The aides are coming daily as mom is remaining in bed and so it appears incontinent when not that long ago although she had a few accidents, she was able to get to the bathroom and if not messed herself and clothing up. Incontinent x 2. So clearly the aides assistance is a blessing. However mom has enough spunk to be sensitive and object to being cleaned up "down there". Her phrases are typically "THAT'S ENOUGH" or "GET OUT OF THERE". Completely understandable. But today as I stood by holding the bag for soiled disposables, Mom was basically lying naked on the bed the aides having removed her gown. Thinking she was chilly or could at least have a bit of coverage I placed the gown over her private area, which brought a comment from the aide that they had gotten it away from her and I basically gave it back (ie. complicating their job). My question is what is SOP? I believe I've read, and experienced myself when in the hospital in the past year, that care should be taken to protect the patient's privacy and to keep them comfortable...i.e. the areas not being cleaned at the time should be kept covered. It's hurtful to think they might make their job easier by taking advantage of someone with dementia, but considering the agency I can't imagine they were not trained correctly. Would you say something to them or a supervisory person?
Taking him from the bedroom to the bathroom she made sure he was covered.
When bed bath became necessary she would expose only the part of his body that she was washing at the time. She would wash, rinse, dry and cover then move to another part of the body.
If the aides are not following this type of process you can say something. If they ignore your request you can call Hospice and and talk to a supervisor or Care Manager.
If your request is still ignored I would contact another Hospice agency as this is one I would not want caring for my loved one.
The aides ought to have done that anyway, without being told, as soon as they removed your mother's gown; so I have a slight red mist forming at the thought that they actively resented your covering her (though I wouldn't have used her gown, myself).
What to do... since you didn't deck them at the time, very restrained of you... put it in writing to their service manager, subject heading "respecting privacy and dignity during personal care." Indeed this ought to have been covered in their training. Perhaps they need a reminder.
Just to underline the importance and versatility of towels: I did a 2:1 round with a male colleague which included a call to a lady bedbound after a stroke. The client was friendly and welcoming, but when it came to changing her pad she called out to her son and said to him: "you know what I want to tell them, don't you?" She was both too embarrassed to have a male helping her, and too afraid to tell us herself directly.* But she's a 2:1 client for a reason - no moving and handling training is going to make it possible for 1 female to turn and wash her - so we reassured her with a compromise. Bath sheet over her, both of us helped her to roll, male worker held her in position, female worker made a sort of tent and did the care. Blushes spared, client happy, and equal opportunities rule!
*Another red flag for me. I seem to spend half my time encouraging people to give feedback and express their needs freely - how else can we get things right? - and it makes me very tight-lipped when they're afraid to. What's been going on?
I think their service manager may in effect be the nurse on the team. Take note that while I realize it may come from a place of compassion, I have also heard one or the other of these two aides refer to mom as "honey" which I know is nit picky of me to be offended by, but I also do a cursory orientation and review with new employees who serve community residents with light housekeeping, and in fact give them an article about using such cute terms without consent and how demeaning it can be. I would in fact want people to inform me as a supervisor of anything that didn't seem to be going right for the very reasons you mention, but I guess when it is our own circumstances, we are not thinking as clearly....In the end doing the right thing, the right way I would hope makes things far easier for all, as you mentioned in your example! Thanks again...
The client's privacy must always be respected when giving a bed bath. That means after their clothes are removed a draw sheet or large towel is used to cover them. The only parts of the client's body that are supposed to be exposed at any time are the ones being bathed. There's no excuse for an aide to slack off the way your mom's are.
Talk to them ONCE about it. Let them know that if they slack off like that again or treat your mom with such indignity, they will be fired at once. Also, let them know you will get them in trouble with their agency. You do not allow them to criticize you for telling them something. Oh no, I don't think so.
There's no excuse to justify slacking off like that and I'm sorry your mom got treated like that. Caregivers like hers give all of us a bad name.
In my husbands 22 month stint with hospice, they only came twice a week to bathe him, and not at all during the 5 months when Covid first appeared.
But that being said, they should be covering your mom with bath towels while they're cleaning her up, if not for her privacies sake, then to keep her somewhat warm. My husband was very particular on how he wanted to be bathed, and so I made sure I let the aides know, as most often we had different aides weekly. With my husband it was more of a "being cold" issue as he was very cold natured, so they learned to keep his top half covered with one towel and his bottom half with another.
Don't be afraid to speak up. You now have to be your moms advocate. Hospice is there to serve you and your mom, so make sure they are doing things the way you both prefer.
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