Assessing an individuals ability to cleanse and dress

Remember that assessment of cleansing and dressing is only part of a holistic nursing assessment and should not be undertaken in isolation without reference to or consideration of the client’s other activities of living.

Specific points to consider when assessing an individual’s ability to cleanse and dress include:
• Physical
Is the client able to cleanse and dress themselves independently?
What is their stage of development?
Do they have any changes in their physical structures, functions or processes impeding their ability to maintain personal hygiene?
Do they have any changes in their physical structures, functions or processes impeding their ability to dress?
Is their skin clean, intact and healthy?
Any bruises, scars, blemishes or alteration in colour?
Is the skin dry or moist?
Any signs of dehydration, for example tenting or loss of elasticity?
Are the nails clean, short and well groomed?
Is the mouth moist and healthy?
Are the teeth intact and well tended? Does the client wear dentures?
What is their normal dental cleansing routine?
Is the hair clean and well groomed? Are there any signs of head lice or dandruff? What is the client’s normal routine?
What is their mode of dress and is this appropriate?
Do they have any specific requirements related to menstruation?
If male, does the client shave and if so what is their preferred method?
Can this be facilitated?
Does the client have any allergies to soap, perfumes or powders?

• Psychological
Are there any gender related issues, for example male client requesting a male nurse for intimate care and vice versa.
Is the client anxious or worried about any issues related to cleansing and dressing, for example does not like to be seen without their dentures in or without their wig or make-up?
Is the client depressed or lacking in motivation to maintain personal hygiene?
Do they lack knowledge or skills related to maintaining cleansing and
dressing, for example infection control?

• Sociocultural
What are the client’s values and beliefs surrounding cleansing and dressing?
Does the client have any specific religious or cultural rituals they need or wish to follow prior to, during or following bathing (for example Muslims are expected to bathe under free-flowing water)?
Does the client have any specific religious or cultural needs surrounding dress (for example Sikhs do not generally remove their turbans in the presence of others)?
Are there any specific issues surrounding modesty and dignity?
What are the client’s normal routines?

• Environmental
Does the client prefer a wash, bath or shower?
Do they have adequate facilities at home for cleansing self and clothing,
for example hot water, washing machine, laundrette near by?
Is the environment conducive to personal cleansing and dressing, for
example too hot/cold, public/private?

• Politico-economic
Are there any financial issues, for example lack of money for clothing,
heating, facilities?
Do they use expensive toiletries, perfumes, lotions or potions?
Can they afford cleansing materials?