Grey area...

[Spacey313]

So, I am a caregiver at a memory care facility. Lately I have had a few residents who are completely incontinent, who refuse care when they are soiled. Residents have the right to refuse... I understand that, but where do we drawl the line between neglect, and resident rights. I don't want to force residents into changing because I don't even know if thats ok but I also don't want to be accused of neglecting a resident. Does anyone have any idea how to deal with this situation? I feel like this is some grey area

 

[irismary]

Interesting question and I don't have an answer - but I would think your manager should give guidance. I get frustrated when my mom's carers don't get her showered or change her clothes because she says no or is already up when they get there. With my husband he says no to showers, tooth cleaning, tablets etc from time to time but I do my utmost to persuade him - the saying used to be "cruel to be kind" - so doing what needs to be done for their best interests however you are in a different position and I think you need to bring concerns to your manager who can decide the best way forward depending on the residents needs. This is just my opinion of course as you are right they can say no - difficult area and I suppose it depends on the individuals needs. Good that you clearly care enough to ask.

 

[AlsoConfused]

You're in a very difficult area Spacey and you need clear, written guidance from your employer on what to do, to protect yourself. Keep a copy of it! I also hope you're never the only worker in the room when you're faced with a self-neglecting but resistant client.

It's difficult enough for family members caring at home, with hopefully full insight into the cared for person's changing moods and the best ways of approaching them. It must be even harder when the client is someone you may only see for part of the week and you need to keep everything calm and happy for the whole group of attendees.

 

[Shedrech]

hello Spacey313
welcome to TP
I agree that this is a situation to go to the manager and seniors for guidance - the manager can give you the home's procedures and the seniors and more experienced staff can share their professional tricks with you
I think it will also become clearer and easier as you get to know each resident and their individual ways
watching the staff in my dad's home, they approach the residents in ways that are positive so there is little room for rejection, and they do not ask the resident if they want to do anything, they speak in a way that assumes the resident will comply, all in a friendly, calm, matter of fact manner
eg "now (name) , it's time for a wash and brush up so lets be off to your room" taking the resident's arm and starting off in the right direction, chatting about something else as they go
I know my dad is more likely to comply if he is talked through each stage ie told what the carer is going to do before they start eg "lets take off your slippers first (name)" and if he feels he is at least a little in control eg "here's the handrail (name), hold onto that as you sit down"
and with some residents, they only do this task in pairs so one can distract and reassure whilst the other gets on
don't think you have to worry about this on your own, chat with other staff and ask for training
best wishes

 

[Selinacroft]

Hi
I know with my own father it is best just to tell him what he is going to do rather than start any approach with "Would you like?" or "Do you mind" to which the answer is always "No". I know in care you are taught to give options but at certain stage in dementia I find people need guidance and clear instruction rather than choices which require thinking about. Perhaps a leading question like"Ok let's get that pad changed now shall we?"or "Time to freshen up before tea isn't it" That's still giving a choice-

 

[Spamar]

It's the taking the arm bit that worries me. OH was covered with bruises on his arms after a few days. I cared for him 10 years and never a bruise!
But I knew how to manage him, I suppose.

 

[Spacey313]

Thank you for the replies.

Next time I see my manager I will definitely ask. I have been doing this for a year now, but the resident that has been refusing just recently started to refuse. The resident in question doesn't respond well to people telling her what to do, it has to be her own idea. If anyone has a suggestion on a new approach I would be grateful.

 

[Zana]

Spacey313.

Get firm directions from your manager in writing if possible this should help protect you if things go wrong while carrying out instructions on how to deal with your resident.

Try to understand whats causing the problem. Its not just dementia.
As a home carer I had a lady with early dementia who was storing her soiled pads in her shower much to the disgust of district nursing who wouldnt help but said it was a home carers job. Her house stunk like a sewer.

After talking a bit with the lady I discovered that it was a sense of shame making her do this. She still lived at home but her neighbour took out her wheelie bin and she didnt want him to see her pads and know intimate things about her.
I went to the shops and bought some lavender scented bin liners so that we could dispose of her pads without anyone seeing. Problem solved.

Somethimes the problem is not that the person doesnt want to be clean its something else worrying them.