Level 4 - Washing & Dressing Assessment (2024)

Level 4 - Washing & Dressing Assessment (1)

This page will cover :-

  • What is a washing and dressing assessment

  • Why Occupational Therapist’s complete them

  • How to complete a washing and dressing assessment

  • Links to videos demonstrating upper body washing and dressing assessment/techniques

  • How to document a washing and dressing assessment in the medical notes

  • An introduction to small aids that assist with washing and dressing

  • Links to videos to show you how to use washing and dressing aids

Now scroll down to see the information and activities to complete.

Work through the information below and complete the activities


Level 4 - Washing & Dressing Assessment (2)

A washing and dressing assessment is classed as a functional assessment, often referred to as a PADL assessment which refers to Personal Activities of Daily Living.

Personal Activities of Daily Living (PADL's) are the everyday, basic tasks that need to be completed to maintain self-care.

These tasks are broken down into a number of categories, including; Personal Hygiene - i.e. showering/bathing of the face and body, drying the body, grooming and oral care.

In simple terms the Occupational Therapist (OT) is working out (assessing) whether the individual is able to wash and dress themselves (the function).

Why do Occupational Therapists complete a washing and dressing assessment?

Functional assessments can be used to predict whether the individual would be safe and independent with their personal care on discharge home.

It can be used to assess an individual's cognitive ability, such as initiating or completing a task, planning, sequencing, safety awareness, problem-solving and concentration.

Washing and dressing assessments can help the therapist determine if that individual will require any assistive/adaptive equipment or carer support for returning home.

Washing and dressing can also be used as a therapeutic technique in addition to assessment. An example of this would be using the activity to work on the individual's mobility, such as standing tolerance, standing balance, dynamic balance, leaning forward and sit to stand.

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How to complete a washing and dressing assessment

  • Firstly, discuss with the nursing team the day before the intended washing and dressing assessment so they don’t get that person washed and changed.

  • Gain information about how the individual has been, asking if there have been any changes in presentation including any improvements or difficulties reported to or noted by the team/carers/family members.

  • Discuss with the assessment with individual and gain consent. Due to the nature of assessing /supporting the individual's personal care needs, reasonable effort must be made to ensure that the individual's preferences are respected about who delivers their care and treatment, such as requesting staff of a specified gender (female/male staff members for intimate/personal care).

  • Consider the social, cultural and religious preferences of the individual. (please see further resources to widen your knowledge in this topic )

  • On the day, check with the nursing team that the individual is well enough to complete the assessment as planned also confirm with the individual that they feel well enough.

  • Decide how you are going to do the assessment.

  • Decide how many people you need; one or two? this information will be gained from your baseline assessment. For example; if the individual currently requires two people to assist from sit to stand, two staff will be required for this part of the assessment. You’ll be doing sit to stand as you wash and dress. If their sit to stand is poor then start with a bowl at the bedside as if you took them to the therapy bathroom they would have to do more attempts of sit to stand, unless you felt that this was something they needed to practise and you feel that they are ready for it (more of a rehab approach).

  • Think about how they normally get washed at home. Try and replicate what they do at home. If in doubt, start with a stripwash at the bedside.

  • Ask them to select what items that are needed for the washing and dressing assessment. This will be things like soap, flannel, toothbrush, clothes and pads. observe here to see if they can plan a task and recall what items they need. Dependent on their mobility, when they identify the item, encourage them to get it out themselves unless unable to. If they identify they need an item and they haven’t got it, then have a look to see if the ward has supplies for them to use.

  • Fill the bowl with soapy water (if doing it by the bedside), put all the items needed on the overbed table and then only intervene if they need you to, remember the assessment is to see how independent they are. Take a few towels for covering the individual for dignity while they are getting washed.

Prompting and assisting

  • Ask before you help, be an observer and hold back on supporting unless there are indications the individual is having difficulty then ask if they would like help.

  • Use your judgement from the baseline assessment. If someone recently needed assistance of 2 for sit to stand then assist with this and not wait to be asked. If someone stands with effort with a zimmer frame then they will need support pulling down their underwear and pyjama bottoms, changing their underwear or pad and washing their lower body as they will need to keep their hands on the zimmer frame in stand. Part of this could be seated until required to stand if needed.

  • Assessing cognition, only prompt with the next stage of the task if needed. During the assessment observe whether they can plan, sequence and problem-solve . Start with subtle hints and get more obvious as needed.

During clinical practice the options include:

Level 4 - Washing & Dressing Assessment (4)

A strip wash at the bedside with a bowl on their overbed table

d tab

Level 4 - Washing & Dressing Assessment (5)

Taking them into the therapy bathroom or ward bathroom for a stripwash with a perching stool

For the purpose of your oncampus placement you will only be required to carry out an upper body washing and dressing assessment at the bedside.

Items required for bedside washing and dressing assessment


  • Take note of recommended items required to complete your bedside washing and dressing assessment on your placement

Now Complete the Activities below

Level 4 - Washing & Dressing Assessment (7)Functional ,working age-Washing and dressing assessment @ bedside .mp4

Functional female of working age

Upper body washing and dressing demonstration at the bedside

03.33 mins

Upper body washing and dressing assessment at the bedside

  • Watch the short video

This will show you how an individual should be able to function to complete the instructed tasks.

  • Following the video complete an activity analysis below for the upper body washing and dressing assessment.

  • Upload a copy of the completed activity analysis to Pebble Pad

Level 4 - Washing & Dressing Assessment (8)Activity Analysis Sheet.pdf

Activity analysis Template

click to open, copy and paste into word to complete your document

See this example of a dressing activity analysis to support you with this activity

04.00 mins

Level 4 - Washing & Dressing Assessment (9)query congnitive disorder-Washing and dressing assessment @ bedside .mp4

Upper body washing and dressing demonstration at the bedside

06.18 mins

Upper body washing and dressing assessment at the bedside

  • Watch the short video to the left

  • Observe the patient as though you were the OT, and assess her.

  • When completing the assessment, identify any difficulties observed during the functional self care assessment.

  • Complete a word document with your work and upload to Pebble Pad

  • You can see an example of how to document your assessment below.

Double click on the document and click on icon to see full example of proforma

How to document a washing and dressing assessment in the medical notes

Once the assessment is complete and you’ve tidied up, it’s time to complete your documentation. You may have a proforma to complete that guides your assessment. (Like the one to the left ).

If you don’t have a proforma and are writing in the notes comment on the following stating if this was observed during the assessment:

  • Transfers: getting on and off chair/bed/toilet

  • Mobility: what are they walking with? How many people do they need to assist?

  • Upper and lower body washing

  • Upper and lower body un/dressing

  • Range of movement: can they reach their head, feet, back, lift their arms to put on clothes?

  • Balance: sitting, standing and dynamic balance

  • Cognititon: planning, initiating, sequencing, problem solving, following instructions, concentration. (Is there any confusion that you’ve noticed?

  • Mood: how cooperative they are, chatty/not chatty, anxious, etc.

  • Equipment used; perching stool, bath board, level access shower etc.

  • Finally summarise your findings.

You can say things like;

Patient X will need a 1 carer on discharge to assist with washing and dressing of lower body and to assist patient lift legs into bath on bath board.

Patient Y will need 1 carer on discharge to prompt with the initiation of tasks and support with dressing due to limited upper limb range of movement to the left side.

These aids can be helpful to assist individuals with washing and dressing.

Read the information and watch the video's below. Then complete the quiz.

Level 4 - Washing & Dressing Assessment (11)

Long Handled Sponges

Great for reaching back and lower limbs for those with difficulty bending and reaching.

Level 4 - Washing & Dressing Assessment (12)

Long handled shoe horns

Great for doing feet and back. No need to bend down when seated which is great for people who struggle reaching their feet or if people have COPD/breathlessness.

Level 4 - Washing & Dressing Assessment (13)

Soxon

The Soxon is a sock aid. The long handle reduces the need to bend down when putting on shoes. It can also be used to remove socks.

Level 4 - Washing & Dressing Assessment (14)

Helping Hand/Grabber

Helping hands help in all aspects of life. They are great for picking up clothes from the floor. They can help put lower body items on such as underwear and trousers.

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Bath/shower step

A bath step is a simple and easy aid which helps someone get in and out of the bath. Bath steps are useful to individuals with conditions which make it difficult to climb over the side of the bath such as mobility, strength or flexibility limitations.

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Adjustable Shower chair

Using a shower chair or bath chair helps to increase safety by decreasing the chance of you falling by providing a secure area in a slippery shower or bath. Shower Chairs and Bath chairs are especially useful for those that are in wheelchairs, the elderly, or anyone who finds excessive movement painful or difficult.


Level 4 - Washing & Dressing Assessment (17)

Adjustable perching stool

The perching stool will allow you to achieve a comfortable seated position when carrying out personal care/domestic activities. The perching stool has arms and a backrest.


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Bath board

A bath board can be used as a shower board, or to sit on while washing while not having to lower into the bath below. Bath boards can be effective if the individual concerned finds it hard to get in and out of the bath.

Level 4 - Washing & Dressing Assessment (19)

Dressing Stick

The dressing stick is a stick with hooks which can be used to don and doff shoes, socks, thread legs into pants, put coats and cardigans on and pull up zips. watch the video on how to use a dressing stick.

02.10 mins

Level 4 - Washing & Dressing Assessment (20)

Button Hook

The button hook makes buttoning clothes less of a barrier when dressing. The hook on the other end is for pulling up zips. This is good for people with arthritis or difficulty with fine motor skills. Here’s a video on how to use it.

00.42 mins

Level 4 - Washing & Dressing Assessment (21)

Bra Angel- Designed by an Occupational Therapist, the Bra Angel helps ladies get their bra on, even with one-handed use. Here’s the Bra Angel video demonstration.

00.51 mins


Simple ways to help with washing and dressing 04.00 mins


Watch the videos below

These will give you an overview of washing and dressing assessments and strategies

upper body dressing

03.04mins

Activities of Daily living after Stroke

04.00 mins

Activity 3

Now complete this Quiz

To complete the quiz , click the square grey box when it appears to the right of the quiz

complete all 12 questions to retrieve your score at the end of the quiz

You can access more useful information, links and videos on the Additional Resources page




Now access the the Multi-Discplinary Team learning page by clicking the sidebar at top left of this page

Level 4 - Washing & Dressing Assessment (2024)
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