HOW HOUSEKEEPING AFFECTS PHYSICAL AND PSYCHOLOGICAL WELL-BEING

Providing a safe, clean, and orderly environment has always been a part of home health care. Illness and disability cause great stress. Clients feel better physically and psychologically and recover more quickly when their homes and families receive care and support.  Infection and accidents are prevented. In addition, families who lack some knowledge about how to manage their homes can be taught valuable house hold management skills. These skills include sanitation, safety, personal hygiene, nutrition, meal planning, shopping, child care, food preparation, communication skills, and specific healthcare techniques. You can be role model for your clients and their families by performing tasks efficiently and cheerfully .  

Here is a list of qualities needed to manage a home and describe general housekeeping guidelines
* Invite family participation. Depending on their abilities and availability client and family members may be asked to participate in housekeeping tasks.
* Invite family and client input when you determine the tasks that need to be done and the methods used.
* Use cleaning materials and methods that are acceptable and approved by the client and their family.
* Be organized when performing tasks. Write out detailed daily and weekly schedules. Seek feedback from your supervisor and the client and family.
* Build in some flexibility into the schedule to allow for changes in the clients condition, needs, appointments, or social activities.
* Organize cleaning materials and equipment by placing them in a closet. Do not leave cleaning equipment around the home.
* Familiarize yourself with the cleaning materials and equipment. Read the labels and the instruction booklets. 
* Maintain a safe environment as well as a clean and healthy one. Do not wax floors if your client is unsteady. Mop up spills immediately.
* Many diseases may be transmitted through improper food handling, dishwashing, hand washing, and unclean bathrooms and kitchens. Use house keeping  procedures and methods that promote health.
* These insects and animals are common carriers of disease. Observe the home environment for signs of infestation by roaches, rats, mice, and fleas.   
Controlling them is vital to family health and cleanliness.
* House keeping can require a great deal of bending, standing, stooping and lifting. Kneel instead of stooping for long periods of time. Use body mechanics in performing home maintenance activities to help prevent injury.
* Clean up and straighten up after every activity. Spills that have dried are difficult to remove later.
* Maintain a shopping lst on a bulletin board, refrigerator door, or other location, and encourage family members to use the list.
* Use your time wisely and efficiently. For example, prepare food while a load of laundry is being done.

Guidelines using household cleaning products

* Read and follow the directions on the label of every product you use. Cleaning products can harm the materials you are trying to clean.
* Do not mix cleaning products. This can cause a dangerous chemical reaction that may harm you or others. In particular, never mix bleach or products with ammonia. the fumes are toxic and can be fatal.
* Open windows when cleaning to provide fresh air. Some cleaning products have fumes that are unpleasant or even harmful if you are exposed to them for a long time.
* Do not leave cleaning products on surfaces longer than recommended time. Do not scrub too hard on some surfaces.
* Household bleach, diluted with four parts water, makes a strong disinfectant solution to clean bathroom surfaces. Diluted with nine parts of water and stored in a spray bottle, bleach makes a milder disinfectant to use on kitchen counters.
Describe proper cleaning methods for living areas, kitchens, bathrooms, and storage areas

Straightening and cleaning living areas:
* Clean up clutter and put objects away in their correct places and pick up newspapers, magazines, and toys as needed.
* Make beds each day. Empty wastebaskets and ashtrays daily.
* Keep essential and frequently used items within reach. Organize them on an accessible table, magazine rack, or hanging organizer.
* Dust and vacuum once a week or when necessary. If your client has allergies, you may need to dust or vacuum daily.
* Floors covered with vinyl, ceramic tile, and linoleum may be washed, some wood floors may not. Dry the floor after you have washed it or close off the area for the time it takes for the floor to dry.

Cleaning the kitchen:
* Clean the kitchen after every use. Ask the family to do the same. Do not wait till the end of the day to clean up. Daily kitchen cleaning tasks include washing dish's, wiping surfaces, taking out the garbage, and storing leftover food. Weekly tasks include cleaning the refrigerator and washing the floors.
* Wash dishes in hot, soapy water using liquid dish detergent. Rinse them in hot water. When working with clients who have an infectious disease or cold, use boiling water for rinsing and add a tablespoon of chlorine bleach to the soapy water.
* Wash glasses first then silverware, plates, and bowls . Pots and pans are washed last. Rinse with hot water and dry on a rack. Air drying dishes is more sanitary than drying with a dish towel. 
* If the house has a dish washer, learn how to correctly load and start it, read all instructions and what may not be put in the appliance. They may also sterilize dish's because of the high temperatures used in washing and drying. do not place the dishes to close together.
*Clean the outside of the stove, the trays, and burners with hot soapy water or an all-purpose cleaner and rinse. Ovens should be cleaned according to manufacturers recommendations. Do not spray the light bulb inside the oven with cleanser, or it may break.
* The refrigerator should be completely cleaned once a week. However  you should wipe it out more frequently. If the refrigerator is not a self defrosting unit, defrost the freezer when necessary. One-half inch of frost usually means it should be defrosted. 
* Mix two tablespoons of baking soda in one quart of warm water. Wipe the inside walls of the refrigerator and freezer. Baking soda will remove odors. Wash the shelves and trays with warm, soapy water.
* Clean counter tops, table, and the stove each time they are used. Clean cabinet and drawer fronts and the refrigerator once a week. If a cutting board or surface has been used to cut fresh meat, scrub the surface thoroughly with warm, soapy water. Rinse well.
* Never place food on soiled work or storage areas or in unclean containers. Keep Food Covered. Close lids of cartons and cover food storage containers to prevent contamination or infestation by insects and rodents.

Cleaning the bathroom:
*Involve the entire family in keeping the bathroom clean. Always wash from clean areas to dirty areas, so you do not spread dirt into areas that have already been washed.  
* Flush the toilet after every use.
* Clean toothbrushes, toothbrush holders, towel racks, holders of toilet paper, and be sure to clean the sides, walls, and curtains or door of the shower or tub.
* Scrub the tub and shower after use.
* Remove hair from drain strainers.
* Hang up all used towels to dry.  
* Put away toiletries. 
* Rinse the sink after brushing teeth, shaving, and washing.
* Place soiled towels in the laundry hamper after they are dry.
* Clean the mirror and any glass or chrome surfaces using glass cleaner or vinegar solution and paper towels or clean rags. Place dry, soiled rags in the hamper or discard wipes.
Cleaning and organizing storage areas:
* Every item in the home should have a storage place that is convenient for use. That means storage places should be as close as possible to where they are used. Items that frequently used should be easily seen and in reach. When they are used they should be replaced immediately. 
* Dangerous materials such as cleaning products should be stored out of reach of children and confused adults.
* Some storage areas need to be cleaned occasionally. Food storage areas and other storage areas that are used frequently should be cleaned more often.
* Do not change the clients or families storage arrangements without talking to them. If you think changes are needed, discuss your ideas with the family.

Cleaning solutions ideas:
 Several types of environmentally safe, non-toxic cleaning solutions can be prepared from common household items.
* Baking soda can be used instead of scouring powder. Baking soda can also be diluted with warm water to make a solution that will eliminate odors when used to clean surfaces.
* White vinegar can be used to remove lime or other mineral deposits on sink, toilets, or chrome fixtures. it cuts grease and removes mildew and odors. When diluted with water can be used instead of glass cleaner. Mix solution using one part white vinegar to three parts water, can also be used to clean sealed wood and tile floors.
* Lemon juice, by itself or mixed with water or other ingredients, can be used to eliminate odors, clean and disinfect surfaces, and cut grease.
* Borax, or sodium borate, is a white powder that dissolves in water. Borax can be used to clean, eliminate odors, and disinfect. While borax is natural and is not an environmental toxin, it should not be swallowed, and it can cause skin irritation. Use care in handling.

Special housekeeping procedures to use when infection is present:
You must follow standard precautions with every client. This is true because you can not know when infection is present.However, when a client has a known infectious disease, such as influenza, you need to take special precautions in housecleaning.
* Use disinfectant when cleaning counter tops and surfaces in the kitchen and bathroom. 
* Clean the clients bathroom daily. Have other family members use a different bathroom if possible.
* Use separate dish's and utensils for the infected client.
* Wash dish's and utensils in the dishwasher or hot soapy water with bleach. Rinse in boiling water and let air dry.
* Disinfect any surfaces that contact body fluids, such as bedpans, urinals, and toilets.
* Frequently remove trash containing used tissues.
* Keep any specimens of urine, stool, or sputum in double bags or sealed sandwhich bags away from food or food preparation areas.

How to do laundry and care for clothes:
* Sort clothes carefully. Make separate piles of whites, colors, and bright colors. Check clothing labels for special washing instructions.Do not wash anything labeled"dry clean only". If hand washing is recommended, do not put in washing machine.
* As you sort laundry, check pockets and remove any foreign objects, remove belts, trims and non-washable ornaments. Close zippers, buttons, and other fasteners. Check garments for stain and areas of heavy soil. If appropriate, mend or repair any holes, snags, rips, tears, pulled seams, and weak spots in garments and other items.
* Use the correct water temperature: hot for whites, warm for colors, cold for bright colors, and delicate fabrics. Use the appropriate laundry products.Follow the washing instructions on the container.
* Follow written instructions or client or family instructions for using the washer. Use the correct washing cycle for the load you are laundering.
* Dry clothes completely either in a dryer, or on a clothes line. If using a dryer, follow the drying instructions. 

Special laundry precautions to use when infection is present
 When a client has a known infectious disease, you must take special precautions when handling laundry:
* Keep clients laundry separate from other family members.
* Handle dirty laundry as little as possible. Do not shake it. Sort it and put it in a plastic bags in the clients room or bathroom. Take it immediately to the laundry area.
* Wear gloves and hold laundry away from your clothes and body when you are handling it.
* Use liquid bleach when fabrics allow.
* Use agency approved disinfectants in all loads.
* Use hot water.  

The importance of sleep and why careful bedmaking is important

Sleep is a natural period of rest for the mind and body. Many elderly persons have sleep problems. Many things can affect sleep, such as fear, anxiety noise, diet, medications, and illness. When a client complains that he or she is not sleeping well, observe and report any of the following:
* Sleeping too much during the day.
* Eating or drinking items that contain too much caffeine late in the day
* Wearing night clothes during the day
* Eating heavy meals late at night
* Refusing to take medication ordered for sleep
* Taking new medications
* Having TV, radio, or light on late at night
* Experience pain

When clients spend all their time in bed, careful bedmaking is essential to their comfort, cleanliness, and health. Linens should always be changed after personal care procedures such as bed baths or any time bedding or sheets are damp, soiled, or in need of straightening. Bed linens should be changed often for these reasons:
* Sheets that are damp, wrinkled, or bunched up under a client are uncomfortable. They may prevent the client from resting or sleeping well.
* Microorganisms thrive in moist, warm environments. Bedding that is damp or unclean encourages infection and disease.
* Clients who spend long hours in bed are at risk for pressure ulcers. Sheets that do not lie flat under the clients body increase the risk of pressure ulcers because they cut off circulation.
Making an occupied bed
If a client cannot get out of bed, you must change the linens with the client in bed:
* Wash your hands
* Explain the procedure to the client, speaking clearly, slowly, and directly. Maintain face-to-face contact whenever possible
* Provide privacy if the client desires it
* Place clean linen on clean surface within reach.
* If the bed is adjustable, adjust the bed to a safe working level usually waist high. If the bed is moveable, lock bed wheels.
* Put on gloves
* Loosen top linen from the end of the bed on the working side
* Unfold the bath blanket over the top sheet to cover the client, remove the top sheet. Keep the client covered at all times with the bath blanket.
* You will make the bed one side at a time. Raise the side rail (if the bed has one) on the far side of bed. This protects the client from falling out of bed while you are making it. After raising the side rail, go to the other side of the bed. Help the client to turn on their side, moving away from you toward the raise side rail.
* Loosen the bottom soiled linen, mattress pad, and protector, if present, on the working side.
* Roll bottom soiled linen toward client, soiled side inside. Tuck it snugly against the clients back.
* Place the mattress pad (if used) on the bed, attaching elastic at corners on working side.
* Place and tuck in clean bottom linen, finishing with bottom sheet free of wrinkles. If you are using a flat bottom sheet, leave enough overlap on each end to tuck under the mattress. If the sheet is only long enough to tuck at one end, tuck it in securely at the top of the bed. Make hospital corners to keep bottom sheet wrinkle-free.
* Smooth the bottom sheet out toward the client. Be sure there are no wrinkles in the mattress pad. Roll the extra material toward the client an tuck it under the clients body.
* If using a waterproof bed protector, unfold it and center it on the bed. Tuck the side near you under the mattress. Smooth it out toward the client, and tuck as you did with the sheet. If using a draw sheet, place it on the bed. Tuck in on your side, smooth, and tuck as you did with the other bedding.
* Raise side rail nearest you. Go to the other side of the bed and lower the side rail on that side. Help to turn the client onto the clean bottom sheet. Protect the client from any soiled matter on the old linens.
* Loosen the soiled linen. Check for any personal items. Roll linen from head to the foot of the bed. Avoid contact with your skin or clothes. Place it in a hamper or basket. Never put it on the floor or furniture. Never shake it. Soiled bed linens are full of microorganisms that should not be spread to other parts of the room.
* Pull the clean linen through as quickly as possible. start with the mattress pad and wrap around corners. Pull and tuck in clean bottom linen just like the other side. Pull and tuck in waterproof bed protector and draw sheet, if used. Finish with the bottom sheet free of wrinkles.
* Ask client to turn onto their back. Help as needed. Keep client covered and comfortable, with a pillow under their head. Raise the side rail.
* Remove the pillow. do not hold it near your face. Remove the soiled pillow case by turning it inside out. Place it in the laundry hamper.
* Remove and discard gloves. Wash your hands.
* If you raised an adjustable bed, return it to its lowest position. Leave side rails in the ordered position. Put any signaling device within the clients reach. Carry laundry hamper to laundry area.
* Wash your hands
* Document the procedure and any observations.
Making an unoccupied bed
If a client can be moved temporarily to a chair or other comfortable spot, your job will be much easier.
* Wash your hands
* Place clean linen on a clean surface within reach
* If the bed is adjustable, adjust bed to a safe working level, usually waist high. If the bed is moveable, lock bed wheels.
* Put  on gloves
* Loosen soiled linen. Roll soiled linen (soiled side inside) from head to foot of bed. Avoid contact with your skin or clothes. Place it in a hamper or basket.
* Remove and discard gloves
* Remake the bed. Start with the mattress pad and wrap around corners. Place bottom sheet, tucking under the mattress. Make hospital corners to keep the bottom sheet wrinkle- free. Put on waterproof bed protector and draw sheet, if used, smooth, and tuck under sides of bed.
* Place top sheet and blanket over bed. Center these, tuck under end of bed, and make hospital corners. Fold the top sheet over the blanket about six inches. Fold both top sheet and blanket down so the client can easily get into bed. If client will not be returning to bed immediately, leave bedding up.
* Remove pillows and pillow cases. Put on clean pillow cases and replace pillows.
* If you raised an adjustable bed, return it to its lowest position. Put any signaling device within the clients reach. Carry laundry hamper to laundry area.
* Wash your hands
* Document the procedure and any observations.    

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* 1. Clean, Safe, and Healthy Environments Quiz
Employee Name:

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* 2. Which of the following housekeeping assignments might a homecare aide be asked to do?

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* 3. How often should wastebaskets and ashtrays be emptied?

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* 4. Which of the following should an HHA not do when washing dish's for a client who has an infectious disease or cold?

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* 5. In what time frame should left over food be eaten?

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* 6. Why is it important to read the instructions for cleaning products?

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* 7. It is helpful to make a cleaning schedule?

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* 8. An aide should clean the bathroom of an infectious person at least once a week?

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* 9. Storage places should be as close as possible to where they are used?

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* 10. Do not change the clients or family's storage arrangements without talking to them first.

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* 11. Cleaning and organizing storage areas will contribute to the order and organization of the home?

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* 12. When handling the laundry of a client with an infectious disease which of the following should they not do?

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* 13. List 3 factors that can affect sleep.

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* 14. What is the safest washing temperatures for most garments?

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* 15. List a guideline for dealing with the dish's of and utensils of a client with an infectious disease.

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* 16. Which of the following problems can a lack of sleep cause?

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* 17. Where should hazardous household materials be kept?

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* 18. How frequently should the refrigerator be cleaned?

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* 19. When making a bed with a client in it you should roll linen from the head to the foot of the bed?

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* 20. Why should cleaning products not be mixed?

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