COMPETENCY-BASED LEARNING MATERIALS

Health, Social and Other Community

Sector: Development Services
Qualification: Caregiving NC II
Unit of Competency: Provide Care and Support to Elderly
Module Title: Providing Care and Support to Elderly

TABLE OF CONTENTS

Date Developed: Document no.

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Caregiving NC II
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Table of Content ………………………………………………………………2
How to use this Competency Based Learning Materials ……………..3
List of Competency ………………………………………………………4
Module Content ………………………………………………………………5
Learning Outcome Summary ………………………………………………6
Learning Experiences ………………………………………………………7
Information Sheet No. 5.3-1 ………………………………………………8
Self-check 5.3-1 ………………………………………………………15
Answer Key 5.3-1 ………………………………………………………16
Information Sheet No. 5.3-2 ………………………………………………17
Self-check 5.3-2 ………………………………………………………22
Answer Key 5.3-2 ………………………………………………………24
Task Sheet A 5.3-2 ………………………………………………25
Performance Criteria Checklist A 5.3-2 ………………………28
Task Sheet B 5.3-2 ………………………………………………29
Performance Criteria Checklist B 5.3-2 ………………………30
Task Sheet C 5.3-2 ………………………………………………31
Performance Criteria Checklist C 5.3-2 ………………………33
Information Sheet 5.3-3 ………………………………………………………34
Self-check 5.3-3 ………………………………………………………38
Answer Key 5.3-3 ………………………………………………………39
Information Sheet No. 5.3-4 ………………………………………………40
Self-check 5.3-4 ………………………………………………………47
Answer Key 5.3-4 ………………………………………………………48
Task Sheet 5.3-4 ………………………………………………………50
Performance Criteria Checklist 5.3-4………………………………51
Bibliography ……………………………………………………………………..52

HOW TO USE THIS COMPETENCY BASED LEARNING

MATERIAL

Welcome to the module in Providing Care and Support to Elderly.

This module contains training materials and activities for you to complete.
Date Developed: Document no.
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 The unit of competency “Provide Care and Support to Elderly"
contains knowledge, skills and attitudes required for Caregiving NC II.
You are required to go through a series of learning activities in order
to complete each learning outcome of the module. In each learning outcome
are Information Sheets, Self-Checks, Task Sheets, Performance
Criteria. Follow these activities on your own. If you have questions, don’t
hesitate to ask your facilitator for assistance.
The goal of this course is the development of practical skills. To gain
these skills, you must learn basic concepts and terminologies. For the most
part, you'll get this information from the Information Sheets and TESDA
Website, www.tesda.gov.ph
This module is prepared to help you achieve the required competency,
in “Providing Care and Support to Elderly".
This will be the source of information for you to acquire knowledge
and skills in this particular competency independently and at your own
pace, with minimum supervision or help from your instructor.

Remember to:
 Work through all the information and complete the activities in each
section.
 Read information sheets and complete the self-check. Suggested
references are included to supplement the materials provided in this
module.
 Most probably your trainer will also be your supervisor or manager.
He/she is there to support you and show you the correct way to do
things.
 You will be given plenty of opportunity to ask questions and practice on
the job. Make sure you practice your new skills during regular work
shifts. This way you will improve both your speed and memory and also
your confidence.
 Use the Self-checks and Performance Criteria at the end of each section
to test your own progress.
 When you feel confident that you have had sufficient practice, ask your
Trainer to evaluate you. The results of your assessment will be recorded
in your Progress Chart and Achievement Chart.

LIST OF COMPETENCIES

No. Unit of Competency Module Title Code

Provide care and support Providing care and support HCS323301

1.
to infants and toddlers to infants and toddlers

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 HCS323302
Provide care and support Providing care and support
2.
to children to children

Foster the social, Fostering the social,

HCS323303
intellectual, creative and intellectual, creative and
3.
emotional development of emotional development of
children children

Foster physical Fostering physical

4. HCS323304
development of children development of children

Provide care and Providing care and

5. HCS323305
services to elderly services to elderly

Provide care and support Providing care and support

HCS323306
6. to people with special to people with special
needs needs

Maintain healthy and Maintaining healthy and

7. HCS323307
safe environment safe environment

8. Respond to emergency Responding to emergency HCS323308

Cleaning living room,

Clean living room, dining HCS323309
dining room, bedrooms,
9. room, bedrooms, toilets,
toilets, bathrooms and
bathrooms and kitchen
kitchen

Wash and iron clothes, Washing and ironing

10. HCS3233010
linen and fabric clothes, linen and fabric

Prepare hot and cold Preparing hot and cold

11. HCS3233011
meals meals

MODULE CONTENT
UNIT OF COMPETENCY: Provide Care and Support to Elderly
MODULE TITLE: Providing Care and Support to Elderly
MODULE DESCRIPTOR: This unit covers the knowledge, skills
and attitudes required in providing support and
assistance to maintain quality care for the elderly to
meet his/her daily needs including nourishment,
mobility, personal hygiene and other support within
the plan of care.
NOMINAL DURATION: 150 hours
Date Developed: Document no.
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LEARNING OUTCOMES:
Upon completion of this module, the trainee/student must be
able to:
1. Establish and maintain an appropriate relationship with elderly
2. Provide appropriate support to the elderly
3. A. Provide assistance with elderly’s personal care needs
B. Provide assistance with elderly’s personal care needs

ASSESSMENT CRITERIA:
1. Personal preferences identified in consultation with the elderly and
a plan for execution is mapped out based on established
procedures
2. The elderly supported and encouraged in exercising their rights
and personal preferences without comprising their safety and those
of others and in accordance with established procedures
3. Short interpersonal exchanges, clarifying meaning and maintaining
interaction to identify the elderly’s preferences conducted based on
established procedures.
4. Time scheduled to effectively listen to the elderly’s preferences to
maximize his / her wellbeing.

LEARNING OUTCOME NO. 3:

PROVIDE ASSISTANCE WITH ELDERLY’S PERSONAL CARE
NEEDS
CONTENTS:
 Types, uses, specifications and maintenance of bathing
paraphernalia
 Procedures of bathing, dressing, mobility, of the elderly
 Proper care of the elderly during ADL (Activities of Daily Living)
 Principles and procedures in administering medicines for the
elderly

ASSESSMENT CRITERIA:
1. Personal preferences identified in consultation with the elderly and a
plan for execution is mapped out based on established procedures

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 2. The elderly supported and encouraged in exercising their rights and
personal preferences without comprising their safety and those of
others and in accordance with established procedures
3. Short interpersonal exchanges, clarifying meaning and maintaining
interaction to identify the elderly’s preferences conducted based on
established procedures.
4. Time scheduled to effectively listen to the elderly’s preferences to
maximize his / her wellbeing.

CONDITIONS:
Students/trainees must be provided with the following:
 Wheelchair
 Walker/cane
 Crutches
 Parallel bars
 Hand rails
 Commode
 Reading materials
 Indoor/outdoor facilities
 Handouts/manual

METHODOLOGIES:
 Lecture - demonstration
 Self-paced instruction
 Group discussion

ASSESSMENT METHODS:
 Hands-on
 Direct observation
 Practical demonstration

LEARNING EXPERIENCES

Learning Activities Special Instructions

 READ and understand the Information
Sheet 5.3-1.CHECK yourself by
answering the Self-Check Guide 5.3-1.
Answer Self-check guide Compare your answers with the Answer
5.3-1 and 5.3-2 Key 5.3-1.

 READ and understand the Information

Sheet 5.3-2.CHECK yourself by
answering the Self-Check Guide 5.3-2.
Compare your answers with the Answer
Key 5.3-2. You must answer all the
questions correctly before PERFORMING
Perform Task sheet 5.3-2A,
the Task Sheet A, B and C 5.3-2.
5.3-2B, 5.3-2C
Evaluate your own work using the
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 Performance Criteria Checklist 5.3-2.
When you are ready, present your work
to your trainer for final evaluation and
recording. Proceed to the next learning
activity after accomplishing these tasks.
 READ and understand the Information
Sheet 5.3-3. CHECK yourself by
Answer self-check guide answering the Self-Check Guide 5.3-3.
5.3-3 and 5.3-4 Compare your answers with the Answer
Key 5.3-3.

 READ and understand the Information

Sheet 5.3-4. CHECK yourself by
answering the Self-Check Guide 5.3-4.
Compare your answers with the Answer
Key 5.3-4. You must answer all the
Perform Task sheet 5.3-4 questions correctly before PERFORMING
the Task Sheet 5.3-4. Ask for trainer’s
assistance in performing Task Sheet 5.3-
4. Evaluate your own work using the
Performance Criteria Checklist 5.3-4.
When you are ready, present your work
to your trainer for final evaluation and
recording.

INFORMATION SHEET 5.3-1

TYPES, USES, SPECIFICATIONS AND MAINTENANCE OF
BATHING PARAPHERNALIA

Learning Objectives:
After reading this information sheet, you must be able to:
1. Identify types of bathing paraphernalia and their usage.
2. Give the importance and maintenance of bathing paraphernalia.

INTRODUCTION:
If the person you're caring for is sedentary or on bed rest, the best
approach to bathing may be a bed bath. It sounds simple enough-you
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basically wipe her clean with a wet cloth. But in reality, giving a good bed
bath is a bit tricky.

Giving a bed bath requires you to wash the person's front, sides, and
back, not to mention crevasses and folds -- while she's lying down.
Depending on her condition, merely touching or moving her body may cause
discomfort. If she weighs a lot, it can be strenuous for you. Not to mention
the challenge of keeping the mattress dry.

BATHING PARAPHERNALIA
1. WATERPROOF SHEET- placed under the cloth sheet or top sheet
to ensure that the mattress stays dry.

2. BATH TOWELS- placed under the person from head to toe to

absorb water. Other used for dying or wiping the body after took a
bath.

3. BLANKET OR LARGE TOWEL- use to cover patient during the

whole bath for both warmth and privacy.

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4. BASIN- an open, shallow, usually round container used especially
for holding liquids.

5. LARGE BOWLS- with warm water, one for washing and one for
rinsing. Put the bowls within easy reach.

6. WASH CLOTH- a small cloth used for washing one’s faced or body.

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7. BATH SOAP- use for cleansing agent made from the salts of
vegetable or animal fats.

8. PATIENT GOWN/ CLEAN DRESS- worn by patients after bathing.

9. COMB- toothed
device used for
styling, cleaning
and managing hair and scalp.

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10. URINAL- a portable receptacle used for urinating for male, by
the bedridden.

11. BED PAN- an object used for the toileting of a bedridden

patient in a health care facility usually made of a metal, glass or
plastic receptacle. A bed pan can be used for both urinary and
fecal discharge of female, and for fecal discharge of male.

12. SOILED LINEN BAG/BIN- hamper for dirty, used or soiled

linens.

13. Other equipment needed in bathing procedure:

a. REMOVABLE BATH BOARDS- provide a seated platform area
over the bath for someone who has difficulty stepping in/out of
the bath. However, the user still needs to transfer his/her legs
over the bath rim, or have assistance to do this from a caregiver.

b. PLASTIC TRANSFER BENCH- it is use to access bath; it is

reversible to accommodate bathroom layout.

c. SHOWER, OVER TOILET & COMMODE CHAIRS- these multi-

functional chairs can be used over the toilet, or as a shower
chair, and have the option of being used as a commode.

d. Drop-down wall mounted rails- these folding toilet rails are

mounted to the wall at the back of the toilet and fold down to a
horizontal position beside the toilet. Some have a support leg
which rests down on the floor when the rail is horizontal.
THE IMPORTANCE AND MAINTAINANCE OF BATHING PARAPHERNALIA
Moving, handling and bathing equipment are essential in a day to day
care package in order to provide a safe environment for both the client and
the caregiver.
The service and repair of this equipment has never been more
significant, especially since the increase in unannounced care home
inspections.
The effects of neglecting such an essential maintenance program
could be detrimental to a care home, should a patient or care giver become
injured as a result of using ill-serviced equipment.
However, the safety of staff and clients is not the only benefit to
complying with maintenance regulations. Care homes will also benefit from
increased equipment efficiency and reduced cost via less reactive service call
outs.

Cleaning

We recommend the regular removal of soap and other residue from

your tub/shower unit and silicone areas by cleaning with an approved
cleaner.
The household and institutional cleaning products for the bathing
paraphernalia must be followed.
It is well known that wet, soapy surfaces can be slippery. Please be
extremely careful when bathing.

SELF CHECK 5.3-1

Name:_________________________________________ Date:_______________
IDENTIFICATION:
Identify the following. Write your answers on the blank provided.
_________________________ 1. It is placed under the person from head to toe
to absorb water. Other used for dying or wiping the body after took a
bath.

__________________________2. It can be used for both urinary and fecal

discharge of female, and for fecal discharge of male.

__________________________3. These folding toilet rails are mounted to the

wall at the back of the toilet and fold down to a horizontal position beside
the toilet.

__________________________4. A portable receptacle used for urinating for

male, by the bedridden.

__________________________5. A small cloth used for washing one’s faced or

body.

__________________________6. Toothed device used for styling, cleaning and

managing hair and scalp.

__________________________7. It is use to access bath; it is reversible to

accommodate bathroom layout.

__________________________8. It is an open, shallow, usually round container

used especially for holding liquids.

__________________________9. Use for cleansing agent made from the salts of

vegetable or animal fats.

__________________________10. Clean dress worn by patients after bathing.

ANSWER KEY 5.3-1

IDENTIFICATION
1. Bath towel
2. Bed pan
3. Drop-down wall mounted rails
4. Urinal
 5. Washcloth
6. Comb
7. Plastic transfer bench
8. Basin
9. Bath soap
10. Patient’s gown

INFORMATION SHEET 5.3-2

PROCEDURES OF BATHING, DRESSING, MOBILITY OF THE
ELDERLY
Learning Objectives:
Upon completion of this module, the students must be able to:
1. Understand the importance of bathing.
2. Understand the guidelines in dressing and undressing.
3. Identify the assistive devices.
4. Demonstrate the procedures for bathing.
5. Demonstrate the procedures for dressing and undressing.
6. Assist the elderly with mobility.

Introduction
 Bathing can be a very pleasant part of the day. After a bath we
feel good, clean and relaxed. If you care for someone who needs help with
bathing, keep things as pleasant and relaxed as possible. You’ll both feel a
lot better afterwards.

A. Bathing
It is defined as cleaning of the body for the purposes of relaxation,
cleanliness, and healing. It is a practice that we’re used soap and water to
remove sweat, oil, dirt and microorganism from physical body.
Types of Bathing
1. Tub bath
 For all client who are independent and there no safety risk.
 Caregiver/Nurse should encourage clients to take shower
independent.
 Most bath room is equipped with rails and handles to promote
client safety.
2. Partial bath
 Washing only body area that are directly cause odor (face, hand,
axillae, perineal area)
 Partial bathing done at sink or with basin at the bed.
3. Bed bath
 Washing with a basin of water at the bed side.
 For client who cannot take shower independently.

Importance of bathing
1. It takes waste products of the skin.
2. It cools and refreshes the client feeling.
3. It stimulates the skin and improves circulation.
4. It requires movement of the muscles.
5. It provides a good opportunity for the home health aide to observe the
client.
6. It provides an opportunity to talk with the client.

The benefits of good personal hygiene are:

1. It helps keep the skin intact and prevents infections.

2. It removes substance from the skin where bacteria can grow, thus
reducing the risk of infection.
 3. It helps keep the teeth and gums health, which in turn promotes good
nutrition.

4. It makes the person feel good about them.

5. It helps to stimulation of circulation.

Tips/Considerations for bed baths

1. Gather everything you need in advance and always wash your hands
before you start;

2. Try to maintain the water temperature at 120 degrees F;

3. Always test it first and replace the water as it cools or gets dirty;

4. Make sure the room is warm and there are no drafts or open
windows ;

5. For privacy and warmth, use a light cotton blanket to cover the person
during the bed.

6. Check that the floor is not slippery. Think about using non-slip mats
if necessary.

7. Try to make sure that you will not be disturbed or distracted and will
not have to leave the person alone.

B. DRESSING- defined as choosing, putting on, and removing clothes for a

person who cannot do this for self while UNDRESSING is to remove the
clothing of; disrobe.

C. ASSISTING WITH MOBILITY

Mobility
 The ability to move in one's environment with ease and without
restriction.
 Denoting movement of the body or body parts, including activities
of walking, swimming, and moving from one position to another.
Assistive Devices
Any device that is designed, made, or adapted to assist a person
performs a particular task. Assistive devices can help a person function
better and be more independent. Assistive devices can make daily task
easier. These devices may help ease the burden on you as a caregiver.
1. Manual wheelchair- depends on physical strength of the user or
attendant. It is requiring arm or leg strength to move, unless there is
someone to push.
2. Motorized or electric wheelchair- powered by battery or electricity.
Less physical exertion is required. No one needs to assist the user. It
must be able to make decisions and maneuver safety.

3. Walker- offer additional support to make up for lost strength. It

provides maximum stability. Should be sized to fit the user.

4. Crutches- they give you greater confidence when walking, and assist
with pain reduction and weight redistribution when you use them for
support. It provides support under the arm to take stress off the leg
more stable than cane.
5. Cane- accessories for individuals who are blind or partially sighted to
establish the nature of their immediate surroundings and act as
guides by locating obstacles in the user's pathway.

6. Metal Step Stool with Handrail- suitable for indoor and outdoor use.
For individuals use for exercising lower extremities.

7. Parallel bar- the apparatus consists of two parallel bars that are held
parallel to, and elevated above, the floor by a metal supporting
framework. It helps patient to regain mobility, strength, balance, and
range of motion.
 SELF CHECK 5.3-2
Name:_________________________________________ Date:_______________
MULTIPLE CHOICE:
Encircle the letter of the best answer.
1. It provides support under the arm to take stress off the leg.
a. Walker c. Wheel chair
b. Crutches d. Cane
2. Accessories for individuals who are blind or partially sighted to
establish the nature of their immediate surroundings and act as
guides by locating obstacles in the user's pathway.
a. Walker c. Wheel chair
b. Crutches d. Cane
3. In assisting with dressing of a person with right side weakness, which
extremity should be dressed first?
a. Right c. Head
b. Left d. None of the above
4. A type bathing used for client who cannot take shower independently.
a. Tub bath c. Partial bath
b. Bed bath d. none of the above
5. All of the following are purpose of bathing, EXCEPT:
a. Removing microorganism’s c. Increase circulation
b. Do physical assessment d. Protection of underlying tissue
6. Considerations of bed bathing the patient, EXCEPT:
 a. Try to maintain the water temperature at 120 degrees F.
b. Always test it first and replace the water as it cools or gets dirty.
c. Make sure the room is warm and no drafts or open windows.
d. None of the above
7. A device that offers additional support to make up for lost strength. It
provides maximum stability. Should be sized to fit the user.
a. Wheel chair c. Walker
b. Cane d. Crutches
8. What to assess when performing bathing?
a. Color of the skin c. Pain upon movement
b. Injury d. all of the above
9. After performing bed bath to your patient. The last thing that you
should do is?
a. Put lotion on the patient’s back
b. Do handwashing
c. Document finding
d. Give privacy
10. A type of bathing where the patient’s wash only the body area
that are directly cause by odor (face, hand, axillae, perineal area).
c. Tub bath c. Partial bath
d. Bed bath d. none of the above
11. The ability to move in one's environment with ease and without
restriction.
a. Walking c. Transferring
b. Mobility d. Migratory
12. It is depends on physical strength of the user or attendant. It is
requiring arm or leg strength to move, unless there is someone to
push or electric.
a. Wheel chair c. Walker
b. Cane d. Crutches
13. It is defined as cleaning of the body for the purposes of relaxation,
cleanliness, and healing.
a. Dressing c. Bathing
b. Handwashing d. Swimming
14. Importance of bathing is?
a. It stimulates the skin and improves circulation.
b. It requires movement of the muscles.
 c. It provides a good opportunity for the home health aide to observe
the client.
d. All of the above
15. It helps patient to regain mobility, strength, balance, and range of
motion.
a. Walker c. Parallel bar
b. Grab rails d. Handrail

ANSWER KEY 5.3-2

MULTIPLE CHOICE:
1. B
2. D
3. A
4. B
5. B
6. D
7. C
8. A
9. C
10. C
11. B
12. A
13. C
14. D
15. D
 TASK SHEET-A 5.3-2

TITLE: Perform Complete Bed Bath

Given the necessary materials and equipment, you
PERFORMANCE are required to do complete bed bath in accordance
OBJECTIVE: with accepted institutional standard.
(Allotted time: 15-20 minutes )
2 basin, 2 wash cloth, bath blanket, bath towel,
MATERIALS: bath soap, comb, patient gown, urinal/bed pan,
linen bag, water
Hospital bed, bedside table, over bed side table,
EQUIPMENT: linen hamper

PROCEDURES:
1. Review the medical record and plan of care for the conditions that may
influence the patient’s ability to move. Assess for tubes, intravenous lines,
incisions, or equipment that may alter the procedure.
2. Identify the patient, greet and assess patient’s preferences about bathing.
3. Assess the vital signs.
4. Explain the procedure to the patient; gather necessary equipment; prepare
environment.
 Make sure the room is warm and there are no drafts or open windows.
 For privacy and warmth, use a light cotton blanket to cover the
person during the bed.
 Always test it first and replace the water as it cools or gets dirty.
5. Remove client’s personal belongings in the bed that may interrupt
procedure. Ask the patient if he/she needs to urinate of defecate.
6. Adjust the height of the bed to comfortable position.
7. Wash hands. Apply gloves. Gloves should be changed when emptying water
basin.
8. Lower side rails on the side close to you and position patient in comfortable
position to close the side near you.
9. If bath blankets are available, place bath blanket over top sheet. Remove top
sheet under bath blanket. Remove patient’s gown. Bath blanket should be
folded to expose only the area being cleaned at the time.
10.Fill wash basin 2/3 full. Permit patient to test temperature of water with the
dorsal part of the hand.
11. Lay the bath towel across the patient’s chest.
12.Make a bath mitten with the wash cloth. To make a mitten: grasp the edge of
the wash cloth with the thumb; fold a third over the palm of the hand; wrap
remainder of the cloth around the hand and across palm; grasping the
second edge under the thumb; fold the extended end of the washcloth onto
the palm and tuck under the palmar surface of the cloth.
13.Ask the preference of the patient about using soap on the face. Wash the
face with the S figure starting from the forehead, across the nose and
cheeks, to the chin then to the back of the ears. Use the back side of the
mitten for the other side of the face. If you use soap on the face, rinse then
pat dry.
14.Wash the neck starting on the farthest side with soap. Rinse then pat dry.
15.Lay the bath towel longitudinal under the arms of the patient on the farthest
side. Wash forearms using long, firm strokes in the direction of distal to
proximal. Support the arms while being washed, starts at the wrist, forearm
arm and axilla. Immerse the patient’s hand into basin of water with soap,
wash inter-digits, palm, fingers, and dorsum part of the hand and under
nails. Rinse arm, hand and pat dry. Do the same procedure on the side of
the arms.
16.Lay the bath towel longitudinal over the patient’s body. Fold/Lower bath
blanket down to the umbilicus. Wash chest using long, firm stroke with male
client. Wash skinfold under female client’s breast by lifting each breast.
Rinse and pat dry.
17.Fold/Lower the bath blanket down to suprapubic area. Wash abdomen
using firm strokes from farthest to nearest side of you. Rinse and pat dry.
Place back the bath blanket onto client’s chest to prevent chilling before
removing the bath towel.
18.Wash legs and feet. Expose leg farthest from you by folding bath blanket up
until thighs are exposed. Place bath towel under the exposed leg.
19.Bend the leg at the knee. Grasp the heel, place client’s foot into wash basin.
Allow foot to soak while washing the leg with long firm stroke in the direction
of proximal to distal (ankle to knee). Clean soles, inter-digits and toes.
Remove wash basin with soap.
20.Replace wash basin for rinsing. Soak the foot the rinse the legs with long
firm strokes from distal to proximal. Rinse soles, inter-digits and toes.
Remove wash basin and pat dry. Perform same procedure on other leg and
foot.
21.Assist client into prone of side lying position facing away from you. Lay the
bath towel parallel to the client’s back.
22.Expose the back of the client. Wash the back using firm, long stokes from
shoulder down to the lumbar area. Rinse and pat dry. Give back rub if not
contraindicated. Cover the back afterwards.
23. Expose the buttocks. Wash buttocks using circular motions on butt cheeks
and firm, long stoke on the middle area. Rinse and pat dry. Assist patient in
going back to supine position.
 24. Perform perineal care.
a. Get cotton balls with the use of forceps, dip in water and squeeze.
b. Clean first the mons pubis on a horizontal manner starting from
top to bottom one stroke.
c. Discard the cotton ball, get another cotton ball- repeat until
thoroughly clean.
d. Get another cotton ball, dip and squeeze- clean the perineal area
using the figure of 7 technique (inner to outer starting on one side).
e. Wipe from the labia majora to labia minora down to the anus-
repeat until thoroughly clean (approximately 2-3 strokes per side;
the 3rd stroke include the inguinal area).
f. Discard cotton ball (remember to use one cotton per stroke).
g. Then do it on the other side.
h. Clean also the middle from top to the bottom down to the anus
until thoroughly clean.
i. Discard cotton ball.
25. Apply clean gown.
26. Place back top linen of the patient as desired. Put back client’s
personal belongings.
27. Raise side rail. Lower the height of the bed.
28. Do after care for equipment’s that you have used.

DOCUMENTATION: Document skin assessment, type of bath given and

client outcomes and responses.

ASSESSMENT Demonstration and oral questioning interview.

METHOD:

PERFORMANCE CRITERIA CHECKLIST-A 5.3-2

CRITERIA
YES NO
DID YOU……
1. Review the medical record and plan of care for
the conditions that may influence the
patient’s ability to move?
2. Assess for tubes, intravenous lines, incisions,
or equipment that may alter the procedure?
3. Assess patient’s preferences about bathing?

4. Remove client’s personal belongings in the

bed that may interrupt procedure?
5. Ask the patient if he/she needs to urinate of
defecate?
6. Position patient in comfortable position to
close the side near you?
7. Observe proper draping while performing bed
bath?
8. Put back client’s personal belongings?

9. Encourage the person to do as much as

possible to boost his independence and
morale?

TASK SHEET-B 5.3-2

 TITLE: Perform Dressing and Undressing the Elderly
Given the necessary materials and equipment, you
PERFORMANCE are required to do dressing and undressing in
OBJECTIVE: accordance with accepted institutional standard.
(Allotted time: 5 minutes)
Clothes, underwear, socks, bath blanket,
MATERIALS: hamper/linen bag

EQUIPMENT: Bed/ chair

PROCEDURES:
1. Carry out beginning procedure actions.
2. Select appropriate clothing and arrange in order of application.
3. Cover the patient with bath blanket.
4. Elevate the head of the bed to a sitting position. Assist the patient to a
comfortable sitting position.
5. Remove night clothing beginning with the strong side first and then the
weaker side.
6. For any garment that slips over the head, gather the garment and place it
over the patient’s head.
7. Grasp the patient’s hand and guide it through the armhole by reaching into
the arm from the outside.
8. Repeat the procedure with the opposite arm.
9. Assist the patient to lean forward and adjust the garment so it smooths over
the body. Assist the patient to sit forward and arrange clothing across the
patient’s back.
10.Button, zip or snap the garment.
11.For underwear or pants, face the bed/chair and gather the patient’s
underwear/pants waist to leg hole.
12.Slip the underwear or pants over one foot at a time; pull underwear/pants up
legs as high as possible.
13.Assist the patient to raise the hips. Draw the garment over the buttocks and
up to the waist. Adjust until comfortable. Fasten the garment, if required.
14.To undress, reverse order of steps.
15.Carry out procedure completion actions.

DOCUMENTATION: Document the type of clothes used, the weak side

or if there is I.V. line.
ASSESSMENT Demonstration and Oral Questioning Interview
METHOD:

PERFORMANCE CRITERIA CHECKLIST-B 5.3-2

CRITERIA
YES NO
DID YOU……
1. Carry out beginning procedure actions?

2. Select appropriate clothing and arrange in

order of application?
3. Cover the patient with bath blanket and
fanfold top bed clothes (if within the bed) to
foot of bed/chair?
4. Assist the patient to the comfortable sitting
position?
5. Remove night clothing beginning with the
strong side first and then the weaker side?
6. Stand as close as you can to the patient?

7. Put on the clothing starting with the weaker

side first?
8. Observe proper draping while changing
his/her clothes?
9. Encourage the person to do as much as
possible himself to boost his independence
and morale.

TASK SHEET-C 5.3-2

TITLE: Assisting with Mobility
Given the necessary materials and equipment, you
PERFORMANCE are required to assist the elderly with mobility, in
OBJECTIVE: accordance with accepted institutional standard.
(Allotted time: 5 minutes)
2 wash basin, 2 wash cloth, bath blanket, bath
towel, bath soap, comb, patient gown, urinal/bed
 MATERIALS: pan, linen bag and water
EQUIPMENT: Hospital bed, bedside table, over bed side table,
linen hamper
PROCEDURES:
MOVING A PATIENT FROM BED TO A WHEEL CHAIR
If the patient cannot use his/her leg, you will need to use a lift to
transfer the patient.
PREPARATION:
Think/Plan through the steps before you act and get help if you need
it. If you are not able to support the patient by yourself, you could injure
yourself and the patient. Make sure any loose rugs are out of the way to
prevent slipping. You may not to put non-skid socks or shoes on the
patient’s feet if the patient needs to step onto a slippery surface.
 Explain the steps to the patient.
1. Place the wheelchair on the same side as the patient’s good leg.
2. Park the brakes on and move the footrests out of the way.
3. Put the brakes on and move the footrests out of the way.

 Getting a patient ready to transfer

Before transferring into the wheelchair, the patient must be sitting.
1. To get the patient into a seated position, roll the patient onto the same
side as the wheelchair.
2. Allow the patient to sit for a few moments, in case the patient feels
dizzy when first sitting up.
3. Put one of your arms under the patient’s shoulders and one behind
their knees. Bend your knees.
4. Swing their feet off the edge of the bed and use the momentum to help
the patient into a sitting position.
5. Move the patient to the edge of the bed and lower the bed so that their
feet are touching the ground.

PIVOT TURN
If you have a gait belt, place it on the patient to help you get a grip
during the transfer.
During the turn, the patient can either hold onto you or reach for
the wheelchair.
1. Stand as close as you can to the patient, reach around their chest,
and assist your patient on his pelvis or grab the gait belt.
2. Place the patient’s outside leg (the one farthest from the wheelchair)
between your knees for support. Bend your knees and keep your back
straight.
3. Count to three and slowly stand up. Use your legs to lift.
 4. At the same time, the patient should place their hands by their sides
and help push off the bed.
5. The patient should help support their weight on their good leg during
the transfer.
6. Pivot towards the wheelchair, moving your feet so your back is aligned
with your hips.
7. Once the patient’s legs are touching the seat of the wheelchair, bend
your knees to lower the patient into the seat. At the same time, ask
the patient to reach for the wheelchair armrest.
If the patient starts to fall during the transfer, lower them down to the
nearest flat surface, bed, chair or floor.

DOCUMENTATION: Document the mobility and assistive device used.

ASSESSMENT Demonstration and Oral Questioning Interview

METHOD:

PERFORMANCE CRITERIA CHECKLIST-C 5.3-2

CRITERIA
YES NO
DID YOU……
1. Think/Plan through the steps before you act
and get help if you need it?
2. Make sure any loose rugs are out of the way
to prevent slipping?
3. Explain the steps to the patient?

4. Place the wheelchair on the same side as the

patient’s good leg?
5. Allow the patient to sit for a few moments, in
case the patient feels dizzy when first sitting
up?
6. Stand as close as you can to the patient?

7. Let the patient help support their weight on

their good leg during the transfer?
8. Count to three, every time you move or lift the
patient?

INFORMATION SHEET 5.3-3

PROPER CARE OF THE ELDERLY DURING ADL
(ACTIVITIES OF DAILY LIVING)
Learning Objectives:
Upon completion of this module, the students must be able to:
1. Enumerate the activities of daily living.
2. Identify the problems encountered by the elderly in performing
ADL and how to do the proper care.

Activities of daily living (ADLs) - is a term used in healthcare to

refer to people's daily self-care activities. Health professionals often
use a person's ability or inability to perform ADLs as a measurement
of their functional status, particularly in regard to people with
disabilities and the elderly.
It is activities that are necessary for daily care of oneself
and independent community living. It includes using the toilet and
grooming, dressing, and feeding oneself; independent community
living includes driving, shopping, homemaking, care of family, work
activities, and so on

Basic ADLs consist of self-care tasks, including:

1. Functional Mobility- is measured as the ability to walk, get in and
out of bed, and get into and out of a chair; the broader definition
above is useful for people with different physical abilities who are
still able to get around independently.

2. Bathing and showering (washing the body) - can be a very

pleasant part of the day. After a bath we feel good, clean and
relaxed. If you care for someone who needs help with bathing, keep
things as pleasant and relaxed as possible. You’ll both feel a lot
better afterwards.

3. Dressing
4. Self-feeding (not including cooking or chewing and swallowing) -
To maintain self-esteem, the person is involved as much as
possible. His or her preferences are asked regarding the order of
items eaten. Condiments are added and food cut according to
patient preferences.

5. Personal hygiene and grooming (including

brushing/combing/styling hair)

6. Toilet hygiene (getting to the toilet, cleaning oneself, and getting

back up) - Try to make sure that the person wipes themselves
properly after using the toilet, or help them to do so if this feels
appropriate. Wiping from front to back, rather than back to front,
helps to prevent infection. Moist toilet tissues, obtainable from any
chemist, can clean more effectively than dry toilet paper, and can
be useful to keep around in case the person has an accident.
 PROBLEMS OF ACTIVITIES DAILY LIVING
The daily living skills most affected by aging and chronic illnesses or
disabilities include self-care activities the people learn in early childhood
and tend to take for granted as they mature. These include basic survival
task such as dressing, bathing, grooming, using the toilet, moving in and
out of bed or a chair, and eating. They also include activities for maintaining
an independent life such as cooking, cleaning, doing the laundry, shopping,
handling money, writing checks, driving, using public transportation, and
using the telephone.
Problems in doing daily living tasks arise for many reasons and are
closely linked to other health problem. For example:
1. People with congestive heart failure or pulmonary (lung) disease may
lack the physical endurance or stamina to manage household tasks
like cleaning, cooking, and laundry on their own.
2. People with arthritis may be unable to perform the small, precise
movements of the hands and arms needed for daily task.
3. Failing eyesight and healing can also make self-care more difficult.
Inability to take medicines correctly may be related to problems such
as being unable to read instructions, open bottles, get a glass of
water, not having the finger dexterity to handle small pills, and even
not remembering to take the medicine in the first place.
These problems are often a matter of degree; for example, an older
person may be able to dress him or herself except for reaching to put on
shoes and tie shoelaces, or managing difficult fasteners (especially zipper
and snaps that close in the back). If that is the case, self-care abilities can
be improved simply by changing the kinds of clothes worn and the way they
are fastened. One person may be able to eat independently except for
cutting foods or handling liquids without spilling them. At the other
extreme, another person may not be able to bring a spoon to his/her mouth
at all, or may even have difficulty swallowing food. Often these problems
arise gradually and may not even be considered a problem for some time.
For example, the first signs may be fatigue in performing common tasks or
an observation that things that used to take just a few minutes are now
taking much longer.

GOAL OF HEALTH PROVIDER

1. Maintain the older person’s ability to function as independently as
possible for as long as possible.
2. Arrange for appropriate care.
3. Involve the older in planning the care.
4. Call for professional help when needed.
SELF CHECK 5.3-3

Name:_________________________________________ Date:_______________

TRUE OF FALSE
Write the word TRUE if the statement is correct and write FALSE if the
statement is incorrect.
______________1. Impaired physical mobility is measured as the ability to
walk, get in and out of bed, and get into and out of a chair.

______________2. After a bath we feel good, clean and relaxed. If you care for
someone who needs help with bathing, keep things as pleasant and relaxed
as possible.
______________3. ADL means adventure in daily living.

______________4. As a caregiver, we have to include the older person when

planning for someone to come into the home to help. Issues of self-care and
problems in living are highly personal and involve the routines and rituals of
daily life.

______________5. Caregiver often uses a person's ability or inability to

perform ADLs as a measurement of their functional status, particularly in
regard to people with disabilities and the elderly.
 ANSWER KEY 5.3.3

TRUE OR FALSE
1. FALSE- FUNCTIONAL MOBILITY
2. TRUE
3. FALSE- ACTIVITIES OF DAILY LIVING
4. TRUE
5. FALSE- HEALTH PROFESSIONAL
 INFORMATION SHEET 5.3-4
PRINCIPLES AND PROCEDURES IN ADMINISTERING
MEDICINES FOR THE ELDERLY

Learning Objectives:
Upon completion of this module, the students must be able to:
1. Identify and enumerate the different routes of medication
administration.
2. Give the types of medication.
3. Enumerate the Guidelines for Safe Administration of Medications
4. Demonstration the Procedures in Administering Medication.
INTRODUCTION:
We take medicine to diagnose, treat, or prevent illness. Drugs are
potentially dangerous, even if they are meant to improve our health. It is
important that you take any and all medication correctly, always following
your doctor’s instructions. Always take all of your medication, and at the
amounts and times the instructions say.
SOME BASIC PRINCIPLES
The basic principles that you will always follow are:
 Talk with the individual and explain what you are doing before you
give medications. Answer any questions that the individual has.
 Help the individual to be as involved as possible in the process.
 Provide privacy for the individual.
 Give medication administration your complete attention.
 Give medications in a quiet area, free from distractions.
 Never leave medications unattended, even for a moment!
 Wash your hands! You must wash your hands before giving
medications and then again after you have given medication to each
individual.
 Remember: if you have a question or a concern, you should always
and call for help!

7 General Principles of Medication Administration

1. Essential information about each drug:
• indications for use
• contraindications
• therapeutic effects
• adverse effects
• specific administration instructions
2. Interpret prescribed orders accurately
• drug name
• dose
• frequency of administration
3. Examine drug labels
• drug name
• concentration (mg/tablet, capsule or mL soln)
4. Accurately calculate dosages
 • ask a colleague to check
• ask colleague to do calculations then compare your results

5. Seek information regarding pt’s medical diagnosis and condition

in relation to drug administration
• ability to swallow po meds
• allergies
• contraindications
• new signs or symptoms which may indicate adverse effects of
administration. Heart, liver or kidney disorders may interfere with pt’s
ability to eliminate drugs from the body.
• Verify client identity before administering medication to the pt
6. Omit or delay doses as indicated by the client’s condition
• report and document omissions appropriately
7. Take great care when administering drugs to children
• high risk of medication errors due to
• changes – in weight and age (eg 2 kgs to 100+)
• most drugs have not been tested in children
• many drugs are marked in dosage forms and concentrations
suitable for adults
• therefore this requires dilution, calculation, preparation and
administration of very small doses
• children have limited sites for IV drug administration, several
drugs may be given through the same site.
• This increases the need for small volumes of fluid and flushing
between sites
WHAT IS MEDICINE ADMINISTRATION?
Medications need to be safe and effective. Doctors, nurses, nurse
practitioners and a few other professionals are trained in how to safely give
you medication. Administration of medications requires understanding how
the medication requires knowledge of when the medication needs to be
administered, possible side effects, and toxicity. Training for professionals
also includes proper storage, handling, and disposal of medications.
Medication error due to the wrong drug, the wrong dose, the wrong
timing of administration, or the wrong route of administration accounts for
1.3 million injuries each year in the United States, according to the Food
and Drug Administration (FDA, 2009).
MEDICATION
 Substance administered for the diagnosis, treatment, or relief of a
symptom or for the prevention of diseases.
 Used interchangeably with the word drug.
 Drug also has the connotation of an illegally obtained substance.
Drug Administration- is very important and can be a dangerous duty
Given correctly- restore patient to health
Given incorrectly- patient’s condition can worsen

PRINCIPLES OF DRUG ADMINISTRATION

To provide safe drug administration, the nurse should practice the
“rights” of drug administration. They are:
1. Right patient
2. Right dose
3. Right drug
4. Right route
5. Right time

Experience indicates that five additional rights are essential to

professional nursing practice;
1. The right assessment
2. The right documentation
3. The client’s right to education
4. The right evaluation
5. The client’s right to refuse
You must check for all rights every time you administer any drug to
any individual. Each time that you give a medication, you also need to
remember to do the "Three Checks". This means that you are going to do a
"triple-check" to make sure that all rights are present each time that you give
a medication. You must:
1. Remove the medication from the locked area and check the
prescription label against the medication log to make sure that they match:
this is the 1st check.
2. Before pouring the medication, check the prescription label against
the medication order to make sure that they match: this is the 2nd check.
3. After you pour the medication, but before you give it, check the
prescription label against the medication log entry again to make sure that
they match: this is the 3rd check.

NURSING IMPLICATION/
CAREGIVER IMPLICATION IF PRESCRIBED BY DOCTOR
 1. Check that medication order is complete and legible.
2. Know why the client is receiving the medication.
3. Check the drug label three times before administration.
4. Know the start date that the drug was ordered and ending date.

ROUTE OF MEDICATION ADMINISTRATION

Medication can be given many different ways.
Some examples include:
1. Oral route: swallowed by mouth as a pill, liquid, tablet or lozenge
2. Rectal route: suppository inserted into the rectum
3. Intravenous route: injected into vein with a syringe or into
intravenous (IV) line
4. Infusion route: injected into the vein with an IV line and slowly
dripped in over time.
5. Intramuscular route: injected into muscle through skin with a syringe
6. Topical route: applied to skin
7. Enteric route: delivered directly into the stomach with a G-tube or J-
tube
8. Nasal route: sprays or pumps that deliver drug into the nose
9. Inhaled route: inhaled through a tube or mask (e.g. lung medications)
10. Otic route: drops into the ear
11. Ophthalmic route: drops, gel or ointment for the eye
12. Sublingual route: under the tongue
13. Buccal route: held inside the cheek
14. Transdermal route: a patch on the skin
15. Subcutaneous route: injected just under the skin

Some routes may not be safe or effective. This can be due to certain
health conditions, dehydration, an inability to swallow, or other factors.
Proper preparation must be taken to prevent complications from the
route of administration. For example, cleaning the skin and using sterile
syringes when injecting via the intravenous or intramuscular routes is
important for preventing infection.
DOSE AND TIME OF MEDICATION ADMINISTRATION
Any prescription or instructions state how often and how much of a
medication should be given. Calculating the correct dosage for some
medications can be very precise, and should only be done by professionals.
Only that dose stated in the prescription or instructions should be taken.
 Sometimes it is very tricky to find the right dose of a sensitive
medication. For example, thyroid medications and blood thinners require
frequent blood tests to find if the right dose is being given. Dosage is affected
by age, weight, kidney and liver health, and other health conditions.
Timing is also important in medication administration. Some
medications need to reach a consistent level in your bloodstream in order to
be effective. This means that your medications need to be administered at
the right times to keep that level of drug in your system. 
Usually your liver or kidneys will remove the medication from your blood.
High levels of the drug can build up in your system and lead to toxicity if
you take a dose too soon. If you miss a dose or wait too long between doses,
there may not be enough drug in your body to work properly.  .
Common Latin abbreviations used in prescriptions include:
 p.o. – by mouth
 p.c. – after meals
 a.c. – before meals
 b.i.d. – twice a day
 t.i.d. – three times a day
 q.i.d. – four times a day
 q.o.d. – every other day
 qAM – in the morning
 q4h – every four hours
 h.s. – at bedtime
 ad lib. –as desired
 prn – as needed
 gtt. – drops

PROBLEMS WITH MEDICATION ADMINISTRATION

Medication administration is not just giving a medication to a patient.
It also involves observation of what happens afterward. Professionals are
trained to know how medications move through the body, what the effect of
the medication is, and what adverse effects may occur.
Adverse effects may include overdose of the drug, allergic reactions to
the drug, and drug interactions between multiple drugs. You must tell your
healthcare provider about any other medications you may be taking, or any
times you’ve had an allergy to drugs or foods. 
Tolerance is another risk with certain medications. Over time, you
may need to take more of a medication as your body becomes used to the
original dose. Only change the dose of medication you are taking after
speaking with your doctor.

SELF CHECK 5.3-4

Name:_________________________________________ Date:_______________

Test I. MATCHING TYPE:

Match column A to column B and write the correct answer on the
blank provided.
 COLUMN A COLUMN B
__________1. every four hours A. p.o
__________2. twice a day B. p.c
__________3. three times a day C. a.c
__________4. after meals D. b.i.d
__________5. as needed E. t.i.d
__________6. before meals F. q.i.d
__________7. by mouth G. q.o.d
__________8. four times a day H. qAM
__________9. as desired I. q4h
__________10. every other day J. al lib
K. prn

Test II. ENUMERATION:

A. 1-4 “Rights” of drug administration
B. 5-7 Basic principles in administering medicines
C. 8-10 Component of a drug order

ANSWER KEY 5.3-4

Test I. MATCHING TYPE
1. I
2. D
3. E
4. B
5. K
6. C
7. A
8. F
 9. J
10. G
Test II. ENUMERATION
A. “Rights” of drug administration. They are:
1. Right patient
2. Right dose
3. Right drug
4. Right route
5. Right time
B. Basic principles that you will always follow are:
 Talk with the individual and explain what you are doing before
you give medications. Answer any questions that the
individual has.
 Help the individual to be as involved as possible in the process.
 Provide privacy for the individual.
 Give medication administration your complete attention.
 Give medications in a quiet area, free from distractions.
 Never leave medications unattended, even for a moment!
 Wash your hands! You must wash your hands before giving
medications and then again after you have given medication to
each individual.
 Remember: if you have a question or a concern, you should
always and call for help!
C. COMPONENTS OF A DRUG ORDER
 Date and time the order is written
 Drug name (generic is preferred)
 Drug dosage
 Route of administration
 Frequency and duration of administration (e.g. x7 days, 3 doses)
 Any special instructions for withholding or adjusting dosage
based on nursing assessment, drug effectiveness, or laboratory
results
 Physician or other health care provider’s signature or name if
TO or VO.
 Signatures of licensed practitioners taking TO or VO.
.
 TASK SHEET 5.3-4
TITLE: Administer Medication Procedure
Given the necessary materials and equipment, you
PERFORMANCE are required to assist the elderly with the proper
OBJECTIVE: procedure in administering medication
(Allotted time: 5 minutes)
Medicines, if liquid, use clean medication spoons,
MATERIALS: syringes, droppers, or medicine cups that have
measurements
EQUIPMENT: Over bed side table
PROCEDURES:
1. Wash hands before preparing medications.
2. Medication errors will be controlled by checking the following six items
each time medication is given:
 Right person
 Right medication
 Right time
 Right dosage
 Right route
  Right documentation
3. Prepare medication on a clean surface away from diapering or toileting
areas.
4. Do not add medication to the person’s bottle or food. Inform the patient
what you are going to do.
5. For liquid medications, use clean medication spoons, syringes,
droppers, or medicine cups that have measurements on them (not
table service spoons)
6. For capsule/pills, medication is measured into a paper cup and
dispensed as directed by the Health Care Provider/legal guardian.
Offer water as needed.
7. Wash hands after administering medication.
8. Observe the patient for side effects of medications and document on
the patient’s form/chart.
9. When a medication error occurs, the Regional Poison Control Center
and the relative will be contacted immediately. The incident will be
documented in the client’s record at the facility.
10. Do after care of the materials used and observe proper hand
washing.
DOCUMENTATION: Document the administered
medication procedure.
ASSESSMENT METHOD: Demonstration and Oral Questioning
Interview
PERFOORMANCE CRITERIA CHECKLIST 5.3-4

CRITERIA
YES NO
DID YOU……
1. Observe proper hand washing before
preparing medication?
2. Check if you have the right person,
medication, time, dosage, route and
documentation?
3. Explain or inform what are you going to the
patient?
4. Proper supplies for administering
medications?
5. Do after care of the materials used and
observe proper hand washing?