When a person grows old, they might lose the ability to completely take care of themselves. Physical restrictions, forgetting to wash up, illness, lack of energy, lack of interest. All of these might lead to poor hygiene in elderly patients. It gets worse when they refuse assistance from family members or caretakers. This is, however, understandable, since personal hygiene is very… personal, therefore it is very important to be very patient and attentive.

When taking care of an elderly and bedridden patient, an effective hygiene ritual is super important. Poor hygiene can lead to skin problems and infections. It also makes elderly person lose their dignity and start feeling dirty and neglected. Personal hygiene is essential for both the physical and mental health of your elderly loved ones, that is why we will present you the answer to the perfect daily hygiene ritual for the elderly & bedridden right now.

A perfect hygiene ritual for dependent elderly and bedridden patients consists of 7 key parts:

1. The sponge bath;
2. Hair washing;
3. Facial hair removal;
4. Oral and dental hygiene;
5. Eye care;
6. Nail care;
7. Changing their clothes (and/or diapers).

Although every caretaker has their own routine for taking care of elderly or bedridden patients, these 7 steps are almost always involved. By following this hygiene strategy for a bedridden person, you make sure that they always feel clean and fresh. This can help prevent skin diseases and keep your elderly loved one in a healthy mental and physical state.

A precise hygiene routine for the elderly is essential. It helps prevent adverse skin conditions and keeps the old person in a healthy mental state. You can adjust your routine to their specific needs since many elderly patients can still maintain some degree of self-dependence.

Image 1: Happy elderly woman in wheelchair with a caregiver

Importance of Personal Hygiene in Elderly Patients

You might be wondering why we’re focusing so much on personal hygiene. Well, hygiene is a part of every person’s self-care routine. It comes naturally to most of us. We don’t have to think about it too much. The lack of it, however, can be very annoying. Not only that, but poor hygiene can even be unhealthy and dangerous, especially with Covid going around.
That being said, hygiene is as much (if not more) important for elderly patients. Here are some of the benefits of a healthy hygiene routine:

• Preserves mental health: Poor hygiene is very annoying. An elderly person who’s unable to keep up with their hygienic needs feels this. But they also feel frustrated from not being able to do anything about it. They fall into a cycle of self-neglect, low self-worth, loss of dignity, shame, and poor hygiene. This can lead to depression in the elderly. It’s one of the main reasons why you should make sure that your aging loved one always feels clean and fresh.
• Prevents diseases: It goes without saying, that maintaining good hygiene keeps you safe from harmful germs and transmissible illnesses.
• Prevents painful conditions: In elderly patients, the skin tends to be more fragile and gets easily dehydrated. Poor hygiene in elderly patients can lead to skin cracking, infections, skin irritation, and pain. An effective hygiene ritual is important to keep your elderly loved one pain-free.
• Allows them to socialize better: Bad smell and visible poor hygiene can sometimes be repelling to people visiting an elderly relative. By helping your loved ones take better care of their body, you’ll make it easier for them to be around other people.

Infographic 1: The importance of proper daily hygiene in the elderly

The 7 Parts of a Perfect Hygiene Ritual for The Elderly

An efficient hygiene ritual can be broken down into 7 parts to tend to different hygienic needs. How many of these cleaning steps you’ll need depends on how dependent your loved one is. A person that is demented and bedridden will need an all-inclusive care plan. An elderly parent that can walk, however, might just need help with a few minor things.

1: The Bed Bath

A bed bath is the central part of any hygiene plan for elderly and bedridden patients. Elderly people and those who might have physical restrictions are many times afraid of taking baths on their own or just can’t do it. It’s essential to help them wash up on a daily basis so that their body stays fresh and healthy.

A bed bath, also known as a sponge bath, is the best alternative for those who can’t shower or bathe on their own. So, as a caregiver, how can you throw an effective bed bath? Here are some tips:

• Stick to the patient’s routine. They like to shower daily at 12? Then we’ll do that, but with a bed bath.
• Keep everything you might need at arm’s length.
• Bring all of your inventory to a rollable table.
• Keep 3-4 towel clothes next to you
• Use a specialized cloth for sensitive skin
• Use two basins – one for soapy water and one for rinsing
• Always clean your hands before and after you start and sanitize them with an antibacterial disinfectant.
• Put a waterproof cloth under the patient
• Use specialized soap
• Use no-tears or no-rinse shampoos .
• Complement the bath with a body lotion
• Use moisturizers. These can replenish the skin and keep it hydrated, counteracting the effect of prolonged bed stay. Soap and water alone can lead to skin dryness and cracking.
• Use emollient oils to encourage cellular regeneration and prevent skin cracking
• Use a specialized deodorant for long-lasting freshness.

A bed bath will make your elderly feel fresh and clean. It will prevent conditions related to poor self-care, such as skin conditions, irritation, and infections. It will also help your loved one feel better about themselves and their body.

Infographic 2: Six Steps to a Perfect Bed Bath in Seniors

Steps of a Sponge Bath

If you’re not sure how to go about performing a bed bath, follow these steps, and develop them into your own sponge bath technique as you go:

• First, make sure that the water you are using is lukewarm. Not too hot or too cold.
• Start by washing the forehead, cheeks, nose, and neck with a moist towel. Do so using gentle patting rather than scraping movements. Make sure you get between any skin folds, as dirt can collect there.
• You can use a specialized derma protective cream, such as to keep the skin hydrated and well-nourished.
• Ear Hygiene: With a flat cloth soaked in detergent solution, first, clean the auricle with movements from top to bottom. With a rolled corner of the cloth soaked in the cleaning solution, clean the external entrance to the ear canal without going deep and with circular movements.
• Now, the arms. Start by placing a towel under the arms to prevent getting the bed wet.
• Support the patient’s arm with your palm under their elbow.
• Clean the arms from the shoulder to the elbow with firm, long strokes using a moist towel. Don’t forget to clean the armpit area, as this can specifically get very odorous.
• Dip the patient’s hand into a basin of water and wash it with water and sope.
• Once the arms and hands are clean and dry, you can use a cotton stick to clean under the fingernails.
• Next, is the chest area. Use a moist towel to clean with multiple strokes. Make sure to clean the area under the breasts in women, since germs and dead skin can collect there and cause irritation.
• Consider using a scented lotion to nourish the skin and keep it fresh for longer.
• Make sure you pat these creases completely dry.
• Next, is the belly. You should clean it the same way as with the chest area.
• Clean the navel with a little lotion applied to a cotton swab.
• To clean the legs, bend their knee upward, hold it with one hand, and use the other hand to clean with a moist cloth.
• Dip the feet in a basin of water to wash them, make sure you wash between the toes thoroughly.
• Dry the area between the toes very well to prevent fungal infection.
• Use a cotton stick to clean under the toenails.
• Consider using an anti-odor cream, having a strong emollient effect.
• Finally, the genital area. Make sure you clean thoroughly using a moist towel, especially the skin creases.
• For uncircumcised men, draw back the foreskin, rinse and dry. Don’t forget to bring the foreskin back forward.
• For females, spread their external labia apart and wash thoroughly.
• Pat everything completely dry to prevent fungal infections. Applying a moisturizing cream that prevents irritations is recommended.
• Once done, apply deodorant under the arms for long-lasting freshness.
• Make sure you clean your hands with a delicate hand cleanser.

2: Oral and Dental Care

Good oral and dental hygiene keep prevents microbes from building up, causing:

• Fungal infections
• Mouth odor
• Gum disease
• Tooth decay
• Dry mouth
• Persistent bad taste

Cleaning the mouth of disabled patients is especially necessary if they’re taking medications with an annoying aftertaste. There are many mouth care products to consider, such as:

• Antiseptic mouthwash– to kill off germs
• Periodontal Serum – for oral health and nourishment
• Vitamin “E” Complex Oral Spray – Effectively counteracts oxidative stress
• Total Protection Toothpaste – Dental and gum protection and repair
• Anti-plaque Toothbrush – Cleans and avoids irritation

As a caregiver, you should help your elderly patient clean their mouth after each meal, or at least twice daily. Brushing the teeth, flossing, and rinsing ensure that no food particles are left behind to cause trouble.

Some elderly people may be able to handle these tasks on their own if you bring them a toothbrush, toothpaste, floss, water, and spit bucket.

Image 2: Elderly woman helped by a caregiver in oral and dental hygiene

3: Facial Hair Removal

Excessive facial hair growth can be annoying. It is a sign of poor hygiene and neglect. It can cause itchiness, skin irritation, and harbor microbes and food debris.

So, from time to time, you should help older male patients to trim or remove facial hair. A razor is the best way to remove facial hair in bedridden and dependent patients. However, you need to choose a suitable shaving cream and aftershave to prevent skin irritation and infections. Here are some products specifically designed for people with delicate skin, especially elderly patients, that you should consider using:

• Aftershave Spray – Alcoholic Lotion
• After Shave Lotion – Alcohol-Free
• Disposable Biogesan Razors

Make sure you do this just before giving them a sponge bath so that the annoying cut hair doesn’t stay there too long. You should also use an apron wrapped around the neck to keep the body clean.

One of the most important things to consider when shaving for a bedridden elderly patient is the use of aftershave and skin moisturizers. This is an essential step to keep the skin hydrated and avoid “barber’s rash”.

4: Hair Washing

The second critical part of a good hygiene routine for senior citizens is washing their hair. This should be done daily or every other day to prevent the hair from clumping and becoming greasy. If your elderly loved one has mobility problems, then you might need to wash their hair in bed or in their wheelchair.

Here are some steps and tips for washing the hair of a disabled, elderly, or bedridden person in bed:

• First, help the patient into a higher position in their bed, just until their head is hanging slightly off the edge.
• Second, put a large plastic bag or waterproof cloth under the head, and a basin to collect the water as it falls down.
• Alternatively, you can use an inflatable plastic basin in which the bedridden person can lay their head.
• Start by rinsing with lukewarm water. Make sure no water gets into the ears.
• Apply the shampoo and massage the head gently for a minute. Make sure you use a specialized and delicate shampoo. Make sure you don’t use too much!
• Rinse the shampoo off with water again, and pat the hair dry.

A similar technique can be done to wash the hair of a person in a wheelchair. Really useful could be the use of a wash basin.

Infographic 3: How to wash an elderly person’s hair in bed

5: Eyes Cleansing

Every now and then, debris might build up in the eyes of a bedridden patient. You should clean these with a moist cotton swab or a moist bath towel (use only water and no soap, of course). Just gently wipe from the inner to the outer corner of each eye.

If there’s sticky eye crust, consider soaking the eyelid for 2-3 minutes with a moist towel before attempting to gently remove it. Once done, pat the eyes dry.

You can also use Bioderm Dermolatte without rinsing. Apply a small amount of product on a disk and proceed with the hygiene, without rinsing.

6: Nail Care

Clean and cut nails are a sign of good hygiene. They also prevent elderly patients from excessively traumatizing the skin if they try to scratch an itch.

Regular nail care can also remove bacteria from underneath the fingernails to prevent infections. You should clean under the nails daily using a cotton stick. Cut the nails when needed to keep them short and tidy.

If your loved one has diabetes, you need to be extra careful not to cut the nails too short and not to cut any skin. This can cause wound infection in diabetics. Yes, people with diabetes, whether type 1 or type 2, are more likely to get a bacterial infection in their wound.

If you notice any swelling, thick or brittle nails, changes in nail texture, changes in nail color, exquisite tenderness, or foot ulcers, then consider consulting a medical specialist.
To keep the skin of the toes and fingers healthy, consider using a moisturizer with an isodermic formula, that contributes to the reconstruction of the depleted hydrolipidic mantle while the lemon extract helps to lighten skin blemishes.

7: Changing Clothes and/or Diapers

Depending on their degree of independence, your elderly loved one might need help changing their clothes, underwear, and sometimes diapers. Involve the elderly in the choice of clothes to maintain a certain degree of autonomy.

To keep them comfortable, we suggest choosing baggy and elastic clothing. This makes it easier to change in bed or when in a wheelchair. Try to stay away from anything that closes with buttons or velcro, as these can be annoying in bed, and would make changing the patient’s clothes a struggle.

Try to encourage the bedridden person to change their clothes themselves, and only lend a hand when they seem like they need help. This helps them feel more capable and independent.

If your elderly loved one wears diapers, then you should change them as needed, sometimes several times daily, to keep the area clean. You should never delay changing diapers. It can be degrading, very annoying, and will lead to eventual skin infections. You can follow these steps to change diapers in a bedridden patient:

• Start by washing your hands and wearing protective gloves
• Put a waterproof pad on the sides of your loved one and tuck it as far as possible under the diaper
• Unfasten the sides of the dirty diaper, tuck them under the patient, and pull the diaper to the level of the hips
• Turn your loved one on their side opposite to where you are standing
• Take off the dirty diaper
• Use special wipes to clean the area. Make sure not to rub too hard so as to not injure the skin.
• Apply skin barrier cream to the groin, genital and sacral area to keep skin hydrated and prevent irritation and injury.
• Once the skin is dry, open the new diaper, and insert it under your loved one while they’re still on their side
• Roll the patient straight on their back, and then towards you while readjusting the clean diaper under them
• Fasten the new diaper and throw away the old one in a closed plastic bag along with the gloves
• Wash your hands thoroughly with soap and water

Infographic 4: Steps on how to change a diaper in a bedridden senior

A successful daily hygiene routine is critical when caring for an elderly, bedridden, or disabled loved one. Not only does a cleaning ritual keep diseases away, it also boosts your patient’s mood and keeps them in a great mental state.