The level of assistance required with personal care, will vary greatly from individual to individual. As a starting point it is advisable to gather as much information as possible from the participant you are assisting, or their parents/carers, as to how much and what type of support they require. This is best done prior to the start of the program.
Patience is a key consideration in helping a participant get dressed and the participant should be encouraged to do as much for his or herself as they can. This may take some time and encouragement. In helping a participant to dress, consider what they may feel or what they cannot feel. Tight clothing or clothing that is not smoothed over their body may result in unnecessary pressure, causing pressure sores and chaffing of skin.
Helping a participant dress may simply involve helping them to maintain balance or it may require that you remove and put on garments for them. Recognise which parts of the body are less able and place clothing on these parts first. For example, when helping a participant put on a jumper, put the arm that has least movement into the jumper first, then the other arm, place the arm in the air and pull the jumper over the head. To take it off, take out the “better” arm first, pull the jumper over the head and pull out the other arm.
Some participants may be more sensitive to temperature changes, so consider any extra clothing that may be needed as temperatures change.
Bathing and showering
Provide as much privacy as possible during bathing and showering. Only be present with the participant when absolutely required. A shower chair is good for participants who are not able to support their own weight and will assist them to wash themselves.
Where participants can independently wash themselves or at least parts of their bodies, encourage them to do so. It is a good idea to stay on the other side of the shower curtain while the participant washes to provide for privacy, but so you are available to assist as needed. Talking to the participant means you can remain aware, by their responses, of their safety.
It is important to ensure that the participant remains warm. Do not arrange for undressing until you are organised, for example, with the shower water on and temperature adjusted. Fresh clothing should be organised beforehand and put-on as quickly after the shower as possible. Be aware of slippery surfaces. Assist and provide protection where you can. Be careful when transferring a person in the bathroom.
Ensure that water temperature is carefully adjusted before the participant enters a bath or shower. Their sensation to hot and cold may be limited and the participant may not be able to communicate discomfort.
A participant may use special aids or equipment to make bathing easier such as a mitt to hold soap, a non-slip bath mator shower chair. Find out about these and make sure that they are available for use. Familiarise yourself with their operation.
Where a participant needs considerable assistance it may be difficult to provide this without getting wet yourself. It may be useful to put on your swimmers and get in the shower with them. Allow the participant to wash areas they can and assist with the more difficult areas to wash. Talk to the participant and find out what they feel comfortable with and how you can best assist them.
When assisting a participant with a bath or shower, ensure that another leader is nearby to avoid potential suggestions of improper conduct.
All areas of personal hygiene may need to be considered, especially when on camp. Oral hygiene can easily be overlooked. Some participants may need assistance, as they may not have the fine motor skills to maintain their teeth and gums. Participants with disabilities due to cerebral palsy may have tactile hypersensitivity that can cause difficulty in having a toothbrush in the mouth. Discuss the regular oral hygiene practices used with the individual and their parents/carers and ensure that these practices are maintained whilst on camp.
Some participants may need little to no assistance in going to the toilet, but may have difficulty in communicating their need to go to the toilet. Establish early in your communications with the participant, their way of letting you know that they need to go to the toilet. Some participants have poor bladder and bowel control and may have a program to be followed ensuring regular toilet attendance. Be aware of the program and make sure that it is followed as closely as possible. This type of information needs to be included on a program registration form.
The amount of assistance that a participant may require to go to the toilet can vary from holding the door open or helping them on or off the toilet. Try not to respond in an embarrassed manner but rather treat the situation in a matter-of-fact way, providing assistance as with any other activity. Either the parents/caregivers will let you know what methods to use or the participant will let you know how best to offer assistance.
A participant may have poor balance while sitting; be sure to support the participant on the toilet if necessary and do not leave them unattended.
Cleanliness and hygiene are very important. Everyone likes to feel and smell good. Make sure that the participant is completely dry and clean. Use sanitary gloves to clean up after bowel or bladder accidents and ensure that you wash your hands thoroughly.
It is also important to be prepared should a female participant have her period, especially during a residential camp. Make sure you get information on this prior to the camp and provide assistance as needed to ensure the participant is comfortable at all times.
In some cases a participant may have their own bedpan, urinal or commode. They are often more convenient to use at night. You will usually be well briefed about these requirements by parents/ caregivers, so do not feel awkward, just find out what to do and assist.
Ensure that all participants go to the toilet before bed. The same applies before going on a bus trip. This will help prevent accidental soiling. If the participant has a history of a lack of control over the bladder and bowels, take clean clothing when going on a trip or hike.
It is important that the participant’s dignity is retained all times. Privacy must be respected and the participant should be provided with as much privacy as possible. It is advisable not to be in situation where you are alone with a participant when you are providing assistance with dressing, showering or toileting. Always have another leader present to avoid potential suggestions of improper conduct. Leaders need to beware of the different interpretations that may be placed on physical contact. What may be considered as a sign of support or show of affection to one may have overtones of physical or sexual intrusion to another.
If it is not possible to have another leader present, think of ways in which you can assist so that other leaders know that you are providing assistance. It may be possible to leave a door open so that others can hear you talking with the participant, and at the same time ensure privacy. It is important that you do not put yourself in a position where a participant may interpret your assistance as inappropriate and as an intrusion of privacy. Limit the amount of time you are alone with a participant and encourage the participant to do as much for themselves as possible, within their abilities, to decrease the amount of physical contact required.