COMPETENCY-BASED TEST

ELDERLY CARE SKILLS

A. Identification of Tools & Materials F. Bathing

B. Unoccupied Bed G. Dressing Up
C. Handwashing H. Occupied Bed
D. Vital Signs I. Aftercare
E. Undressing

A. IDENTIFICATION OF TOOLS AND MATERIALS

 1 thermos with boiled water
 1 alcohol as disinfectant
 1 thermometer tray with 4 medicine glasses
 1 empty glass for the used cotton ball
 1 glass with dry cotton balls
 1 glass with cotton balls soaked in alcohol
 1 glass with lukewarm water
 1 pitcher with lukewarm water
 1 powder/lotion
 1 watch with second hand
 germicidal soap with a nail brush
 1 for patient and 1 for the caregiver
 towelettes for sponging the face, body and genitals
 3 towels for pat drying the face, body and genitals
 4 bed linens – 2 top sheets and 2 bottom sheets
 2 small basins – 1 for soiled towelettes and 1 for sponging
 2 pails – 1 with lukewarm water and 1 for used water
 2 rubber sheets to avoid spillage; 1 for covering the bedpan and
1 for protection of basin while sponging
 1 laundry basket for used linen, gown and pillowcase
 2 pillows, 4 pillowcases, 2 patient gowns
 1 gown
 1 bedpan for cleaning the genitals
 2 chairs for support/bedrails
 1 bed
 1 mattress, 1 mattress cover (if there is)
 1 hand towel for the caregiver
 rubber draw sheet (if available) or disposable bed protector
 cloth/cotton draw sheet
 1 pair of gloves
B. UNOCCUPIED BED
1. Stand on the right side and face the bed in order to avoid reaching and twisting
the body.
2. Holding it as its centerfold, place the bottom sheet at the foot part of the bed
keeping the wider hem in line with the edge of the mattress. Unfold and remove
towards the head part keeping the centerfold along the center of the bed
3. Tuck the excess length of the bottom sheet under the head part of the mattress
and make a half-mitered corner.
4. Place one foot forward flex the knees and while rocking backward, tuck the sheet
along the side of the bed.
5. If needed, place the rubber sheet followed by the draw sheet. Tuck them
together under the mattress.
6. Unfold the top sheet, wrong side up at the head part of the mattress with the
centerfold at the center of the bed. Tuck it at the foot part to finish the bed.
7. Go to the other side to finish the bed.
8. Take the half-mitered corner of the bottom sheet at the head part.
9. Pull the bottom sheet tightly grasping the sheet with the palms down so that the
action is produced by the arm and the shoulders. Tuck it along the side of the
bed with the palms upward and the knees flexed as mentioned.
10. Do the same with the rubber and the draw sheet.
11. Get the pillow and fluff its contents.
12. Get the pillowcase this way:
a. If both ends of the pillowcase are open insert one arm through the
pillowcase. Pull in the pillow by gripping it at one end, while the other hand
adjusting the pillowcase.
b. If only one end is open insert the pillowcase and hold one corner from the
inside. With the same hand, grasp one corner of the pillow while the other
hand adjusts the pillowcase on the pillow.
 Open-end must be away from the door to prevent dust.
13. Place the covered pillows on the head part of the bed under the top sheet.

C. HANDWASHING PROCEDURE
BEFORE HANDWASHING
1. Regulate the room temperature to avoid sudden chilling. This is done by closing
the doors and windows, switching off the aircon, electric fans and other cooling
appliances.
2. Remove all the hand jewelry of the caregiver and the patient.
3. Cut long fingernails short to avoid injuries and scratches.
4. Loosen the bedsheet.
HANDWASHING PROCEDURE
1. Gather the needed materials for handwashing; get the hand towel and
germicidal soap with a nailbrush.
2. Open the faucet and regulate the water temperature. (Use a paper towel when
opening the faucet)
3. Wet hands and apply soap.
 4. Form a lather by rubbing hands together. Pay particular attention in between
fingers wherein most bacteria stay.
5. Use circular motion up to 2-3 inches above the wrist.
6. Brush your nails. Rinse your hands thoroughly.
7. Turn off the faucet by using a paper towel.
8. Let the water drip off your hands by raising it up with palms facing the chest.
9. Get the towel. Pat and dry your hands.
10. Put used hand towel to the laundry basket.

D. VITAL SIGNS
This is a very important procedure. It serves as a baseline data to your elderly’s
health status. Once you forget this procedure automatically you will fail and will be
scheduled for a repeat assessment.

VITAL SIGNS PROCEDURE

1. Remove the thermometer from the case
2. Temperature reading should be below 35 degrees celsius
3. Dip the thermometer into the glass of tap water, hold it upright, then wipe it
with a dry cotton ball from bulb to stem
4. Wipe again with a cotton ball soaked in alcohol.
5. Insert under the tongue or armpit for 3-5 minutes.
6. Read the temperature and shake it down.
7. Repeat procedures 3 and 4, and then return to the case.
8. Get the blood pressure, pulse rate and respiratory rate.

E. UNDRESSING
This is the time that you should remove the clothes of your patient.
NOTE: Do not expose any vital part of the patient. Always provide a pillow and a
chair for support.

UNDRESSING PROCEDURE
1. Put the patient in a side-lying position by placing a pillow on his front and a chair
near the bed for support.
2. Untie the lace knots of the gown at the back.
3. Remove the gown from under the top sheet, without exposing any part of the
body of the elderly.

F. SPONGE BATHING
a. FACE
1. Gather the needed materials.
2. Place the bath towel underneath the head
3. Place the rubber sheet, small basin with lukewarm water and germicidal soap on
the chair near the face of the client.
4. Wet the towelette, squeeze, form a mitten and wipe each eye from inner to outer
side rinsing the towelette before switching sides.
5. Rinse the towelette, apply soap, squeeze using the 8 motion, sponge one side of
the face from the forehead, to the nose bridge, to the cheek, to the chin, to the
ear and pay particular attention at the back of the ear.
6. Rinse the face 2-3 times then pat and dry with the towel. (Do the same to the
other side)
7. Discard the towel to the laundry basket.
8. Discard the used towelette to the empty basket
9. Change the water.

b. ARM
1. Expose the arm, put a bath towel underneath the arm.
2. Wet the towelette, apply soap, squeeze and form a mitten and sponge from wrist
to the shoulder on long front strokes.
3. Rinse 2-3 times then pat and dry. Rinse the towelette, apply soap, squeeze,
sponge starting from the wrist up to the armpit. Dry the client’s axilla, apply
deodorant or powder if desired.
4. Bring along a rubber sheet, small basin and germicidal soap with a nailbrush to
the hand of the elderly.
5. Wet the hands, apply soap, form a lather, pay attention in between fingers and
then brush the nails.
6. Rinse the hand thoroughly, then pat and dry.
7. Change the water in the basin. (Do the same procedure to the other side)

c. CHEST
1. Place the bath towel across the client’s chest.
2. Fold the bath blanket down to the client’s abdomen
3. Rinse towelette, squeeze, apply soap and start sponging under the towel from
the neck to the chest, to the breast, pay particular attention to the breast line
down to the umbilicus in circular motion.
4. Rinse 2-3 times. Pat and dry with a towel.
5. Change water in the basin.

d. LEG (Distal to Proximal)

1. Expose the thigh and place bath towel underneath.
2. Wet the towelette, apply soap, squeeze then wipe from the ankle to the hip.
Rinse 2-3 times.
3. Rinse the towelette, apply soap, squeeze then sponge from the ankle ending at
the groin in a long firm stroke. Rinse 2-3 times.
4. Bring along the rubber sheet, small basin and germicidal soap with a nail brush to
the foot of the client.
5. Wet the foot, apply soap, form a lather, pay attention in between toes. Brush the
toenails.
6. Rinse thoroughly then pat and dry.
7. Change the water in the basin. (Do the same procedure on to the other side)
 e. BACK
1. Help the client to a side-lying or prone position.
2. Provide a chair and pillow for support.
3. Place bath towel under the area to be bathed.
4. Wet towelette. Apply soap, squeeze. Wipe from the nape down to the buttocks
in a circular motion. Rinse 2-3 times.
5. Give the client a back rub with lotion now or after the completion of the bath.
(Do this 1-1 ½ min)
6. Turn the patient in a supine position.
7. Change the water in a basin.

f. GENITALS
1. Arrange the linen in a diamond position.
2. Bend the knees, set them apart and cover.
3. Insert the bath towel, rubber sheet and the bedpan underneath the buttocks
from the sides while the other hand supports the hip.
4. Put on gloves.
5. Get wet cotton then wipe from above the urinary meatus down to the groin.
Wipe the labia majora in a downward direction. Wipe the labia minora in a
downward direction. Wipe the urinary meatus to the vaginal orifice down to the
rectum. (1 cotton on each side, discard all the used cotton in the bedpan)
6. Remove the bedpan and cover it with a rubber sheet and set it aside.
7. Pat and dry. Discard the towel to the laundry basket.

G. DRESSING
1. Expose the arm of the elderly/disabled at the side then let the arms pass through
the sleeves of the gown and pull it upward.
2. Pull the soiled top sheet under the gown then cover the elderly.
3. Place the elderly in a side-lying position then tie the gown at the back.

H. OCCUPIED BED
1. While the elderly/disabled is at the side lying position, roll the bottom sheet
towards the center and tuck well under the client.
2. Spread the new bottom sheet at the centerfold, spread and make a half-mitered
from the head part to the foot part of the bed.
3. Roll the unused part bottom sheet going inside and place the plastic draw sheet,
spread and roll the unused part under the bottom sheet. The plastic draw sheet
serves as protector to prevent soiling of the beddings.
4. Then put the cotton draw sheet, spread and roll the unused part under the
plastic draw sheet. Then tuck them together from the head part to the foot part.
The cotton draw sheet is used to prevent skin irritation from direct contact with
the rubber.
5. Change the pillowcase at the head part by rolling down the pillowcase without
touching the outer part to prevent contamination and put at the back of the
chair to serve as a soil bag. Then insert one hand through the pillow while the
other hand adjusting the pillowcase.
 6. Then the top sheet, place at the centerfold, spread and must be head level only,
then make the half-mitered corner of the top sheet at the foot part and tuck.
7. Roll over the patient to the fully made part of the bed and cover with the top
sheet.
8. Turn to the other side and change the pillowcase and put at the back of the head
of the client.
9. Roll all the soiled linens from head part to the foot part. Put at the soiled bag and
spread the new linens, make a half-mitered corner and tuck them together.
10. Position the patient at the center of the bed and cover the top sheet. Fold the
top sheet 12-18 inches from the head part of the bed.

I. AFTER CARE
1. Collect all soiled clothes and linens then bring these to the laundry room.
2. Wipe the tables dry.
3. Mop the floor.
4. Dispose garbage and trash.