The main function of a nursing assistant is to provide assistance to clients with activities of daily living. Activities of daily living (ADLs) include hygiene, grooming, dressing, fluid and nutritional intake, mobility, and elimination needs. See Figure 5.1^[1] for an illustration of ADLs. Hygiene refers to keeping the body clean and reducing pathogens by performing tasks such as bathing and oral care. Grooming also keeps the body clean but refers to maintaining a resident’s appearance through shaving, hair, and nail care.

Specific ADLs are provided based on the time of day and the needs of the resident. Personal care performed in the morning is referred to as A.M. care, and personal care performed in the evening is referred to as P.M. care. Full baths or showers may be provided with either A.M. or P.M. care, depending on resident preferences, but a partial bath should be provided each morning.

A.M. care includes tasks such as the following activities:

• Toileting, changing incontinence brief (if used), and providing perineal care
• Performing oral and/or denture care (before or after breakfast based on resident’s preference)
• Assisting with a partial bath, full bath, or shower depending on the resident’s personal schedule
• Changing the client’s hospital gown or assisting with dressing
• Assisting with grooming, such as shaving or hair care, and applying makeup, accessories, or jewelry per resident preference
• Assisting with eating breakfast
• Providing hand hygiene to the resident as needed
• Assisting with attending activities, physical therapy (PT), and occupational therapy (OT)
• Making the bed and tidying the resident’s room

P.M. care includes tasks such as the following activities:

• Toileting
• Assisting with lunch and dinner
• Assisting with a partial bath, full bath, or shower depending on the resident’s personal schedule
• Assisting with oral and denture care before bed
• Helping with oral care after meals if resident prefers
• Washing face and removing makeup if worn
• Changing into gown or pajamas
• Providing hand hygiene to resident as needed
• Tidying the resident’s room