12.5.3: Nail, Hand and Foot Care
Procedure: Nail Care
Providing nail care for a patient allows Home Health Aides/Personal Care Aides an opportunity to assess the health of their patient’s skin, nails, and the strength of their hands and feet. It also provides a sense of comfort and promotes self-esteem for the patient. While many patients may enjoy having their hands and feet cared for, take special care with patients who do not find this a pleasurable experience. Some patients have very sensitive feet and may be ticklish. Home Health Aides/Personal Care Aides should always tell a patient when they are going to touch their feet and inform them of what they are doing so that they expect the touch.
Make sure to follow directions from a supervisor and those written in the Care Plan for nail care performed. Never use a nail clipper to clip finger or toe nails. Use an emery board to smooth nail edges. Home Health Aides/Personal Care Aides should inform their supervisor if advanced nail care needs to be performed. Never perform toenail care on a patient who has diabetes. These patients require special care from a podiatrist . It is acceptable to cleanse and inspect these patient’s feet, but never clip their toenails
Procedure: Hand Care
- Explain the procedure to the patient.
- Wash and dry your hands. Put on gloves as necessary.
- Gather equipment and supplies as needed.
- Use proper working height by raising the bed to waist level if the patient is bed bound. If the patient is sitting in a chair or wheelchair, Home Health Aides/Personal Care Aides may sit next to them to avoid bending their back. Keep the back straight, feet planted on the floor and face the direction you are working.
- Soak patient’s hands in warm (not hot) water. Temperature should be no greater than 105 degrees Fahrenheit. Soak hands for at least five minutes, or according to patient preferences. Clean under nails with a soft nail brush or nail stick, or do as directed in the Care Plan.
- Remove the patient’s hands from the water and wash with a soapy wash cloth. Rinse and dry well. Be sure to rinse and dry between fingers.
- Remove basin from the patient area.
- File nails as necessary and as requested with an emery board or nail file to keep edges smooth and free of rough edges or hangnails.
- Massage hands with lotion.
- Apply nail polish as the patient requests.
- Discard the water and rinse the basin. Put away equipment and supplies.
- Lower the bed to its lowest level and ensure side rails are up.
- Remove your gloves. Wash and dry your hands.
- Document completion of task and record any changes in condition or behavior. Report any skin conditions observed.
Procedure: Foot Care
- Fill a basin with warm water. Do not exceed 105 degrees Fahrenheit. Have the patient test the water for comfort.
- If providing foot care in bed, soak and work with one foot at a time. Place the basin of water over a waterproof pad or towel at the foot of the patient’s bed. If the patient is sitting, place the basin on the floor with a towel or waterproof pad underneath. Ensure the patient’s feet and ankles are supported. Feet should be flat against the bottom of the basin.
- Soak the patient’s feet in warm (not hot) water for at least 10 minutes. Add warm water to the basin as needed. Clean under their toenails with a soft nail brush.
- Working with one foot at a time, remove a foot from the basin and wash with a soapy wash cloth. Take care to clean between toes. Rinse their foot well. Make sure no soap is left between the toes.
- Dry the patient’s foot. Take special care to dry well in between toes.
- Repeat for the other foot.
- File toenails as needed. Do not cut patient ‘ s toe nails . Discuss any needed advanced toe nail or foot care with a supervisor.
- If applying lotion on feet, take care to not apply lotion between the toes. Place socks and/or other footwear on patient once done.
- Apply nail polish as the patient requests.
- Discard the water and rinse the basin. Put away equipment and supplies.
- Lower bed to its lowest level and ensure side rails are up.
- Remove your gloves. Wash and dry your hands.
- Document completion of task and record any changes in condition or behavior. Report any skin conditions observed. Report and document any discoloration of the feet, blood, drainage, ingrown toenails, thickened toenails, reddened heels, or foot/ankle swelling.