Program Structure
The Towel Bath: A Gentle Bed Bath Method for Nursing Home Residents
Equipment
- 2 bath blankets
- 1 large plastic bag containing: 1 large (6'6" x 3') lightweight towel (fan folded), l standard bath towel, 2 washcloths
- 2 quart plastic pitcher filled with bath temperature water (approximately 105 degrees Fahrenheit), to which you have added: 1 ounce of no-rinse soap (such as Septi-Soft, manufactured by ConvaTec Skin Care Products)
Preparing The Resident
Explain the bath. Make the room quiet or play soft music. Dim the lights if this calms the resident. Assure privacy. Wash hands. If necessary, work one bath blanket under the resident, to protect the linen and provide warmth. Undress the resident, keeping him/her covered with bed linen or the second bath blanket. You may also protect covering linen by folding it at the end of the bed.
Preparing The Bath
Pour the soapy water into the plastic bag, and work the solution into the towels and washcloths until they are uniformly damp but not soggy. If necessary, wring out excess solution through the open end of the bag into the sink. Twist the top of the bag closed to retain heat. Take the plastic bag containing the warm towels and washcloths to the bedside.
Bathing The Resident
Expose the resident's shoulders and upper chest, and immediately cover the area with the warm, moist large towel. Then gently and gradually uncover the resident while simultaneously unfolding the wet towel to recover the resident. Start washing at whatever part of the body is least distressing to the resident. For example, start at the feet and cleanse the body in an upward direction by massaging gently through the towel. Wash the backs of the legs by bending the person's knee and going underneath. As you move upward, roll the towel upward and cover the person with the bath blanket. After bathing the trunk, use the upper end of the towel to bathe the face, neck, and ears. You may also hand one of the washcloths to the resident and encourage them to wash their own face. Then turn the resident to one side and place the smaller warm towel from the plastic bag onto the back, washing in a similar manner, while warming the resident's front with the bath blanket. No rinsing or drying is required. Use a washcloth from the plastic bag to provide perineal care. Gloves should be worn when washing perineal and rectal areas.
After The Bath
If the resident desires and it provides a relaxing break, let him/her remain unclothed and covered with the bath blanket and bed linen, begin dressing when the resident seems ready. A dry cotton bath blanket (warmed if possible) placed next to the skin and tucked close provides comfort and warmth. Place used linen back into plastic bag, tie the bag and place in a hamper.
The Bag Bath
Equipment
- 2 bath blankets
- 10 washcloths
- no-rinse cleanser with emollient
- water according to directions on cleanser
- zip closing plastic bag
- microwave access
Preparing the Resident
Explain the bath. Make the room quiet or play soft music. Dim the lights if this calms the resident. Assure privacy. Wash hands. If necessary, work one bath blanket under the resident, to protect the linen and provide warmth. Undress the resident, keeping him/her covered with bed linen or the second bath blanket. You may also protect covering linen by folding it at the end of the bed.
Preparing the Bath
- Washcloths, enough cleanser and water to moisten washcloths, (water is added first to prevent sudsing), are put into a zip closing plastic bag (Can not use twist tie in microwave.)
- This can be done ahead of time by a volunteer or unit assistant to be used within a couple of hours. (If prepared and not used within a few hours, they should be put into the laundry and a freshly prepared bag used to guard against build up of microorganisms.)
- Open, thinner washcloths that are "scrunched" up absorb liquid and retain heat longer than folded thick ones. They fit in the bag easier and are easier to wring out, also.
- Either prepare with warm water just before use or heat in microwave to correct temperature. Check temperature before using for safety. (About 1 minute 30 seconds is usual depending on the temperature of the microwave. Follow facility procedure). Bring bag to bedside.
Bathing the Resident
Use a different washcloth for each part of the resident's body and massage in a gentle manner. The skin is allowed to air dry. Evaporation takes only about 30-80 seconds. Keep the rest of the resident's body covered while washing each area. Start washing at whatever part of the body is least distressing to the resident. Washcloths are discarded in the laundry hamper as used. Talk to the resident in a calm, soothing manner. Do not rush the bath. Keep the resident warm. Follow resident preferences for environmental considerations and bathing routines.
Advantages
- Washbasins that can harbor germs if not properly cleaned, are not necessary.
- The no-rinse cleansers are non-drying to geriatric skin and most even contain an emollient.
- There is no cross-contamination from using one washcloth for all body parts.
- It uses less equipment and is less messy saving, cleanup time.
- Fragile skin is not rubbed with a towel to dry, preventing damage to skin cells caused by friction.
- It can be given by one person providing more individualized care, gentleness and privacy.
- Residents feel clean after this type of bath.
- The full strength cleanser can be used for a no-rinse shampoo.
- The procedure is easy to learn.
- Reduced time to give a bath allows the caregiver to spend more time with residents in other activities.
- There is no need to use bath towels or for the laundry to fold washcloths.
Forms to Assist in Care Planning
- Sample ID Care Plan (PDF, 54KB, 1pg.)
