How can I keep myself looking presentable and tidy?

Every day we have to carry out different activities for our own wellbeing. Our self care is our own responsibility. It is important because it impacts on how we feel about ourselves and what others think of us. Part of looking after ourselves is knowing when to take our medication. It is important to take your medication correctly as it can affect your ability to look after yourself.

Self care includes:

• Showering and bathing
• Dressing
• Grooming and personal hygiene
• Taking medication
• Eating

 

How can I be more independent in washing myself?

Showering includes washing, using soap and drying. Showering is important to help you stay clean and healthy. When you don't wash regularly using soap your body is more likely to get infections from bacteria that live on your skin. Showering also helps you to look healthy, clean and tidy. When you look healthy and clean, people are willing to talk with you. When you look good, you also often feel good.

After a brain injury you may not be able to shower as you used to before the injury. This may be because you have:

• difficulty with your balance
• received some fractures that have limited your ability to move in different directions
• difficulty getting yourself organised and remembering everything you need
• remembering the different steps to shower properly
• problems with your sensation, feeling hot and cold temperatures.

Suggestions

Some suggestions that may help you to shower successfully include:

• Pictures or written instructions to remind you of the necessary steps needed to wash and dry yourself.
• A thermostat or temperature control on your hot water if you have difficulty regulating the water temperature - feeling hot or cold.
• Setting up your shower with all the necessary items you will need so they are always there. For example, your soap, shampoo and conditioner, shaving cream and razor in the shower recess.
• Placing all your shower items in a toiletry bag so you only have to remember to bring the toiletry bag to the shower recess.

Helpful hints

Equipment that might be useful to help you be safe in the shower include:

• Shower chair; shower stool; bath board or commode chair depending on your physical needs. By sitting to shower you can safely wash your legs, body and hair without fear of overbalancing. If you get tired after standing or need a rest to let you do all your showering yourself, this equipment can let you rest between each step. Sitting can also help when you dry yourself. You can safely reach your legs and feet, and if you place a second towel on the chair after you have showered, you can lean back on the chair and dry your back and buttocks.


• Rails in the shower recess. Rails can be fitted in your shower recess or around your bath to help you safely get in and out of the bath or shower, or to help you stand from sitting if you sit to shower or bath. Rails need to be recommended by an occupational therapist so they will best suit you.


• A shower hose. A shower hose is a shower rose that is able to be held in your hand and has a long rubber hose that connects it to the wall. A hand-held shower enables you to move the water to the places that need washing. They are good if you are sitting to shower.


• A long-handled brush to wash your back and feet if you are unable to reach can be useful.


• A soap mitt if you drop the soap and have difficulty picking it up.


• After showering, you can put on a terry-toweling bathrobe that will help you dry yourself off between the bathroom and where you get dressed.

Talk to an occupational therapist who can recommend the equipment or bathroom modifications which will help you be most independent.

Joan's Experience

Joan was a resident in a nursing horne. One of her goals was to shower independently. Joan stated she couldn't remember what she had done and what she hadn't done. Joan stated she would frequently forget to bring everything she needed to the shower and wouldn't wash properly because of this. A few simple strategies were suggested to Joan by the occupational therapist that enabled Joan to be independent in showering. Joan placed everything she needed for her shower in a toiletry bag. She kept her shampoo and conditioner, soap and face washer in her toiletry bag. Joan made a list of what should be in the toiletry bag with the occupational therapist. Prior to showering every morning Joan would check she had all these items using a checklist in her room. When in the shower recess Joan used a large checklist that told her what to wash. The checklist referred to hair, face, neck, front of body, back, arms and underarms, legs and "privates" Joan was independent in showering using this checklist.

Joan was a little unsteady on her feet and felt like she was going to fall when showering. Joan was provided with a shower chair so she could sit when she showered. A hand-held shower was installed so Joan could direct the water to where it was needed. Joan stated she felt much safer in the shower recess now she was sitting.

Joan didn't like dressing in the shower recess because her clean clothes got wet. It was suggested Joan use her bathrobe between her bedroom and the shower recess and vice versa. Joan said this was great because it meant she only had to worry about her bathrobe not getting wet. She also said she had free hands to carry her toiletry bag. Joan no longer wants staff around when she showers - in fact Joan requests to be able to do it herself!

 

How can I be more independent in dressing myself?

Dressing includes:

• knowing what clothes to wear in different types of weather and in different situations
• taking clothes off and putting clothes on, including doing up buttons, zippers, putting on shoes and any splints or slings needed as well.

Dressing helps you look presentable. When you look presentable, people are willing to talk with you. When you look good, you also often feel good.

After a brain injury you may not be able to dress as you used to before the injury. This may be because you have:

• difficulty with your balance
• received some fractures that have limited your ability to move in different directions
• difficulty knowing what clothes to wear
• difficulty getting yourself organised and remembering where everything you need is kept in your bedroom
• remembering what order to put your clothes on
• keeping clean clothes on hand (See Section 17 Laundry).

Helpful hints

Some suggestions that may be helpful when dressing successfully include:

• Sitting on the edge of your bed or on a chair when you dress. This will help you safely get to your legs and feet to put on your underpants, pants, socks or pantyhose without falling. Once you have them on your feet you can stand to pull them up. You can also dress your upper body when sitting.


• To help you remember where you keep your clothing around the bedroom, label your drawers and cupboards. For example, socks, T-shirts, jeans.


• To know what clothes to wear for different types of weather, remember to look out the window of your bedroom and see what the weather is like outside. Once you have done that remember what season it is. This will also help you decide what clothes are most appropriate to wear.


• Different clothes are required for different situations. The clothes you wear around the house are different to the ones you would wear if you were going out to dinner with friends at a restaurant in the city. To save you having to change your clothes unnecessarily during the day, work out what activities you have planned. You then can make a decision about what the most appropriate clothing would be.


• Sometimes remembering what order to get dressed in and what clothes you have to put on can be confusing. To help you get it right all the time develop a checklist. For example, put on underwear, socks, pants and shirt. You can have written instructions or pictures to help you remember the right order.


• People who have one arm that is weaker or does not work as it used to, may find it difficult to dress themselves. Some hints to help you be independent in dressing include wearing button up shirts. Button up shirts allow you to dress your weaker arm first. You can then bring the shirt around your back and dress your stronger arm. You can then use this arm to do up the buttons -using one hand if you have to. If you are wearing a T-shirt, you can do the same thing. Dress your weaker arm first. Make sure you pull your T-shirt up over your elbow. Then place the T-shirt over your stronger arm. Pull the T-shirt to your shoulder, and then pull it over your head. Bigger T-shirts are better as looser shirts are easier to get over your head.

Helpful equipment

Some equipment that may be helpful doing the above include:

• Button hooks, if you have one stronger arm.
  
  
• Dressing sticks, to help you dress legs.


• Sock/Stocking gutters, to help you put on your socks and stockings.


• Easy reachers. Easy reachers act like an extension of your hand. They have a small claw that you can use to pick up your clothing and pull it over your legs.


• Elastic shoelaces, no bows or slip on shoes, shoes without shoe laces.

Shane's experience

Shane was not able to use one of his arms following his brain injury. He was unsteady on his feet and not able to balance on one leg. Shane was finding it difficult to get dressed. He wanted to stand to dress as he used to. Unfortunately he kept overbalancing and as a consequence had a few falls. His parents were concerned and Shane stated they kept "fussing" over him. Shane wanted to dress himself without their help. The occupational therapist worked with Shane toward his goal of dressing independently.

Shane now sits to dress himself. When he is sitting he can dress both of his legs and put on his own shoes. Shane wears his ordinary joggers and tucks his shoe laces into the side of his shoes. Shane learnt how to dress his upper body using one hand. He can independently don a shirt with buttons and a T-shirt. Shane learnt how to do up buttons single handedly. Shane has had no falls since learning these new techniques and his family has left him to dress by himself.

 

 

How can I be more independent in looking presentable and well groomed?

Grooming includes brushing hair and teeth, shaving or applying make-up, washing hands and face. Grooming is the final step in helping you to look healthy, clean and tidy. When you look clean and tidy, people are willing to talk with you. When you look good, you often feel good also.

After a brain injury you may not be able to do grooming activities as you used to before the injury. This may be because you have:

• difficulty with your balance
• received some fractures that have limited your ability to move in different directions
• difficulty getting yourself organised and remembering everything you need
• problems with your sensation, not knowing how hard you are putting make-up on or are shaving.

Helpful hints

Some suggestions to make it easier include:

• Setting up all items in the bathroom. You can then label the cupboards to know where different items are. You can keep your deodorant in one drawer, make-up in another drawer. The secret is to keep everything in the one place.
  
  
• Having pictures in the toilet / bathroom reminding you how to do your personal grooming. A checklist to help you make sure you clean your teeth, brush your hair and put on deodorant.
  
  
• You can use long-handled brushes and combs to groom your hair. If you used to pull your hair back in elastics you may have to trial other elastics or clips to see how you can be most independent.

Helpful equipment

Equipment that might be useful:

• A suction brush stuck to the sink can enable someone with one stronger hand to either clean their dentures or wash their fingernails.


• A toothpaste dispenser can allow you to push down to load your toothbrush.


• An electric toothbrush can help you to clean your teeth if you find it difficult to move your hand in the cleaning action.


• A chair can provide you with a way to sit and perform these tasks safely and provide you with a chance to take your time and rest as needed.


• An electric shaver can allow you to shave independently if you have a tremor or have difficulty knowing how heavily you are pressing against your skin. Electric shavers are available for men and women.


• Perform the activity in front of a mirror. You can then see what you are doing.

Gemma's story

As a result of Gemma's accident she received some facial scarring. Gemma spent about one hour each day covering the scarring. She had special cream to assist in the management of her scarring and then spent time carefully applying make-up. Gemma did not like going out without wearing make-up as she was very conscious of what her scarring looked like. Gemma became tired when standing in her bathroom and applying her make-up. She stated when she became tired she used to smudge her make-up and then it would take her twice as long. Gemma realised it took her a long time to get ready for the day and was conscious of the impact it had on the other people she shared the house with.

Gemma worked with the occupational therapist to see how she could speed up the process. The first goal Gemma and the occupational therapist identified to work on was to reduce Gemma's tiredness. To do this it was suggested Gemma use a chair to sit and perform her scar management and apply her make-up. Gemma found this too difficult at first because it was different to how she normally did it. Gemma persevered and with time got used to sitting. She found she did not get tired and did not make any mistakes. Within three months, Gemma was able to perform her skin care routine in half the time. This made her and her flatmates very happy!

 

How can I make sure I take my medication properly?

Taking medication properly involves remembering to renew scripts, purchase medication at the chemist, knowing how much medication to take and remembering when to take your medication.

Helpful hints

To remember to renew scripts follow these steps:

• Mark on a calendar or in your diary when you started your new packet of medication.
  
  
• On the packet of the medication it will tell you how long that box will last. Count that number of days from the date you marked on the calendar as having started your new packet of medication. Mark this date on your calendar. This is when you will need to get another script of medication filled by:
  
  
• Some scripts have repeats marked on them. There will be a number of repeats. This varies. If your prescription has repeats, make sure you fill the repeat prior to the date marked on your calendar that tells you when you will run out of your current medication. If your prescription does not have repeats, you will need to see your doctor to get another script prior to your current medication running out.
  
  
• Medication can be expensive so it is important to budget for how much it will cost and when the best time is to get it. See Section 12 Finances and Money Handling, to know how to budget for medication. This budgeting section will also help you identify when it is best to purchase your medication. Medication is very important. It is as important as paying rent and buying your food. Paying for your medication is more important than purchasing a CD or having a take-away meal. Medication enables you to be well and in control.

Helpful equipment

Equipment that might be useful if you take one or more medications:

• A whiteboard where you can write down when you are meant to take your medication and what medication you are meant to take. You can then place a tick next to the medication when you have taken it. You can do this same thing in your diary also. If you are using a diary or whiteboard to help you take your medication, you must make sure you set up your diary or whiteboard to help you each day. See Section 13 Managing Your Time, to show you how.
  
  
• A blister pack can be arranged with your local chemist. They will put all your tablets in the one 'blister' and mark them with the time of day when they are to be taken. For example, Tuesday morning. You then push the tablets out of the blister and take them. Later, if you are unsure if you took your medication, you can then look at the blister pack and see whether or not you have taken your medication. The chemist will charge you for this service.
  
  
• Sometimes you can be taking lots of different medications and it is hard to keep track of what each one is and what it is for. So you will always know what you are taking and why, it is useful to write this down. Using an exercise book, write down the names of the different medications. Write down when you were given that script. Ask your doctor what the medication is for. Write this down underneath the name of the medication. You can draw a picture of the medication, noting its shape, size and colour to help you recognise it. Also write down when you are meant to be taking the medication and how many you are meant to be taking. This will help you keep track of the medication you are taking.

Calvin's story

Calvin had his brain injury in a car accident. He spent time in an inpatient brain injury service and went to a transitional living unit before going home. In the transitional living unit Calvin identified he wanted to be independent in taking his own medication. He worked with the occupational therapist to work out some ways he might be able to remind himself of what he was taking and when he was meant to take it.

Calvin didn't know what the different medications he was taking were. So he wrote in the back of his diary what each was, what it looked like and when he was meant to take it. He filled this out with his doctor in a clinic appointment.

Calvin's medication was filled in a blister pack. This meant he didn't have to work out what particular medication he was taking when. To remember when he had to take medication he used his whiteboard and an alarm on his wristwatch. Calvin had to take medication in the morning and evening. Calvin would write on his whiteboard the times he had to take his medication. At night he would clear off his ticks beside when he took his medication that day. He then would set his wristwatch alarm for the next morning. That morning he would tick on his whiteboard that he had taken his medication and reset his alarm for the evening time medication. That night he would take his medication from the blister pack, tick on his whiteboard he had taken his evening medication and then set his watch for the following morning.

Calvin occasionally slipped up, however the staff at the transitional living unit and then his family at home provided supervision. Calvin felt he had achieved his goal, as he was responsible for ensuring he took his medication. Calvin's mother was glad, as she didn't have to "nag" him to take his medication.