Personal care problems, violence.

Discussion in 'I care for a person with dementia' started by Callieflower, Jan 2, 2014.

  1. Callieflower

    Callieflower Registered User

    Jan 9, 2013
    50
    Tyne and Wear
    Hi. Mam has been in a nursing home for a few months now. The problem we are having is with her personal care. It takes three or four staff members to shower her as she is aggressive. Now they only shower her every five or six days and never change her incontinence pants. They rarely dress her and leave her in the same clothes for days. Is this usual? We appreciate how difficult it must be when she lashes out and scratches etc but the Manager insists that they can handle it but then we end up back in this situation. Any help, advice or suggestions would be much appreciated.
     
  2. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,512
    Female
    England
    It is not right and needs to be sorted. There will soon be problems with infection and breakdown of skin if her pads are not changed. It is important that the pads are changed.

    If there was not a problem with the changing of the pads then I personally would not worry about the showering as long as she has one at least once a week with good cleaning of the pad area each change of the pad. When I was young it was a bath once a week and a wash in the sink every morning. Maybe we are getting obsessed with showering and bathing on a daily basis.

    I would certainly have words with the home manager because it is your Mothers basic rights to be kept clean and tidy and not too much to ask that her clothes are changed daily. She has the used clothes removed at night so why is it difficult to put clean ones on next day? Tell them you understand it is difficult because of her behaviour but it is necessary for her to be clean and dry to prevent further health issues.

    See how that is received and if nothing changes, take your complaint further. If the home is run by a company then contact the company and also contact CQC and complain about the lack of personal care and how you feel your Mother is being neglected.What is happening to your Mother is not acceptable and she was assessed and you were told that the home could manage your Mother.

    Hope this helps and others can add some ideas to help you get this sorted very quickly.

    Jay




    Sent from my iPad using Talking Point mobile app
     
  3. Callieflower

    Callieflower Registered User

    Jan 9, 2013
    50
    Tyne and Wear
    Thank you Jay. They often don't change her clothes at night. It's difficult as you don't want to make a fuss but it's my Mam and I want the best for her. Sunday night was bath night for us too so I understand your point and agree with you but they don't usually wash her during the week. My disabled Dad tends to do what he can when he visits (defeating the purpose of her going into the nursing home). We will speak to the Manager in the morning, I'm sick of them saying that they can manage when it is obvious that they can't. If it continues then I will take your advice and contact the home owners. Thanks again for the advice. :)
     
  4. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,512
    Female
    England
    Calliflower you are not making a fuss. You are just asking them to carry out the care your Mum needs and is entitled to receive. She is not staying in a hotel where all she can expect for her money is a clean bed and meals. She is paying for care and the most basic of care is not being given. We all know what happens to a babies bottom when nappies are not changed regularity and how difficult it is to clear up a sore bottom.

    My husband has progressed quite a way and to me all he has left is his dignity. I have supplied clothing and toiletries and expect him to be clean and tidy and well groomed as he would have been when he was at home. Luckily he is.

    Jay


    Sent from my iPad using Talking Point mobile app
     
  5. Haylett

    Haylett Registered User

    Feb 4, 2011
    1,145
    100% agree with jaymore. Aggression is a sad facet of dementia, but the home is failing to deliver the basics of care to your Mum. It is too convenient to walk away, and say that they don't want to force her to wash or change. No-one wants to force anyone. But there is cajoling, distracting, persuading; and gentle but firm ways to change pants so that sores don't break out. Your Mum doesn't understand that she needs a change: they do.
     
  6. Callieflower

    Callieflower Registered User

    Jan 9, 2013
    50
    Tyne and Wear
    Great points made. You're both right and I appreciate the kick up the backside I need. It's one thing not to rock the boat and another where I am ignoring Mam's best interests and I've crossed the line. I have worried about repercussions but at what cost? Will speak to the Manager in the morning. Many thanks.
     
  7. Haylett

    Haylett Registered User

    Feb 4, 2011
    1,145
    Good luck Calliflower.
     
  8. FifiMo

    FifiMo Registered User

    Feb 10, 2010
    4,710
    Wiltshire
    It sounds to me that despite what the home are saying, that they are not equipped to deal with your mum's care. Some people with dementia, for example, need support in a a facility which specialises in managing challenging behaviour. There is absolutely nothing wrong with a care home admitting that someone has deteriorated to the point that they struggle to manage them. What IS wrong is continuing in denial of them not providing the person with what is the basics if care, eg regular changing of pads. I think perhaps you are at the stage where you need to contact your social work department and get them involved. It does sound to me that your mum's needs are now beyond the capability of the care home and may well be beyond the extent of the care home's licence. Whilst you can go down the route of the care quality commission, if it was me, I would focus in getting your mum out of there and in to either an assessment centre or a facility that has the trained staff to deal with her behaviours. To this end I would focus on persuading the home that they MUST call in the relevant professionals or you will do it for them. Any review or recriminations can wait until your mum gets the help that she requires.

    I don't want to worry you further but if the pads are not being changed, is there any evidence that the home are restricting access to drinks or food, in order to deal with the problem? It might be worth hanging around at meal times and watching how often she is offered drinks when you are around. Has there been any obvious weight loss recently?

    I hope you and your mum find a quick solution to this problem.

    Fiona
     
  9. dottyd

    dottyd Registered User

    Jan 22, 2011
    1,064
    n.e.
    That's neglect.

    Pure and simple.
     
  10. Shash7677

    Shash7677 Registered User

    I'm so sorry to hear about the problems you are having, it begs belief doesn't it that someone isn't changed and washed.

    My mum when she first went into her home was notoriously difficult when it came to her personal care, she once dragged a carer into the bag with her!!! They did start to give her a small dose of diazepam before they bathed her just so they could get her washed and cleaned. Now however they have got it down to a tee, one person and one person only baths mum, usually the same lady but if she is off then there are 2 other carers mum trusts enough to bath her for her not to kick off. They don't try and wash her, they put the shower gel on the flannel and mum does it herself all be it with visual que's do the carer will lift her arm and say 'under here' and mum copies.

    They also don't dress her, they put jumpers over her head then let mum do the rest, fuss to much and try to help she freaks out and starts lashing out.

    Do you think maybe the home are trying to do too much when they do bath your mum so she is getting frustrated at the lack of dignity they are showing her? It's just a thought, all those people looking at your bits and bobs, trying to wash them for you, dementia or no dementia it's a no go area isn't it for older people (mum is 68).

    Not sure what else to suggest really but just want to share my experience.

    Sharon
     
  11. Callieflower

    Callieflower Registered User

    Jan 9, 2013
    50
    Tyne and Wear
    Thanks for the posts, it really does help. We had a talk with the manager this morning and she had no idea that this was going on. When I went to Mam's room today there were plates of food from the previous day still there and she was in the same clothes that Dad had changed on Tuesday so obviously no pads changed since. We have been assured that there will be no repeat of this. In the next few days some people are coming from a challenging behaviours team to assess the staff and Mam to see what can be done to help the situation. We are going to make the social worker aware of the problems too. I will give it a few days to see if there are improvements, the last thing we want is for Mam to end up in hospital again as she loathed it and was terribly distressed but her welfare is paramount so it may come to that. I will give them their dues, she always has drinks available. Still feel like we are doing the wrong thing but I'm concerned that if we move her they won't be able to cope with her there too. So distressing.
     
  12. Callieflower

    Callieflower Registered User

    Jan 9, 2013
    50
    Tyne and Wear
    Visited Mam early this morning and she was in clean pyjamas. When my sister visited this afternoon they had showered her and dressed her in clean clothes. It proves that they can do it when they have to and it has purely been neglect and laziness that Mam has received the care she needs. Absolutely disgusting and I am furious.
     
  13. susy

    susy Registered User

    Jul 29, 2013
    801
    North East
    Well done you for dealing with this. It does take courage to confront care home managers and staff. You have done so well and your lovely mum will totally benefit from this even if she never realises, we all know xx
     
  14. geordie

    geordie Registered User

    May 11, 2010
    108
    keep at them - it's not easy dealing with the aggression (I have had the bruises to prove it!) etc but they can keep trying diff options until they find sth that works. I move my mum alone but respite care agency say it takes 3 people - I think it's really as a get out clause to doing nothing - but I'm not rolling over (my God they have tried every move to make me do so!) and if they say it takes 3 carers - so be it - I'm not willing to condone her sitting for hours.
    We are the voice of the dementia suffer - to me that is one of the most important aspects of care giving me can provide.
    best wishes
     
  15. Haylett

    Haylett Registered User

    Feb 4, 2011
    1,145
    We are the voice of the dementia suffer - to me that is one of the most important aspects of care giving me can provide.

    Absolutely. We articulate what those whom we care for can't, and hope that if we can change things even a little bit, maybe we can do something to improve the lot of the poor souls who have no-one at all to speak for them.

    Well done, Callieflower. If you can, when you can, try to keep track of the care for your Mum in a journal or note it down in some way - and if you can let that be known at the home, so much the better. Written evidence is very hard to refute. I know that doesn't help your Mum but if they can cope, and they have been hiding behind that old "human rights infringement" catch-all excuse, then it might just bounce them into doing what they should have been doing in the first place.

    Most of us on this forum have faced aggression one way or another - and I know that there are some here for whom aggression has spiralled out of control. Trying to help someone who is much bigger and stronger and feeling threatened will always be a challenge. But in many instances, there are "windows" of opportunity, even for someone who is prone to hitting, slapping, biting, spitting.

    Not many of us would like to be forced out of our clothes by a group of people and made to undress. Hardly surprising that in a fuggy world of confusion, there is resistance. But with a lot of patience and gentleness, "time outs", distractions, music, singing, taking it slowly, it is possible to get pads changed, bottoms washed etc.

    I hope this marks the start of much better caring care for your Mum. Understandable that you're angry but well done for what you have achieved.
     
  16. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,289
    SW London
    To be honest that sounds to me like a bad, lazy manager. She ought to know what is going on. That is her job.
     
  17. Callieflower

    Callieflower Registered User

    Jan 9, 2013
    50
    Tyne and Wear
    Thank you for your lovely comments. When I visited Mam on Sunday morning she was wearing the same clothes from Saturday, no change into pyjamas, hadn't been washed again or pads changed. We have made a decision as a family that we are going to remove her from this home. Unsure of the how to go about it but will discuss it with the social worker in the morning. It's disgusting that people can treat a human being so badly. So distressing but we have to do what is best for Mam.
     
  18. FifiMo

    FifiMo Registered User

    Feb 10, 2010
    4,710
    Wiltshire
    Hiya,

    What you as a family can do is get ahead do the process. Go out and look around other care homes and see what is out there. Use it as a source of independent advice. Ask questions about whether they could cope with her behaviour. If not, where do they think could do so? Would they recommend that her next home is found following a period of assessment, say, in hospital? Gather up as much local information that you can find and take note of advice that the people give you. All this, if nothing else, will give you reassurance when dealing with the SW or the behavioural management team etc.

    So far as existing place goes, I will stamp my feet and insist that she is moved immediately eg today. Even a temporary placement or an assessment place has to be better than the neglect she is currently experiencing.

    Good luck. I hope tomorrow brings you some resolution even if it is temporary.

    Fiona
     
  19. dottyd

    dottyd Registered User

    Jan 22, 2011
    1,064
    n.e.
    Seconded!
     

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