What is Perineal Care?Perineal care refers to caring for the genital and rectal areas of the body. Specifically, perineal care covers the area known as the perineum. It encompasses the area between the anus and genitals. In women, this is the area between the anus and vulva (the exterior genitals). In men, it is the area between the anus and the scrotum. Show
The perineum contains structures (muscles, bones, etc.) that support the urinary, reproductive and gastrointestinal systems in your lower body. It helps protect the pelvic floor muscles and the blood vessels that supply the genitals and urinary system, as well as protecting blood vessels and nerves located there. These blood vessels and nerves provide sensation and nutrition to the genital area; in men, some of these nerves control urination or erection in men. The Importance of Perineal CareThe perineum’s location makes it important to support the lower organs such as the intestines and the bladder, as well as urinary and reproductive functions. However, the skin of the perineum is very thin and sensitive and is vulnerable to damage. In pregnant women, perineum tears can occur during childbirth while the baby is being pushed out of the birth canal. Moreover, any damage to the perineum can also affect the muscles, blood vessels and nerves located there, which could lead to various complications to the systems that depend on them, such as pelvic floor dysfunction. Because of its location, poor perineal hygiene can also lead to complications such as urinary tract infections (UTIs). Bacterial or fungal growth and even infections can lead to discomfort, pain or swellings that will require medical intervention to properly treat. Perineal Care for the ElderlyThe perineum must be cleaned thoroughly and regularly to prevent infections. This is especially important when you are caring for an elderly loved one who is bedridden. Bedridden seniors are confined to the bed indefinitely because of a permanent disability that prevents them from performing basic activities of daily living (ADL). Even if your loved one is not bedridden, other health complications could make it difficult for them to do things on their own. Bedridden seniors with incontinence or requiring a catheter for urination are at higher risk of developing a perineal infection. Because they are unable to control their bowel movements or bladder functions, the perineum can easily be stained by urine or waste matter, which can then lead to itching, unpleasant odours, a burning sensation, and the risk of developing infections if left unwashed. Perineal care also ensures that the risk of bedsores in that area is reduced. Bedridden loved ones are already at risk because they are constantly lying down at all times. It also helps to keep them comfortable at all times by preventing adverse reactions from affecting their rest and recovery. For elderly loved ones who retain some independence, teach them proper genital hygiene. This includes washing hands before and after using the toilet and keeping the perineal area dry and clean after using the toilet or taking a bath. Other healthy practices include wearing comfortable cotton clothes and underwear, showering regularly, and staying hydrated. Be sure to stay close by in case they may need help. It may be rather embarrassing for your loved one to depend on you to clean their private area. Be sure to discuss it with them beforehand, and tell them how you will help clean them and what they might need help with specifically, or if they may have particular requests or concerns. Having a heart-to-heart talk with them can help alleviate worries they might have by being able to speak to someone they can trust while maintaining their dignity. If caregiving for your loved one is complicated due to work or personal concerns, speak to them about hiring a professional caregiver and how it will be scheduled. Be sure to address their concerns clearly, and to take them into serious consideration to guarantee their safety. Perineal Care for the Elderly with DementiaIf your loved one has dementia, the caregiving process may be complicated because of their declining cognitive functions. As dementia progresses, communicating with your loved one becomes more difficult as they begin to lose their memory, become unable to articulate their feelings, or go into unpredictable mood swings. Providing the necessary care for them can be an arduous task if they are unable to think for themselves or recognise your efforts to care for them. Communication remains an essential tool in ensuring your loved one receives the best care you can give them. Be sure that they understand what you or the professional care provider are doing for them, and why it is important. Have consistent schedules for activities, such as bathtimes, that they can easily adhere to. If possible, involve them in the bathing process where possible. Be observant of any unprecedented changes and adapt accordingly Be sure to prioritise their safety at all times, as well. Falls are especially hazardous to elderly persons, so keep environments tidy and safe. Performing Perineal CareIf you are preparing to clean your loved one’s perineum, here are the items you will need:
Make sure you wash your hands thoroughly and rinse them before putting on gloves and beginning the care process. Also, ensure that there are no obstructions that can affect the cleaning process and make it uncomfortable for both of you. Tell your loved one that you will be washing their private area. Be sure that they are aware of what you will be doing in the process, and make it as comfortable as possible for them. Ensure you protect their privacy at all times. If they ask to be part of it, accommodate their request as best as you can and emphasise increasing their independence over time.
4a. For women, wash the external genitals first. Carefully wash them, including within the skin folds of the external genitals. Wipe from the perineum to the rectum (front to back) with short, downward strokes. Repeat on the opposite side with another part of the washcloth. Rinse and dry the area properly. 4b. Once done, carefully separate the labia (the external genitals) and wash downward from the pubic region to the rectum in a smooth stroke. Use a separate part of the washcloth with each stroke. Cleanse the area thoroughly, then rinse and dry the area from front to back. 5a. For men, gently hold the penis and retract the foreskin, if your loved one is uncircumcised. Carefully wash the penis from the tip using a circular motion. Be sure to use separate sections of the washcloth as you clean. When done, rinse and dry thoroughly, and return the foreskin to its natural position. 5b. Clean the shaft of the penis and the scrotum as well. Be sure to wash the underlying skin folds of the scrotum. Cleanse the area thoroughly, then rinse and dry the area from front to back.
If need be, take this time to also change the bedsheets so you do not have to bother them in the future. Perineal Care ComplicationsImproper perineal care can lead to a host of health complications. They can cause your loved one to experience a burning sensation, or itchiness, in the perineal area, or they can even lead to other complications caused by bacterial or fungal growth, or even infection. Urinary Tract Infection (UTI)A UTI affects your urinary system, which includes your urethra, bladder, ureters, or kidneys. UTIs are caused by bacteria that get into the urinary system, mainly the lower tract which include the urethra and bladder. Lower tract UTIs can cause perineum pain, a burning sensation when urinating, an intense and frequent need to urinate, as well as a dull pelvic pain. If it affects the upper tract (mainly the kidneys), the complications can be more severe, including fevers, chills, nausea, and urosepsis, where the bad bacteria gets into the blood and can cause low blood pressure or even death. Pelvic Floor DysfunctionThe pelvic floor refers to a group of muscles and ligaments in the pelvic region, or the lower part of the torso. Pelvic floor dysfunction refers to the inability to control the muscles of your pelvic floor, contracting them instead of relaxing them. This may happen because of conditions or injuries that weaken your loved one’s pelvic muscles or cause tears in the connective tissue. This dysfunction can negatively affect your loved one by causing perineum pain, unpleasant urinary or bowel issues, constipation, and pain in the lower back, rectum or genital area. Bedsores or Other InjuriesAny kind of injury to the perineum can cause a number of complications besides pain. This may include damage to the nerves and blood vessels in the perineum, which can then lead to other complications. Bedsores can also damage the skin lining of the perineum, making it more susceptible to infection. Getting Professional HelpIf you and your loved one feel that professional help is a better option, make sure you hire an accredited, professional home nurse that can help attend to your loved one’s needs. Generally, the process of hiring one will require you to provide information of your loved one’s conditions and what you will both need from caregiving by a nurse. For us here at Homage, we can cater to your needs by providing professionally trained care providers that are well versed in various fields, including dementia care, physiotherapy and more. They are able to provide companionship, nursing care, night caregiving, home therapy and more, to keep your loved ones active and engaged. Provide the best care to your loved one today! Fill up the form below for a free consultation with our Care Advisory team. Fill out the details below and our Care Advisors can get back to you with the care information you need. References Alzheimer’s Association. (2009). Dementia Care Practice Recommendations for Professionals Working in a Home Setting, Phase 4. Retrieved 15 February, 2022 from https://www.alz.org/national/documents/phase_4_home_care_recs.pdf Anthony, K. (2018). Pelvic Floor Dysfunction. Retrieved 15 February, 2022 from https://www.healthline.com/health/pelvic-floor-dysfunction Baptist Health. (n.d.). What is Perineum Pain? Retrieved 15 February, 2022 from https://www.baptisthealth.com/services/urology-care/specialties/perineum-pain Bolton NHS Foundation Trust. (n.d.). MATERNITY PERINEAL CARE LEAFLET. Retrieved 15 February, 2022 from https://www.boltonft.nhs.uk/wp-content/uploads/2017/12/Perineal-Care.pdf Centers for Disease Control and Prevention. (2021). Urinary Tract Infection. Retrieved 16 February, 2022 from https://www.cdc.gov/antibiotic-use/uti.html Cohen, K. R., Frank, J. & Israel, I. (2011). UTIs in the Geriatric Population: Challenges for Clinicians. U.S. Pharmacist, 36(6), 46-54. Retrieved 15 February, 2022 from https://www.uspharmacist.com/article/utis-in-the-geriatric-population-challenges-for-clinicians Daily Caring. (n.d.). How Often Should Seniors Bathe? 3 Essential Health Tips. Retrieved 15 February, 2022 from https://dailycaring.com/senior-bathing-whats-really-necessary/ Galan, N. (2021). The Importance of the Perineum in Childbirth. Retrieved 16 February, 2022 from https://www.verywellhealth.com/the-perineum-2616422 Green Tree Home Care. (2019). Perineal care for elderly adults: Here’s what you should know. Retrieved 15 February, 2022 from https://greentreehomecare.com/perineal-care-elderly-adults/ Hoffman, K. (n.d.). URINARY TRACT INFECTIONS IN THE ELDERLY [PowerPoint slides]. Retrieved 15 February, 2022 from https://spice.unc.edu/wp-content/uploads/2018/05/13-UTIs-in-the-Elderly.pdf Jewell, T. (2020). What Are The Causes of a Perineum Lump? Retrieved 15 February, 2022 from https://www.healthline.com/health/perineum-lump Lights, V. (2021). Everything You Need to Know About Urinary Tract Infection (UTI). Retrieved 16 February, 2022 from https://www.healthline.com/health/urinary-tract-infection-adults#_noHeaderPrefixedContent MedlinePlus. (n.d.). Skin care and incontinence. Retrieved 15 February, 2022 from https://medlineplus.gov/ency/article/003976.htm Milton Keynes University Hospital. (n.d.). Perineal Care. Retrieved 15 February, 2022 from https://www.mkuh.nhs.uk/patient-information-leaflet/perineal-care Mosby’s Nursing Video Skills. (n.d.). Bathing – Performing Perineal Care for a Female Patient. Retrieved 15 February, 2022 from https://www.ndsu.edu/pubweb/bismarcknursing/basic/skill/B004.html Mosby’s Nursing Video Skills. (n.d.). Bathing – Performing Perineal Care for a Male Patient. Retrieved 15 February, 2022 from https://www.ndsu.edu/pubweb/bismarcknursing/basic/skill/B005.html MSD Manual. (2020). Vaginal Itching and Discharge. Retrieved 15 February, 2022 from https://www.msdmanuals.com/professional/gynecology-and-obstetrics/symptoms-of-gynecologic-disorders/vaginal-itching-and-discharge MyHEALTH Kementerian Kesihatan Malaysia. (n.d.). Perineal care. Retrieved 15 February, 2022 from http://www.myhealth.gov.my/en/perineal-care/ Nall, R. (2021). What Causes an Itchy Perineum and How to Treat It. Retrieved 16 February, 2022 from https://www.healthline.com/health/itchy-perineum National Health Service. (2018). Keeping your vagina clean and healthy. Retrieved 16 February, 2022 from https://www.nhs.uk/live-well/sexual-health/keeping-your-vagina-clean-and-healthy/ Osborn, C. O. (2018). What Causes Perineum Pain? Retrieved 15 February, 2022 from https://www.healthline.com/health/perineum-pain Sager, B. (2019). 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Retrieved 15 February, 2022 from https://apps.who.int/iris/handle/10665/333290 When should perineal care be performed for an incontinent person?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.
What is perineal care for male?Perineal care involves washing the genital and rectal areas of the body. It should be done at least once a day during bed bath, shower, or tub bath. It is done more often when a patient is incontinent. This prevents infection, odors and irritation.
Why is perineal care important?Proper perineal care allows for inspection of the skin. It keeps the perineal area clean and less likely to break down. It also decreases the risk for urinary tract infections.
Which technique does the nurse use when providing perineal care for a male patient quizlet?The supine position is recommended for providing perineal care to male patients. Patients are placed in Fowler's position so the nurse can insert nasogastric tubes.
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