My mom is in a small ALF. She’s end stage Alzheimer's and has hospice. Hospice sends a bath aide 7 days a week. My mom is bedridden so she bathes her and changes the sheets everyday. I appreciate that she is being kept clean but one thing really bothers me. I’m allowed to have a camera in her room so I observe how she is being bathed. The aide will come in very early in the morning, wake her up then start to take off her gown. My mom is still sleepy from her medications and fights to keep her clothes on. Then after she removes her clothes she starts washing her whole body and doesn’t cover her up or dry her right away. Leaves her naked and wet as she turns her from side to side to change the sheets. Her bed is under an ac vent and she’s cold!! So many times I’ve asked them to please keep her covered at all times. My poor mom looks so uncomfortable and struggling to keep herself covered with her arms. Every bath aide she’s had does the same thing. I’m so fed up. Don’t they get training? How should I handle this?
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We are taught to bathe one area of the body at a time, keeping the remainder of the body covered and dry and warm and to maintain the person's dignity. Period. To force a person be essentially all-over naked and wet violates training and, I have no doubt, the standard procedure for the facility. This is offensive to me on so many levels.
The only thing I can--almost--understand is the aide trying to get your mother bathed before she's fully awake. Most facilities don't have enough aides and there's just no extra time. Since this is a small ALF I would hope they'd wake everyone, if needed, than return later when the client is more awake.
I'd get photos or video of these occurrences for documentation, then meet with the DON (Director of Nursing) and complain like crazy, then threaten to contact the State. Even if the aides are overwhelmed, the clients deserve--AND NEED--to be warm and dry and to allow them their dignity.
Side note: The ALF where I took my practicals had a fluid schedule and allowed the elders to sleep until they woke up (aides often checked on them), then they were assisted with dressing if need be, bathed, and wheeled to breakfast, et al. This facility was Native American-owned and their clients were treated as the honored elders that they were, which was SO beautiful. How the aides performed and how the elders were treated should be freakin' national standard.
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From "Skills for dementia care" from the Michigan Coalition for Dementia:
2.8 Recognize that every person has a need for:
• Relationships with others
• Inclusion (being part of a group)
• Occupation (having things to do)
• Individuality (feeling unique)
• Dignity
• Feeling secure emotionally
• Privacy
• Intimacy and touch
• Socialization (being with others)
• Meaning
• Physical comfort
• Meaningful activities
So - don't these people get training? I'm sure they do. Whether or not they are given the leadership that reminds them to make it part of daily practice appears to be a different question.
I'm too cross just now to find the right words to suggest you might put to the manager - in your position I'd be too apoplectic to speak.
Does your camera record these images? You might make an appointment to see (or Zoom, or MS Team, or whatever) their manager at hospice, ask them to observe what you've seen, and tell them you'd like to hear their comments.
In fairness, he was pretty young (21?) and elderly people 'grossed him out'--so he should have been in a different field.
I don't CARE how old you are, how demented, how sick, everyone has the right to be treated with a level of dignity. I know what I said to him resonated, he actually didn't last long in the field.
I remember having my babies (c-sections) so I wasn't allowed to shower--the nurses were SO GENTLE and made the bathing experience so pleasant and comforting. At no time was I exposed to cold air--I was covered completely in a very warm, wet blanket and then parts of me were slowly uncovered and washed and then recovered. A backrub follwed this bed bath and a fresh gown and I felt so much better. I always had long hair and they even made the effort to wash my hair.
Yes, it took about 5 minutes longer to do my bath than if they just dumped a basin of tepid water on me--but it was a sweet and gentle gesture.
I've had to bedbath DH many times and while that is a whole different dynamic--I used the method the nurses used and he would always feel so much better. Even if it were just a 'bath wipe' bath, we took it slow and gently.
I would ask that they show up after breakfast. I did this with the "in home" agency Mom had for therapy who also handles Hospice. Explain that the aides wake up Mom. She is one disoriented, and two frightened. Not a good experience for her.
If this does not work, you have the right to change Hospices. And I would tell them that. They make money off of Medicare.
My husband does not agree with me on this...telling agencies when a time is not convenient for me. I figure my home and I have a right to dictate the time convenient to me. With my Mom, she did not wake till 8am. It was get her up, get her dressed and feed her breakfast. If I woke her up, she would be disoriented. The agency wanted to be here at eight for therapy. I said No, 10am would be better. Because after I got her ready, I then got my shower and dressed.
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