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Personal Care – Bathing, Dressing, Toileting

The limitations of aging or illness often make it hard to do basic self-care tasks
without assistance. Bathing or showering, grooming, dressing, eating, getting in and
out of bed or a chair, walking, and using the toilet all require strength, balance,
and stamina. Your loved one may be having problems with these activities, and may or
may not tell you. Looking for signs can be tricky. Remember to look for changes from
their usual appearance or activities. Simple remedies can often be of great help to
do these tasks.

To find out if your loved one may need additional help, answer the following
questions as best as you can.

Does your loved one need assistance with:

1. Bathing, dressing, and personal hygiene?

2. Using the toilet?

3. Walking steadily and keeping their balance?

4. Getting in and out of a chair or bed?

5. Using the telephone?

6. Do they have trouble swallowing or using eating utensils?

Have you noticed these changes in your loved one’s patterns?

7. Are they dressing differently? (Example: Puts clothes on incorrectly, or clothes are uncharacteristically dirty or rumpled.)

8. Are they caring for their appearance differently? (Example: Not brushing hair as often; stopped shaving; makeup is unruly.)

9. Do they seem to be neglecting oral hygiene? (Example: Breath is unusually bad; does not brush teeth or dentures regularly.)

10. Do they have a recent unpleasant body odor? (Example: Appears to be skipping regular baths or showers; or may be having trouble controlling bladder or
bowels.)

11. Have they unexpectedly gained or lost weight?

12. Have eating habits changed? (Example: Eating less than two nutritious meals a day.)

13. Have the contents of the refrigerator changed? (Example: The shelves are now bare, or there is moldy or expired food.)

14. Has the appearance of their skin changed? (Example: Has unexplained bruises or cuts, perhaps from a fall.)

15. Are there recent changes in the condition of the home? (Example: Stains on the carpet from dropped food or bathroom accidents, or holes or dents in the wall from someone falling.)


Your Results: 0 (Total number of “Yes”answers)

Low Risk (Score: 0)

Your loved one is probably safe and able to live independently if they:

  • Can perform basic self-care activities alone or with minimal assistance or
    supervision
  • Can walk steadily, alone or with a cane
  • Can still control bladder and bowels
  • Can use the toilet safely
  • Are not losing weight unexpectedly
  • Do not show signs of falling or losing balance
  • Can telephone for assistance if help is needed

Seek the advice of a social worker or geriatric care manager if you think your
loved one is starting to have trouble with self-care. Get help immediately if there
are any problems. These activities are key to good health and safety.

Medium Risk (Score: 1–2)

Your loved one may be OK living independently, but may very likely need some
form of daily assistance.

Things to look out for include:

  • Occasional falls or injuries
  • Poor hygiene
  • Increased difficulty performing basic self-care activities in a safe and
    timely manner
  • Difficulty getting in and out of bed or a chair, or off the toilet
  • Losing control of bladder or bowels

With your loved one’s level of care needs, it’s probably borderline
as to whether they are safe without help from others. We highly recommend that you
seek the advice of a social worker or geriatric care manager. Your loved one
probably needs daily assistance, if not now, then very likely sometime in the near
future. You may be able to provide this at home, or it may be necessary for your
loved one to move to a situation where 24-hour access to help is available.

If your loved one does not already have an emergency pager, consider purchasing
such a service. Typically, this is an alert button that is worn around the neck or
wrist. When pressed, it sends out an alert for emergency help. At least, this
provides some assurance that they’ll be able to call for help in case of
emergency or injury.

High Risk (Score: 3–15)

It appears your loved one needs significant assistance or supervision. If living
alone, they should probably move to a more structured or supportive setting. Family
members may be able to provide enough help. However, your loved one likely needs to
have someone available 24 hours a day, and preferably a person strong enough to
lift them in case there’s a fall. This may be difficult to arrange among
relatives. A home visit by a social worker or geriatric care manager can help you
get a better idea of your loved one’s specific needs. On the other hand, you
may prefer to ask the doctor for a nurse to assess the home. These professionals
can help you decide if you need the help of outside services.

Assisted living communities and adult foster homes are good options if your
loved one needs more care than you can provide as a family. If your loved one also
has dementia, Alzheimer’s disease or significant memory loss, a residential
care center may be more appropriate. Nursing care centers are for those who
actually need a skilled nurse 24 hours a day. If your loved one does not need that
level of care, you might investigate the home health services of a visiting nurse a
few times a week, or of hospice services if your loved one has a terminal illness.
Ask your doctor what’s appropriate for your loved one’s situation.

Remember to talk with your loved one to find out whether they’re aware
that more help is needed. They may likely feel embarrassed for needing help with
daily tasks, depressed about losing independence, or may not want to burden you.
It’s important to include your loved one in the decision-making process for
getting more help.

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