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Chronically ill elders: spotlight on ethnic hair care

by Isabel Fawcett

Caregiving requires commitment to intricacies of individual care. For elders who are hospitalized or in nursing homes, bad hair days are common. Depending on geographic location of healthcare institutions and population demographics, ethnic hair care for elders can be a challenge.

All hair is not equal. Hair coloration differences aside, textures vary. At the roots, hair may be kinky, straight, curly, tightly waved, or a combination of textures. For some individuals who are racially identified as Black, natural hair roots may be kinky, or tightly curled. Using a fine-toothed comb to groom an elder's ethnic hair if kinky, for example, could cause physical discomfort and excessive hair loss.

The elder's physical discomfort may be expressed as grimacing, or abrupt body movements away from the care provider as a means of escape from the source of discomfort, namely improperly selected hairstyling implements.

Dealing with Elder Hair: Matted Hair

Several years ago, one of my mother's peers was seriously injured and had to be hospitalized for months. For several weeks after her accident, she was not allowed visitors while her worst symptoms subsided. After the visitor restriction was lifted, I visited her at the hospital. I was pleased that she engaged in lively conversation though still unable to stand or walk.

She shared what had transpired since I had seen her and apologized for her appearance, repeatedly pointing to her matted, blood-soaked hair. Her main concern was hair loss due to dried, caked blood that had hardened into her hair, staining her scalp and normally beautiful silver hair over a period of months. For the remainder of her hospitalization, I visited often. After she started walking while hooked up to an intravenous (IV) pole, I asked her to inquire of her doctor whether I could wash her hair weekly. I decided I would use the sink next to her hospital bed, if allowed.

So an additional unpaid part-time caregiving journey began for me.

Dealing with Elder Hair: Relaxers

Relaxers are chemical products that straighten hair. For some Blacks, Hispanics, Mediterraneans, and other ethnic groups who may have non-straight hair roots, application of relaxers simply makes hair easier to comb by straightening hair at the roots.

Our friend's racial self-identification is Black. Her doctor had no concerns about my washing his patient's hair. I'm not a licensed beautician. I simply understand textural nuances in hair and the urgency of a reasonable individual to have dirty, kinky or matted hair roots washed, relaxed, gently disentangled, or transitioned back the elder's natural hair texture instead of being allowed to become entangled and brittle.

There are other ethnic hair styling techniques which avoid the use of harsh chemicals. Historically, hair relaxers have been widely used in some ethnic hair care though increasingly less popular among some ethnic groups and younger generations.

Dealing with Elder Hair: Tips

1. If the elder is lucid, ask about hair grooming preferences. An elder may wish to revert to natural hair texture instead of enduring harsh chemical treatments every 6 weeks.

2. Choose a wide-toothed comb/brush for ethnic hair. Avoid tug-of-war.

3. Sometimes the best comb for ethnic hair is a wide-toothed hairbrush. I use one to detangle my mother's hair daily. Elders often recline, or rest the back of their heads against a bed or high chair, creating a mess of tangled hair at the back of their heads. They may be too weak to comb their own hair or unable due to painful arthritis.

4. Regardless of race or ethnicity, matted hair should be gently detangled at first opportunity subject to medical input.

5. Periodic touch-ups throughout the day afford the elder respect and dignity, elder-caregiver interaction, and regular supervised care.

Neglect of elders is not an option. There are products for all textures of hair and hair issues, including to mitigate breakage, scalp sensitivity and dryness. Ask a professional, or contact beauty schools to ask whether any students are skilled in providing ethnic hair care under beauty school supervision. Beauty school instructors might also provide in-service education for health care staff.

Always coordinate with physicians, nursing staff and relatives if you are not the primary caregiver relative. Keep safety visible at all times in direct care settings.