Hand-Washing Best Practices for Seniors and Family Caregivers


When we were young, our parents insisted that we wash our hands before meals, when we came in from playing outside and after using the restroom. But hand-washing is much more than a habit or a social norm. Proper hand hygiene is a critical part of infection control that stops the spread of viruses and bacteria. The catch is that there is a right way and a wrong way to clean your hands.

Why Is Hand-Washing Important?

People encounter germs that have obvious sources, such as feces, uncooked/unwashed food and soil, but the truth is that microbes are lurking everywhere. While it’s absolutely beneficial to wash your hands after changing an adult brief, before preparing food and when you’re done digging around in the garden, people can also contract infections from seemingly innocuous sources like doorknobs, shopping carts at the grocery store, airplane tray tables, light switches and even money.

Person-to-person contact can result in the direct spread of infectious diseases, but the only way to avoid this is to limit interactions with and proximity to other individuals, especially those who are showing signs of illness. However, we come into contact with countless high-traffic surfaces in our homes, our workplaces, the gym, doctor’s offices and long-term care facilities that harbor viruses, bacteria, fungi and other microbes. To make matters worse, an infected individual doesn’t even have to physically touch a surface to contaminate it. When they cough, sneeze or talk, infectious respiratory droplets are dispersed into the air and then settle on the things around them—sometimes up to six feet away! Simply touching your eyes, nose or mouth after unsuspectingly encountering a contaminated surface can introduce these germs into the body and cause disease.

Regularly disinfecting surfaces is an important part of infection control, but there are logistical barriers to this practice, particularly in public places frequented by high volumes of people. Therefore, hand-washing is one of the best options for preventing the spread of diseases like influenza, the common cold, coronavirus (COVID-19) and gastrointestinal illnesses. Practicing good hand hygiene not only allows individuals to take control of their own exposure to germs, but it also limits the spread of microbes from their hands to surfaces and others’ hands.

According to the Centers for Disease Control and Prevention (CDC), community hand-washing education reduces respiratory illnesses (e.g. the common cold, pneumonia, influenza) in the general population by 16 to 20 percent. More widespread practice of hand hygiene could have a significant impact on health outcomes for older adults. For example, the CDC estimates that between 70 and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older, and between 50 and 70 percent of seasonal flu-related hospitalizations have occurred among people in the same age group. Fortunately, vaccinations and antiviral treatments are available for the flu, but despite these interventions, nearly 6 million adults age 65 and older became ill during the 2017-2018 flu season and an estimated 50,903 adults in this age group died. Diligent hand-washing remains a critical preventative action for diseases without vaccines and/or cures, such as coronavirus.

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Best Practices for Hand-Washing

Everyone benefits from more frequent and effective hand-washing, especially people who are at high risk of infection like older adults and those with chronic health conditions. It is equally important for those who interact with high-risk individuals, such as family members and caregivers, to make good hand hygiene a priority. However, proper hand-washing techniques must be used to maximize the effectiveness of this preventative measure. The CDC recommendations for washing hands address both how and when to wash up.

When Family Caregivers and Seniors Should Wash Their Hands

  • Before, during and after preparing food
  • Before eating food
  • Before and after caring for someone at home who is sick with vomiting or diarrhea
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing adult incontinence products or cleaning up an elder who has used the toilet
  • After blowing your nose, coughing or sneezing
  • After touching an animal, animal feed or animal waste
  • After handling pet food or pet treats
  • After touching garbage

How to Wash Your Hands the Right Way

The CDC advises individuals to follow these five simple steps every time they must wash their hands:

  1. Wet hands with clean, running water (temperature does not matter), turn off the tap and apply soap.
  2. Lather by rubbing hands together with the soap. Lather the backs of the hands, between the fingers and underneath the nails.
  3. Scrub hands for at least 20 seconds. (Humming the “Happy Birthday” song from beginning to end twice takes approximately 20 seconds.)
  4. Rinse hands well under clean, running water.
  5. Dry hands using a clean towel or air dry them.

Choosing the Right Hand-Washing Products

There is a great deal of confusion and misinformation surrounding antibacterial personal care products, especially when it comes to the best type of soap for washing hands. While antimicrobial hand soaps sound like they’d be better for killing germs and preventing illness, studies have not shown a marked difference in effectiveness between these varieties and plain soap. In fact, research suggests that the use of antiseptic hand soaps containing active ingredients like triclosan may not be safe over the long term and may contribute to the development of antibiotic-resistant bacteria—a huge risk for seniors who often rely on antibiotic medications to treat infections like bacterial pneumonia and urinary tract infections (UTIs).

The U.S. Food and Drug Administration (FDA) began enforcing a regulatory rule in 2017 that banned the sale of over-the-counter consumer antiseptic washes containing triclosan, triclocarban and 19 other antimicrobial ingredients. There are other chemicals under FDA investigation, including benzalkonium chloride and benzethonium chloride, which are still used in both hand sanitizers and hand soaps. It is worth noting that there is uncertainty over exactly what germs these ingredients are effective against (particularly the new coronavirus) and whether negative health effects may be tied to their use as well.

Despite the convenience of hand sanitizers, these products tend to be another source of confusion for family caregivers who are trying to minimize their loved ones’ chances of getting sick. While washing up with plain soap and water remains the best preventative option, alcohol-based hand sanitizers that contain at least 60 percent alcohol are an acceptable alternative while in a pinch or on the go. Alcohol-free sanitizers and products with a lower alcohol content do not remove all microbes from the hands stresses the CDC. Any attempt at keeping your hands clean is better than nothing; just remember to read labels carefully and use products as directed to ensure you get their full benefits as advertised.

Make Hand-Washing Part of Your Daily Caregiving Routine

Proper hand hygiene is important at any age and in every setting. All it takes is a little practice and commitment to make washing hands more frequently a part of your elderly loved one’s care plan. If everyone uses effective hand-washing techniques, then it significantly reduces the spread of infectious diseases and offers greater protection for most vulnerable populations who are older and have weakened immune systems.

Sources: Show Me the Science - Why Wash Your Hands? (https://www.cdc.gov/handwashing/why-handwashing.html); People 65 Years and Older & Influenza (https://www.cdc.gov/flu/highrisk/65over.htm); Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths in the United States — 2017–2018 influenza season (https://www.cdc.gov/flu/about/burden/2017-2018.htm ); Coronavirus Resource Center (https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center#Caregivers); Publications, Data, & Statistics: Handwashing (https://www.cdc.gov/handwashing/publications-data-stats.html); When and How to Wash Your Hands (https://www.cdc.gov/handwashing/when-how-handwashing.html); Antibacterial Soap? You Can Skip It, Use Plain Soap and Water (https://www.fda.gov/consumers/consumer-updates/antibacterial-soap-you-can-skip-it-use-plain-soap-and-water); You Might Be Buying a Hand Sanitizer That Won’t Work for Coronavirus (https://www.propublica.org/article/coronavirus-hand-sanitizers-cdc-recommended-alcohol); Show Me the Science – When & How to Use Hand Sanitizer in Community Settings (https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html)

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