient’s preferences; maybe they have special lotion or soap they like using, for example. Fragrance-free products may be required for sensitive skin. Ask them to choose a fresh change of clothing for themselves.
Privacy is very important. Close doors and curtains/blinds, or make use of bed screens, and ensure others know not to enter the room at this time. Keep a cover – towels or some bedclothes – over the person being bathed.
The temperature of the room should be comfortable: sufficiently warm and not draughty.
Get the following items ready:
• Soap
• Face cloth / wash cloth
• Towels
• Wash basin
• A chair or other firm surface next to the bed where you can place the basin
• Body products – lotion, powder, etc
• A fresh change of clothes or nightwear
Steps for giving a bed bath:
1. Wash your hands, and ensure they are at body temperature before touching the patient.
2. Add warm water to the basin. Test and adjust the temperature until it is comfortable, and check with the person being bathed if they are happy with the temperature too.
3. Undress the person, encouraging them to help, but retain a light layer of bedclothes or towels to maintain privacy and so they don’t feel cold. Keep the body covered, except for the area being washed. You can leave the lower-body clothing on until the top part of the body has been bathed, dried and covered.
4. Encourage the person being bathed to assist as much as possible. In some cases, they’ll be able to wash themselves, or some parts of the body, adequately without your help.
5. Wash the face first with warm soapy water. Take care not to get soap in the eyes. With the person’s eyes closed, gently wipe from the inner corner of each eye outwards toward the ear. Wash behind the ears and gently (but not deeply) inside them; any wax build-up should be professionally removed.
6. Wash the trunk, and the limbs one at a time. Pay particular attention to skin folds and between fingers and toes. Towel-dry each washed part of the body well as you go; pat rather than rub dry.
7. Roll the person onto their side to wash and dry the back surfaces of the body.
8. Wash the genital and anal area last. With the person lying on their back, tuck a towel under the buttocks and bend the knees up. Wash the genital and anal area using gentle downward strokes, front to back.
9. Be thorough, but don’t take too long over the bath – you want to avoid the patient getting fatigued or chilled.
10. Ending off the bath by adding lotion or powder to the skin is pleasant for the patient and also helps with circulation. Brushing or combing the hair and cleaning the teeth can also be part of the daily bathing ritual, and is important for general wellbeing. Hair should be washed and nails trimmed regularly.
