How does family mediate between an extremely arthritic 190 lb resident and CNAs that are careless so the resident scratches aid?

To clarify, the CNAs are not changing her wound ever! My point was that besides having brief changes, she requires daily wound care from a nurse.

A CNA should not be doing wound changes. They are not trained in this just Nurses. My daughter is an RN doing wound care. There are so many things that need to be looked for. I would go above the DON to the doctor at the facility. I agree with the sign. But don't be surprised if they don't do anything.

Have you seen the article in New York Times about nursing homes?
‘It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years https://nyti.ms/2NwWw6c

The staff at my mom’s facility are always overworked and underpaid. Currently the aids and nurses are working 16 hour days. The facility is rated better than most but staffing is a serious problem everywhere. In an effort to resolve problems as an advocate, I run into obstacles at every level from the state on down. Very discouraging. Medicaid is simply impossible to negotiate. The state regulations are not helpful to the residents. No bedrails allowed in Michigan facilities. How stupid. I am told case workers are overworked and underpaid and so far, I’ve never been able to contact one. I just don’t see any answers.

Its just my opinion, but id change Homes ..if you can. High turnover of staff is usually a bad sign . ( least in my opinion)

By the time they get to your mom they are probably overworked and tired.

We have attended CARE meetings and I've discussed this issue with DON. I can't help but believe they consider my mother is difficult, however I will make a sign near her bed and address DON again. Thank you for your help.

In addition to CW's comment, you can put a sign on the bed, head of the bed, or on the stand next to the bed. Sometimes these signs tends to be moved though. I would go for a discussion with the DON as CW suggests.

Talk to the RN on duty and/or the DON and make sure proper procedure is documented in her care plan.