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Bedridden Patients: Sponge/Bed Bath vs Actual Bath

Hi, if you are a caregiver who is looking after someone who has difficulty bathing himself/herself, you should read this article below. Unless there is enough manpower(such as a nursing home), sponge baths or bed baths are used to bath people who are bedridden or unable to bath on their own due to health reasons. Giving a bed bath involves washing and rinsing the entire body one section at a time while the person remains in bed. It is imperative to gather all the required bathing supplies needed before you begin so you do not have to leave the person unattended. A good bed bath will leave the person feeling comfortable and clean. This is essential for good rest and the prevention of bed sores. Unclean areas always promote bacteria growth and worsen bed sores.
Sponge bath
Step 1: Feel 2 pails with warm water. One is used for washing and the other is for rinsing. Ensure the temperature is comfortably hot. We do not want to scald the person or cause discomfort as some of them cannot even voice out due to certain medical conditions.

Step 2: Choose soap that rinses away easily. Or you can also consider shower foams. Do not use soaps or foams that have exfoliating beads that are difficult to remove if the washing is not thorough. Avoid no-rinse soaps as this will cause residues that are difficult to remove.

Step 3: If shampoo is required, do consider baby shampoos. These persons are like big babies who require our tender loving care and these baby shampoos are apt and gentle enough for them. Try to get an extra shallow basin for washing the hair. If this is not available, we need to get extra towels to prevent the bed from getting too wet.
Step 4: Try to get waterproof disposable drawsheets and place it over the bed to prevent it from getting wet. If this is not available, do put additional towels below.

Step 5: Remove the clothing of the person accordingly and try to be as professional as possible. The person might feel embarrassed.

Step 6: First apply soap or shower foam to the person’s skin. Scrub it gently with a sponge to remove dirt and bacteria. Thereafter, place the sponge in the soapy basin. Dip a second piece of sponge or cloth into the rinsing basin and use it to rinse away the soap. Pat the area dry with another towel. Remember to alternate between the wash and rinse sponges. If they become dirty, switch to clean ones. Change the water in the basins as necessary.

Step 7: Start with the person’s face. Gently wash the person’s face, ears and neck with soapy water. Rinse away the soap with a clean cloth. Dry the cleansed area with a towel.

Step 8: Thereafter, when washing the person’s hair, gently lift their head into the shampooing basin or inflatable basin for hair wash. Wet the hair by pouring water over the person’s head, taking care not to get it in their eyes. Apply shampoo before rinse it away. Pat the hair dry with a towel.

Step 9: When washing the person’s left arm and shoulder, fold over the drawsheet/towels on the left side of the body down to the hip. Place a towel beneath the exposed arm. Wash and rinse the person’s shoulder, underarms, upper arms and hand. Dry the wet areas with a towel accordingly. Dry the washed areas thoroughly, especially the underarms as we need to prevent chafing and bacteria growth.

Step 10: When wash the person’s right arm and shoulder, fold over the sheet to expose the right side. Place the drawsheet/towel beneath the other arm and repeat.

Step 11: When washing the person’s torso, fold the sheet down to the waist and gently wash and rinse the chest, stomach and sides. Be sure to wash carefully among any folds in the person’s skin, as bacteria growth is common there. Towel dry the torso carefully, especially among the folds.

Step 12: When washing the person’s legs, uncover the person’s right leg up to the waist, and wash, rinse and dry the leg and foot. Recover the right leg and uncover the left, then repeat. Towel dry accordingly.

Step 13: Change the water in the pails or basins. Ask the person to roll on their side if they are able to. Assist the person if required. Make sure they are not too close to the edge of the bed.

Step 14: To wash the person’s back and buttocks, fold the sheet over to expose the entire back side of the patient. Wash, rinse and dry the back of the patient’s neck, back, buttocks and parts of the legs you may have missed.

Step 15: When washing the genital area and anus, put on latex gloves if desired. Lift the person’s leg and wash from front to back. Use a clean cloth to rinse the area. Be sure to clean thoroughly between folds, and dry the area thoroughly as well. For males, try to wash behind the testicles. For females, there is no need to clean the vagina, just wash the labia will do.

Step 16: Redress the patient after ensuring the person is towelled dry. When you’re finished, dress the patient in clean clothes or a robe. First replace the patient’s shirt, keeping the sheet over his or her legs. Then remove the drawsheet and wear the person’s underwear and pants. Elderly skin tends to get dry, so you may want to apply moisturising lotion to the arms and legs before putting their clothes back on. Comb the person’s hair and apply cosmetics and other body products according to the patient’s preferences if require.

*You can actually check many youtube videos online on the procedures for a sponge bath. The idea or central principles are the same, just that the steps taken might have some tweaks.
Nursing Home Toilet – Clover Care Centre
There you have it, the steps involved in giving a bed sponge bath. We personally feel that it is better to go for an actual real bath in the toilet. Hence, if the resident is a bedridden, put him/her on a patient trolley or wheelchair and push him/her into the toilet safely. Of course, there must be an additional pair of helping hands for this kind of endeavour. This time round, we use the soap and shower generously. We are of the opinion that this is cleaner and preferred by the residents. Somehow with sponge baths, we don’t think it is really that clean. Do remember to towel dry thoroughly since we are using a higher volume of water this time round. The time taken for both the sponge bed bath and actual real bath in the toilet can more or less be the same if done efficiently. Remember this: Quality matters! No point doing more sponge baths if it is done in a hurried manner.