6.3 Hair Care, Grooming, and Shaving

Hair Care, Grooming, and Shaving

Grooming is far more than cosmetic. How a resident looks shapes their self-image, mood, and willingness to socialize, so careful grooming is part of dignified, person-centered care. CNAs assist with hair care, shaving, and basic nail care while respecting individual and cultural preferences.

Hair Care

Brush or comb the hair at least daily. To work out tangles, start at the ends and work upward toward the scalp, holding the hair above the tangle so you do not pull on the scalp. Use a wide-tooth comb on coarse or curly hair and never cut out a tangle without permission. Inspect the scalp for sores, dandruff, dryness, and lice (pediculosis) during care.

Shampoo methods are matched to mobility:

When shampooing in bed, protect linens with a waterproof pad, keep water at 105°F or less, rinse until no soap remains (residue itches), and dry the hair to prevent chilling.

Cultural and Personal Preferences

Always ask before you begin. Tightly coiled or African American hair often needs less frequent washing, leave-in moisturizer, and should not be brushed dry. Some Orthodox Jewish and Muslim women keep their hair covered and require strict privacy. Document and honor each resident's products and routine.

Shaving

CNAs favor the electric razor for safety because there is no exposed blade.

Always use an electric razor for residents on anticoagulants such as warfarin (Coumadin), heparin, or apixaban (Eliquis), residents with a bleeding disorder, and residents who move unexpectedly. Before shaving, inspect the face and avoid moles, warts, and skin lesions, pull the skin taut, and shave in the direction of beard growth (electric razors may move in small circles). Clean the razor per facility policy afterward. If facility policy permits a safety razor, soften the beard with a warm wet towel, lather with shaving cream, shave in the direction of growth, rinse the blade often, and discard blades in a sharps container.

Nail Care and Scope of Practice

Basic nail care is within the CNA role, but cutting nails for certain residents is outside CNA scope because a nick can become a non-healing wound or serious infection.

When filing, file in one direction rather than sawing back and forth, and shape toenails straight across to prevent ingrown nails. Apply lotion to keep skin supple, but do not apply lotion between the toes, where trapped moisture promotes fungal infection. Report any foot wound, redness, or thick discolored nail on a diabetic resident to the nurse immediately.

Foot Care and Diabetic Considerations

Daily foot care is a quiet but important grooming duty, especially for residents with diabetes. Wash the feet with mild soap and water no hotter than 105°F, rinse, and dry carefully, paying special attention to the spaces between the toes where moisture causes maceration and fungal infection. Inspect the soles, heels, and toes for cuts, blisters, calluses, redness, and any color change, since a diabetic resident may not feel a developing wound. Apply lotion to the tops and bottoms of the feet but never between the toes, and make sure socks are clean, dry, and free of tight seams.

Report any open area, swelling, or change in skin color immediately, because in poor-circulation residents a minor sore can progress to a serious ulcer.

Makeup, Beard, and the Care Plan

Grooming also includes the small touches that make a resident feel like themselves: applying makeup the way they prefer, trimming or maintaining a beard or mustache to their usual style, and keeping eyeglasses and hearing aids clean and in place. Always ask the resident or check the care plan rather than assuming. Let the resident look in a mirror and approve the result when possible. These steps cost little time but have a large effect on mood, cooperation, and the sense of being treated as an individual rather than a task.

Whenever a grooming preference is unclear, ask the resident, the family, or the nurse rather than guessing, and document any new preference so the whole team can honor it.