How to Give Perineal Care to the Elderly

At some point in your life, you may become the caretaker of an elderly person. This care may involve what is called perineal care: washing genitals, perineum, and anus. During my first semester of nursing school, I did a clinical at a nursing home and was required to give perineal care to several patients. I'll teach you how to provide perineal care to the elderly and give some tips on how to handle this task.

Ensure privacy

If you are taking care of an elderly person in his home or your home, ensure privacy by closing the door to the room where the perineal care will take place. Do not allow other people in the room unless you need assistance.

Gather your supplies

Prepare the supplies needed to give perineal care to the elderly: 2 containers of water, one clean and one soapy, 3-4 washcloths, towel, bath blanket, plastic bag, clean underwear/diaper, and clean sheet. Place the bath blanket under the buttocks of the elderly person to keep bed sheets dry. Depending on how messy the job is, you may need more washcloths and clean water. Do not use hot water (over 110F.)

Wash from front to back and be gentle

When giving perineal care, always wipe from genitals to anal area to avoid fecal contamination. Start with the soapy washcloth and begin cleaning the genital area. Our skin thins as we age, so be gentle when cleaning to avoid skin tears. For uncircumcised men, pull back the foreskin of the penis to wash it. For women, clean from outer to inner-from the labia majora to labia minora, vagina, and clitoris. Move from the genital area to the perineum and then the anus. If there is feces present, remove it, wrap it in the washcloth, place in plastic bag, and continue with a new washcloth. Rinse with a wet washcloth. Never use the same washcloth for both washing and rinsing. Elderly people tend to get colder more quickly than younger people, so cover as much of the person as possible while performing perineal care. After you are done cleaning the perineal area, gently pat dry with a dry washcloth. Placed used towels and washcloths in the laundry. Put clean underwear or diaper on the elderly person and dress them accordingly.

Special consideration for elderly with dementia

Dementia is primarily a disease of the elderly. If you need to give perineal care to someone with dementia, take these extra steps to ensure the procedure goes smoothly:

Be prepared: People with dementia can become agitated quickly. Have all supplies out and ready

Speak calmly and do not yell.

Address the person by name and repeat your name often to reduce feelings of confusion.

If the person becomes distressed, stop immediately and find out what is causing the distress. You may have to finish the perineal care at a later time.

Sources:

Kozier, Barabra Glenora, Erb Berman, Audrey Snyder, Shiree J Kozier and Erb's Fundamentals of Nursing, Chapter 33 Hygiene (2008) Prentice Hall, New Jersey