M5 · Needs help to wash
Actual Movement and self-care
Definition
The person cannot bathe or wash alone.- Weakness
- pain
- paralysis
- low energy
- confusion
- Needs help to reach, wash, and dry
- skin not cleaned
📋 Scenario
A stroke patient cannot wash his back or legs.
Subjective (S): "I can't reach my back."
Objective (O): Needs help washing back and legs after stroke; right arm weak; skin clean otherwise.
Assessment tools for this scenario: CP-MOVE Movement & Self-Care Score CP-SKIN Skin & Wound Score
Validated scales to consider: Barthel Index, Katz ADL, Braden Scale, TIME wound chart
**CarePath diagnosis:** Needs help to wash related to weakness, as evidenced by needs help to reach, wash, and dry and skin not cleaned.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Assist as needed. | Helping with the parts he cannot do keeps him clean and comfortable and protects his skin while he recovers from the stroke. |
| Let him do what he can. | Doing what he can for himself keeps his abilities, builds confidence and supports recovery after stroke. |
| Ensure privacy. | Privacy protects his dignity and lowers embarrassment, which helps him accept help with washing after the stroke. |
| Check skin. | Washing is a chance to look at skin for redness, sores or other changes, especially on areas he cannot reach. |
| Protect dignity. | Treating him with respect keeps his self-esteem and encourages him to take part in his own care. |
**Expected outcomes**
- Washes face and front independently with set-up.
- Completes bathing with minimal help within 1 week.
**Linking the data to the diagnosis**
A stroke patient says, "I can't reach my back." He needs help washing his back and legs, and his right arm is weak, although his skin is otherwise clean. He is already unable to wash alone, so an actual statement fits. The plan aims to give help where needed while he does what he can. The expected outcomes are washing his face and front independently with set-up, then completing bathing with minimal help within 1 week, while his privacy and dignity are protected.
CarePath diagnosis
Needs help to wash related to weakness, as evidenced by needs help to reach, wash, and dry and skin not cleaned.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Assist as needed. | Helping with the parts he cannot do keeps him clean and comfortable and protects his skin while he recovers from the stroke. |
| 2. Let him do what he can. | Doing what he can for himself keeps his abilities, builds confidence and supports recovery after stroke. |
| 3. Ensure privacy. | Privacy protects his dignity and lowers embarrassment, which helps him accept help with washing after the stroke. |
| 4. Check skin. | Washing is a chance to look at skin for redness, sores or other changes, especially on areas he cannot reach. |
| 5. Protect dignity. | Treating him with respect keeps his self-esteem and encourages him to take part in his own care. |
Expected outcomes
- Washes face and front independently with set-up.
- Completes bathing with minimal help within 1 week.
Linking the data to the diagnosis
A stroke patient says, "I can't reach my back." He needs help washing his back and legs, and his right arm is weak, although his skin is otherwise clean. He is already unable to wash alone, so an actual statement fits. The plan aims to give help where needed while he does what he can. The expected outcomes are washing his face and front independently with set-up, then completing bathing with minimal help within 1 week, while his privacy and dignity are protected.