Helping clients get ready and dressed is part of a nursing assistant’s job. Do the CNAs in your workplace know how important this daily task is to your clients? Do they use dressing and grooming activities as an opportunity to observe their customers? By sharing the following information and tips at your next CNA training meeting, you can give your attendees a different perspective on self-care.

Look Good… and Feel Better!

At first glance, getting ready for the day is so clear and easy that we often don’t think twice about it. We just get dressed, brush our teeth, comb our hair, and do all the other chores we need to do to stay presentable. Now imagine if:

• Your arm was stiff and you couldn’t put your shirt on.
• You couldn’t reach back to close a zipper or hook your bra.
• Her legs ached and she couldn’t bend down to put on her socks or shoes.
• Your fingers were bent from arthritis and you couldn’t tie your shoelaces.
• You couldn’t remember how to put your clothes on, or in what order.
• Your arms were shaking so much that you couldn’t brush your teeth, comb your hair or shave.

For people who are physically or mentally challenged, dressing and grooming tasks are often difficult to accomplish alone. Sometimes they may take out their frustration on the people around them.

That’s where you come in. With your help and encouragement, your clients won’t be put off by their appearance or embarrassed that they can’t dress themselves in private.

A dozen benefits of good preparation

1. Letting your customers choose their own clothes gives them a sense of being independent and in charge.
2. Encouraging customers to do their best while getting dressed builds team spirit and gives them a sense of belonging.
3. Allowing your clients to do as much as they can for themselves helps increase their self-sufficiency.
4. Expressing your approval when dressing and grooming gives customers a sense of being valued.
5. Looking good boosts each client’s self-esteem and can even help a bad mood go away!
6. Dressing your clients helps protect skin from injury and maintain proper body temperature.
7. Making sure your clients’ clothes fit well keeps all of their body systems unrestricted.
8. Brushing your clients’ hair promotes a healthy scalp and strong hair.
9. Daily mouth care prevents the onset of painful mouth conditions and protects the mouth from oral diseases.
10. Keeping your clients’ nails trimmed with no ragged edges prevents nicks and cuts that can cause infection.
11. Reporting toenail changes helps your clients receive care from a podiatrist as needed. This can prevent complications for people with diabetes, heart conditions, or poor circulation.
12. Moving your clients’ joints and muscles during the grooming process helps maintain body movement and prevents contractures.

keys that matter

Dressing and grooming tasks give you daily opportunities to look for clues that trouble may be brewing. For example:

• Be aware of customers’ facial expressions. Clients may tell you that they are not in pain, but their faces may reveal the true story.
• Clients put on and take off their clothes several times a day. As you help them, look at their entire body and note any areas of redness, rashes, bedsores, or other skin changes.
• Report any unusual body odor. A strange smell can be a symptom of an illness.
• Some health conditions cause the body to swell. Watch for signs of swollen hands (like tight rings) and swollen feet (like shoes and socks that are suddenly too small).
• As you brush or comb your client’s hair, check for lice. (Head lice can happen to anyone, no matter how young or old, dirty or clean, rich or poor.) Look for white eggs known as “nits.” They look like little bits of dandruff, but they don’t wash off or come off. Instead, they stick firmly to the hair strands.
• If you take care of nail care, look for white or yellow areas on your fingernails and toenails. Your client may have a nail fungus.

Dress up and grooming challenges

For confused customers, grooming and dressing involves many steps and the use of many different skills. It can be a very confusing time. Clients with dementia may be more cooperative if you give them something to do. Let them help you by putting toothpaste on a toothbrush, holding a sock while you put on a shoe, or folding washcloths while you brush your hair.

Consider using a “mirror technique” when helping confused customers. For example, hold a toothbrush and pretend to brush your teeth to help a client understand how to do the task on their own.

When clients have shaky limbs, sit down and talk with them for a few minutes before beginning care, as certain types of tremors improve when clients feel relaxed. Encourage them to support one arm with the other when doing tasks like shaving or brushing their teeth.

To help customers with vision problems feel in charge, educate them on clothing styles and/or colors and guide their hands to where toiletries are stored. Talk when you’re coming and going to keep them aware of their surroundings and to let them know if they’re alone or with others.
Keep in mind that many people with arthritis suffer from “morning stiffness.” Your joints may be especially swollen and painful during morning grooming and dressing chores. Encourage your arthritic clients to dress their legs and feet first, as this requires the most energy. Ask them to sit down for most of the dressing and grooming process to save energy and prevent them from having to bend over as much.

If a client asks for a pain pill before getting dressed, let the nurse or family member know that the client is in pain and needs attention.

Remember that some of your clients may be silent about their pain because of fear, beliefs, or cultural heritage. Be sure to look for nonverbal signs of pain like:

• Clench or grind your teeth.
• Rubbing or holding a part of the body.
• Crying.
• Losing interest in your appearance.
• Changes in blood pressure (usually higher).
• Perspiration.

As you assist your clients with personal care, remember that it is your duty to notify your supervisor when you know, or suspect, that a client is in pain. Every client has the right to pain relief!

Security issues

Keep in mind that some of your clients may find it safer and easier to get dressed while lying down, especially when it comes to pulling up their pants. If a customer is weak on one side, encourage him to wear the weaker side first.

Report frayed cords on grooming devices like hair dryers or electric razors to keep you and your customers safe.
Consider using a “buddy system” when serving customers who have a history of being combative. This is not so you can “huddle up” with the customer, but so you can stay safe while doing customer service.

Remember that some people feel dizzy when their body temperature drops. Help your clients maintain an even body temperature by dressing them appropriately for the weather and keeping them out of drafts.

Be sure to adjust your clients’ clothing when seated in wheelchairs to prevent the wheels from pulling on clothing.

The bottom line

Remember that everyone has the right to participate in their own care. Therefore, encourage your clients to be involved in their personal care. Even if they aren’t strong enough to dress themselves, they can probably wash their faces or comb their hair.

It takes patience and understanding to step back and let your clients “do it for themselves.” However, allowing your clients to be as independent as possible when it comes to dressing and grooming can positively affect their health and improve their overall quality of life.