Grooming: Hair care

Hair care is one of several grooming activities that are important for a person’s physical and emotional well-being. Clean and well-maintained hair improves a client’s self-esteem and speeds up their recovery.

Clients are usually motivated to take care of their hygiene on their own, but as a nursing assistant, you’ll come across individuals who have weak motor skills or other conditions that prevent them from managing their own hair and therefore require your assistance.

Before we continue, there are several important definitions you’ll need to be familiar with. Dandruff is a skin condition that mainly affects the scalp. This condition is not contagious and it’s typically associated with itching and flaking.

Dandruff can be caused by seborrheic dermatitis, which is a skin condition that also affects the scalp. It’s characterized by yellow or white patchy scales, crusts, and itching. In infants, seborrheic dermatitis is also known as cradle cap.

Next up is tinea capitis, a scalp condition caused by a fungal infection, which is also associated with itching and flaking. Next, we have pediculosis capitis, which is a condition caused by small parasitic insects called head lice. Head lice lay their eggs, called nits, onto the shaft of the hair. Nits are easy to confuse with dandruff, but the nits cannot be brushed off while dandruff can.

The last one is alopecia, more commonly known as hair loss, which can be inherited or acquired. Acquired alopecia can be age-related or it can be caused by chemotherapy and radiation therapy or other problems like poor nutrition.

First, prepare your working area by covering the overbed table with paper towels and placing your equipment. Make sure that your client is in a supine position. When combing their hair, raise the bed and head of the bed to a comfortable height as tolerated by the client; when shampooing and washing their hair, lower the head of the bed until it’s flat. Also, lower the side rail on the side of the bed that you’ll be working. Check for common hair and scalp conditions before proceeding.

Now, let’s focus on shampooing. Supplies for this procedure can include clean gloves, bath towels, washcloths, shampoo, comb, brush, hair dryer, water pitcher, waterproof pad, shampoo board, and wash basin.

Hydrogen peroxide or saline can be used to clean the hair and scalp if there are wounds on the head. If the client has limited mobility, an inflatable basin can be used while they remain in bed. Other supplies include hair conditioner or other hair products that the client brought with them, and you should always ask if they have any preferences.

To wash the hair of a bed-bound client, start by filling a pitcher with water that’s at a comfortable temperature; you can ask the client to confirm the temperature is right by having them check with their finger.

Next, place a waterproof pad under the client’s head, neck, and shoulders and place the shampoo board under the head. The trough spout must extend beyond the edge of the bed so you can position a chair and wash basin below it.

For more comfort, take another towel, roll it over, and put it under the client’s neck. Additionally, use another towel and place it over the person's chest and shoulders to keep them dry.

Before the procedure, remove any tangles using a comb and place a washcloth over the client’s eyes for protection. Pour the water over the person’s hair until it’s completely wet. Portions of the hair that are matted with blood should be cleaned with hydrogen peroxide and saline instead.