Question

Discuss how to address poor perineal hygiene with a parent without seeming to imply that he or she is neglecting the child.

Answer 1

Perineal care is usually called “peri care.” It means washing the genitals and anal area. Peri care can be done during a bath or as a separate procedure. Peri care prevents skin breakdown of perineal area, itching, burning, odor, and infections.
Peri-care—also known as perineal care—involves cleaning the private areas. Because this area is prone to infection, it must be cleaned at least daily, and more if your loved one suffers from incontinence. Typical times to perform peri-care include as part of daily bathing, after the use of the bedpan, and following episodes of incontinence. Regular peri-care can not only minimize odors, it can also can help prevent urinary tract, bladder and kidney infections.

Moving from front to back, use warm water and a clean washcloth (or disposible wipes) to clean the perineal area. For females, this involves cleaning the inner legs, labia and groin area while for men it requires cleaning the tip and shaft of the penis, along with the scrotum. Both men and women require cleaning of the anal area, which will involve turning the patient on his/her side. If possible, use a fresh wipe for each "swipe". If using a wash cloth, use a clean area of the cloth for each motion, and never move from back to front as this can spread germs and cause urinary tract infection. Have several wash cloths handy just in case you need more than one.

If your loved one has a foley catheter, wipe around and down the tubing, but avoid tugging on the foley as this can be painful and harmful. When you are finished and the entire perineal area is clean, make sure to thoroughly dry each area as excess moisture can lead to chapping and bed sores. Moisturizers and creams can help protect this delicate area. Always be gentle, as this area of the body is sensitive.

Occasionally bed linens will become soiled during perineal care. If so, remove them and launder them along with the wash cloth. A waterproof pad placed under the buttocks, meanwhile, can be a moisture barrier between your loved one and the bed linens.

Remember: the more comfortable you feel with this task, the more comfortable your loved one will feel. Conversely, if you treat peri-care awkwardly or with disdain, your loved one's discomfort will be amplified. Maintain a pleasant demeanor, and be sure to explain what you're doing every step of the way.