{"id":1609,"date":"2024-09-26T18:29:35","date_gmt":"2024-09-26T22:29:35","guid":{"rendered":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/back-rub-2\/"},"modified":"2024-09-27T17:11:19","modified_gmt":"2024-09-27T21:11:19","slug":"back-rub","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/back-rub\/","title":{"raw":"4.5 Back Rub","rendered":"4.5 Back Rub"},"content":{"raw":"<p style=\"text-align: justify;\">Back rubs can conveniently be given after baths, before bedtime, or after repositioning. Back rubs help boost relaxation, stimulate circulation, and promote sleep. Back rubs do not need to be long, and typically take about 5 minutes of your time. Always ensure it is okay to provide a back rub. Health Care Assistants must check with their supervisor and check the care plan. Again, giving a back rub gives the HCA the opportunity to observe skin condition for rashes, bruises, red, white, or open areas, and other signs of skin breakdown. Always report and record observations of any changes in skin condition.<\/p>\r\n\r\n<h1>Purpose for Giving a Back Rub<\/h1>\r\n<ul>\r\n \t<li>To give comfort<\/li>\r\n \t<li>To stimulate blood circulation<\/li>\r\n \t<li>To promote rest and sleep<\/li>\r\n \t<li>To prevent pressure sores<\/li>\r\n \t<li>To observe the skin condition<\/li>\r\n \t<li>To relax and relieve tension in tissues and muscles<\/li>\r\n \t<li>To refresh the client and relieve fatigue<\/li>\r\n<\/ul>\r\n<h1>General Instructions for Giving a Back Rub<\/h1>\r\n<ul>\r\n \t<li>Back care is given as a part of A.M. care and P.M. care.<\/li>\r\n \t<li>When giving a back rub, use more pressure (gentle) on the upward strokes towards the head and less pressure on the downward strokes.<\/li>\r\n \t<li>Back rubs may be contraindicated in clients susceptible to clotting disorders \u2014 check with the supervisor.<\/li>\r\n \t<li>Do not take your hands off of the client\u2019s back until the end of the procedure.<\/li>\r\n \t<li>Stop the back rub if, at any time, the client reports discomfort or no longer wishes you to continue.<\/li>\r\n<\/ul>\r\n<table class=\"grid\" style=\"border-collapse: collapse; width: 100%;\" border=\"0\"><caption>Table 4.5.1 Procedure: Back Rub<\/caption>\r\n<thead>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"col\">STEP<\/th>\r\n<th scope=\"col\">ACTION<\/th>\r\n<th scope=\"col\">REASON<\/th>\r\n<\/tr>\r\n<\/thead>\r\n<tbody>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">1.<\/th>\r\n<td>Explain the procedure and position to the client.<\/td>\r\n<td style=\"width: 42.3715%; height: 15px;\"><\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">2.<\/th>\r\n<td>Perform hand hygiene and gather all supplies.<\/td>\r\n<td style=\"width: 42.3715%; height: 15px;\">Good organization is time efficient.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">3.<\/th>\r\n<td>Adjust bed to a comfortable height.<\/td>\r\n<td style=\"width: 42.3715%; height: 15px;\">Prevent back strain and injury.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">4.<\/th>\r\n<td>Provide privacy and adjust the light, temperature, and sound in the room.<\/td>\r\n<td style=\"width: 42.3715%; height: 31px;\">Client comfort.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px;\">\r\n<th scope=\"row\">5.<\/th>\r\n<td>Lower the side rails and help the client assume a prone or side-lying position (Sim\u2019s position).<\/td>\r\n<td style=\"width: 42.3715%; height: 31px;\"><\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">6.<\/th>\r\n<td>Expose the client\u2019s back, shoulders, upper arms, and buttocks, and cover the remainder of the body.<\/td>\r\n<td style=\"width: 42.3715%; height: 31px;\"><\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px;\">\r\n<th scope=\"row\">7.<\/th>\r\n<td>Use lotion that has been warmed in a basin of warm water, or by running the bottle under warm water for a few minutes.<\/td>\r\n<td style=\"width: 42.3715%; height: 31px;\"><strong>Do not heat lotion in the microwave. Rationale: It may explode or be too hot and burn the skin.<\/strong><\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px;\">\r\n<th scope=\"row\">8.<\/th>\r\n<td>\r\n<ul>\r\n \t<li>Place a small amount of lotion in your hand, and rub your palms together to warm the lotion and lubricate your hands.<\/li>\r\n \t<li>Caution the client that the lotion may still feel cool.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<td style=\"width: 42.3715%; height: 47px;\">This lubricates your hands during the back rub, and helps warm the lotion so the client does not feel too cold.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 45px;\">\r\n<th scope=\"row\">9.<\/th>\r\n<td>\r\n<ul>\r\n \t<li>Apply both hands to the sacral area (the lower back), applying gentle pressure moving upward along each side of the spine.<\/li>\r\n \t<li>Massage in a circular motion, strokes moving upwards from buttocks to shoulders, and then back down the outer part of the back (see Figure 4.5.1).<\/li>\r\n<\/ul>\r\n<\/td>\r\n<td style=\"width: 42.3715%; height: 107px;\">Use gloves only if you or the client have any open cuts, wounds, or sores to prevent infection.<\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">10.<\/th>\r\n<td>Continue this massage pattern for about 2\u20133 minutes.<\/td>\r\n<td style=\"width: 42.3715%; height: 15px;\"><\/td>\r\n<\/tr>\r\n<tr style=\"height: 45px;\">\r\n<th scope=\"row\">11.<\/th>\r\n<td>You may change the pattern to small circular motions, either making a circular movement moving upward along the spine and outward from the spine, and laterally alongside the back, down to the iliac crest (hip) or downward and inward toward the spine (see Figure 4.5.1)<\/td>\r\n<td style=\"width: 42.3715%; height: 63px;\"><\/td>\r\n<\/tr>\r\n<tr>\r\n<th scope=\"row\">12.<\/th>\r\n<td>Continue this massage pattern for about 2\u20133 minutes.<\/td>\r\n<td>\r\n\r\n[caption id=\"attachment_1608\" align=\"aligncenter\" width=\"300\"]<img class=\"wp-image-1608 size-medium\" src=\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Back-rub-300x174.jpg\" alt=\"\" width=\"300\" height=\"174\" \/> <strong>Figure 4.5.1<\/strong> Back rub motions[\/caption]<\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px;\">\r\n<th scope=\"row\">13.<\/th>\r\n<td>When you are almost done with the back rub, let the client know so they are prepared for\u00a0the ending of their back rub.<\/td>\r\n<td style=\"width: 42.3715%; height: 31px;\"><\/td>\r\n<\/tr>\r\n<tr style=\"height: 30px;\">\r\n<th scope=\"row\">14.<\/th>\r\n<td>\r\n<ul>\r\n \t<li>Wipe away any excess lotion.<\/li>\r\n \t<li>Assist the client with dressing.<\/li>\r\n \t<li>Position the client for comfort.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<td><\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">15.<\/th>\r\n<td>\r\n<ul>\r\n \t<li>Lower the bed to its lowest setting.<\/li>\r\n \t<li>Ensure the side rails are up.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<td><\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">16.<\/th>\r\n<td>Put away equipment and supplies. Dispose of any dirty linens.<\/td>\r\n<td><\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px;\">\r\n<th scope=\"row\">17.<\/th>\r\n<td>Wash and dry your hands.<\/td>\r\n<td><\/td>\r\n<\/tr>\r\n<tr style=\"height: 31px;\">\r\n<th scope=\"row\">18.<\/th>\r\n<td>Document the client's response and record any changes in condition or behaviour.<\/td>\r\n<td><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<div class=\"textbox textbox--examples\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Watch the video:<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=3sH9MD49ZJM\r\n\r\n<a href=\"https:\/\/www.youtube.com\/watch?v=3sH9MD49ZJM\">Backrub Skills Demonstration<\/a> by Frances Payne Bolton School of Nursing (2010).\r\n\r\n<\/div>\r\n<\/div>\r\n<div class=\"textbox textbox--key-takeaways\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Key Takeaways<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nBack rubs are important because they:\r\n<ul>\r\n \t<li>Provide relaxation and comfort.<\/li>\r\n \t<li>Can be given as part of the bathing process or in the evening care.<\/li>\r\n \t<li>Are soothing and often a highlight for the immobile client.<\/li>\r\n \t<li>Help prevent skin breakdown.<\/li>\r\n \t<li>Offer direct observation of the client\u2019s skin condition.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>","rendered":"<p style=\"text-align: justify;\">Back rubs can conveniently be given after baths, before bedtime, or after repositioning. Back rubs help boost relaxation, stimulate circulation, and promote sleep. Back rubs do not need to be long, and typically take about 5 minutes of your time. Always ensure it is okay to provide a back rub. Health Care Assistants must check with their supervisor and check the care plan. Again, giving a back rub gives the HCA the opportunity to observe skin condition for rashes, bruises, red, white, or open areas, and other signs of skin breakdown. Always report and record observations of any changes in skin condition.<\/p>\n<h1>Purpose for Giving a Back Rub<\/h1>\n<ul>\n<li>To give comfort<\/li>\n<li>To stimulate blood circulation<\/li>\n<li>To promote rest and sleep<\/li>\n<li>To prevent pressure sores<\/li>\n<li>To observe the skin condition<\/li>\n<li>To relax and relieve tension in tissues and muscles<\/li>\n<li>To refresh the client and relieve fatigue<\/li>\n<\/ul>\n<h1>General Instructions for Giving a Back Rub<\/h1>\n<ul>\n<li>Back care is given as a part of A.M. care and P.M. care.<\/li>\n<li>When giving a back rub, use more pressure (gentle) on the upward strokes towards the head and less pressure on the downward strokes.<\/li>\n<li>Back rubs may be contraindicated in clients susceptible to clotting disorders \u2014 check with the supervisor.<\/li>\n<li>Do not take your hands off of the client\u2019s back until the end of the procedure.<\/li>\n<li>Stop the back rub if, at any time, the client reports discomfort or no longer wishes you to continue.<\/li>\n<\/ul>\n<table class=\"grid\" style=\"border-collapse: collapse; width: 100%;\">\n<caption>Table 4.5.1 Procedure: Back Rub<\/caption>\n<thead>\n<tr style=\"height: 15px;\">\n<th scope=\"col\">STEP<\/th>\n<th scope=\"col\">ACTION<\/th>\n<th scope=\"col\">REASON<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">1.<\/th>\n<td>Explain the procedure and position to the client.<\/td>\n<td style=\"width: 42.3715%; height: 15px;\"><\/td>\n<\/tr>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">2.<\/th>\n<td>Perform hand hygiene and gather all supplies.<\/td>\n<td style=\"width: 42.3715%; height: 15px;\">Good organization is time efficient.<\/td>\n<\/tr>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">3.<\/th>\n<td>Adjust bed to a comfortable height.<\/td>\n<td style=\"width: 42.3715%; height: 15px;\">Prevent back strain and injury.<\/td>\n<\/tr>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">4.<\/th>\n<td>Provide privacy and adjust the light, temperature, and sound in the room.<\/td>\n<td style=\"width: 42.3715%; height: 31px;\">Client comfort.<\/td>\n<\/tr>\n<tr style=\"height: 30px;\">\n<th scope=\"row\">5.<\/th>\n<td>Lower the side rails and help the client assume a prone or side-lying position (Sim\u2019s position).<\/td>\n<td style=\"width: 42.3715%; height: 31px;\"><\/td>\n<\/tr>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">6.<\/th>\n<td>Expose the client\u2019s back, shoulders, upper arms, and buttocks, and cover the remainder of the body.<\/td>\n<td style=\"width: 42.3715%; height: 31px;\"><\/td>\n<\/tr>\n<tr style=\"height: 30px;\">\n<th scope=\"row\">7.<\/th>\n<td>Use lotion that has been warmed in a basin of warm water, or by running the bottle under warm water for a few minutes.<\/td>\n<td style=\"width: 42.3715%; height: 31px;\"><strong>Do not heat lotion in the microwave. Rationale: It may explode or be too hot and burn the skin.<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 30px;\">\n<th scope=\"row\">8.<\/th>\n<td>\n<ul>\n<li>Place a small amount of lotion in your hand, and rub your palms together to warm the lotion and lubricate your hands.<\/li>\n<li>Caution the client that the lotion may still feel cool.<\/li>\n<\/ul>\n<\/td>\n<td style=\"width: 42.3715%; height: 47px;\">This lubricates your hands during the back rub, and helps warm the lotion so the client does not feel too cold.<\/td>\n<\/tr>\n<tr style=\"height: 45px;\">\n<th scope=\"row\">9.<\/th>\n<td>\n<ul>\n<li>Apply both hands to the sacral area (the lower back), applying gentle pressure moving upward along each side of the spine.<\/li>\n<li>Massage in a circular motion, strokes moving upwards from buttocks to shoulders, and then back down the outer part of the back (see Figure 4.5.1).<\/li>\n<\/ul>\n<\/td>\n<td style=\"width: 42.3715%; height: 107px;\">Use gloves only if you or the client have any open cuts, wounds, or sores to prevent infection.<\/td>\n<\/tr>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">10.<\/th>\n<td>Continue this massage pattern for about 2\u20133 minutes.<\/td>\n<td style=\"width: 42.3715%; height: 15px;\"><\/td>\n<\/tr>\n<tr style=\"height: 45px;\">\n<th scope=\"row\">11.<\/th>\n<td>You may change the pattern to small circular motions, either making a circular movement moving upward along the spine and outward from the spine, and laterally alongside the back, down to the iliac crest (hip) or downward and inward toward the spine (see Figure 4.5.1)<\/td>\n<td style=\"width: 42.3715%; height: 63px;\"><\/td>\n<\/tr>\n<tr>\n<th scope=\"row\">12.<\/th>\n<td>Continue this massage pattern for about 2\u20133 minutes.<\/td>\n<td>\n<figure id=\"attachment_1608\" aria-describedby=\"caption-attachment-1608\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1608 size-medium\" src=\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Back-rub-300x174.jpg\" alt=\"\" width=\"300\" height=\"174\" srcset=\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Back-rub-300x174.jpg 300w, https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Back-rub-65x38.jpg 65w, https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Back-rub-225x131.jpg 225w, https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Back-rub-350x203.jpg 350w, https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Back-rub.jpg 653w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-1608\" class=\"wp-caption-text\"><strong>Figure 4.5.1<\/strong> Back rub motions<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<tr style=\"height: 30px;\">\n<th scope=\"row\">13.<\/th>\n<td>When you are almost done with the back rub, let the client know so they are prepared for\u00a0the ending of their back rub.<\/td>\n<td style=\"width: 42.3715%; height: 31px;\"><\/td>\n<\/tr>\n<tr style=\"height: 30px;\">\n<th scope=\"row\">14.<\/th>\n<td>\n<ul>\n<li>Wipe away any excess lotion.<\/li>\n<li>Assist the client with dressing.<\/li>\n<li>Position the client for comfort.<\/li>\n<\/ul>\n<\/td>\n<td><\/td>\n<\/tr>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">15.<\/th>\n<td>\n<ul>\n<li>Lower the bed to its lowest setting.<\/li>\n<li>Ensure the side rails are up.<\/li>\n<\/ul>\n<\/td>\n<td><\/td>\n<\/tr>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">16.<\/th>\n<td>Put away equipment and supplies. Dispose of any dirty linens.<\/td>\n<td><\/td>\n<\/tr>\n<tr style=\"height: 15px;\">\n<th scope=\"row\">17.<\/th>\n<td>Wash and dry your hands.<\/td>\n<td><\/td>\n<\/tr>\n<tr style=\"height: 31px;\">\n<th scope=\"row\">18.<\/th>\n<td>Document the client&#8217;s response and record any changes in condition or behaviour.<\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Watch the video:<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Backrub Skills Demonstration\" width=\"500\" height=\"375\" src=\"https:\/\/www.youtube.com\/embed\/3sH9MD49ZJM?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=3sH9MD49ZJM\">Backrub Skills Demonstration<\/a> by Frances Payne Bolton School of Nursing (2010).<\/p>\n<\/div>\n<\/div>\n<div class=\"textbox textbox--key-takeaways\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Key Takeaways<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>Back rubs are important because they:<\/p>\n<ul>\n<li>Provide relaxation and comfort.<\/li>\n<li>Can be given as part of the bathing process or in the evening care.<\/li>\n<li>Are soothing and often a highlight for the immobile client.<\/li>\n<li>Help prevent skin breakdown.<\/li>\n<li>Offer direct observation of the client\u2019s skin condition.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n","protected":false},"author":123,"menu_order":5,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[50],"contributor":[],"license":[],"class_list":["post-1609","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":81,"_links":{"self":[{"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/pressbooks\/v2\/chapters\/1609","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/wp\/v2\/users\/123"}],"version-history":[{"count":1,"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/pressbooks\/v2\/chapters\/1609\/revisions"}],"predecessor-version":[{"id":1885,"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/pressbooks\/v2\/chapters\/1609\/revisions\/1885"}],"part":[{"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/pressbooks\/v2\/parts\/81"}],"metadata":[{"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/pressbooks\/v2\/chapters\/1609\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/wp\/v2\/media?parent=1609"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/pressbooks\/v2\/chapter-type?post=1609"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/wp\/v2\/contributor?post=1609"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-json\/wp\/v2\/license?post=1609"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}