Eeekk!!Patients sexual needs???!!! - page 3
Hi,Im pretty new to all of this so PLEASE help me if you can.Im getting ready to take my exam to be a cna so I can be working while attending nursing school this Fall.I was browsing through my... Read More
Jun 8, '04Quote from Chad_KY_SRNAyou know, i have to agree with chad. i would first inform my nsg. supervisor and let her handle it....mainly because there are so few a&o pts. where i worked....most have dx's of some type of dementia. so although i recognize everyone's right to fulfill their sexual needs, there's too much damn liability when you're dealing w/pts that don't make decisions form themselves.I think that the correct answer is D. It is in my facility anyway. If you witness this you better run to the nursing supervisor. They would STAT page the social worker and start charting q15 or q10. If either one has the slightest amount of confusion or altered mental status they would put them on different units. I am pretty sure that only the married couples in my facility can have sexual relations.
Jun 8, '04According to the state (in Texas anyway) Two consenting adults can have sexual relationships reguardless. Now , there are times when they are so confused that you can deter them. In this case they knew what they wanted to do, even if there POA's did not consent ( but in this case they did) . The state did come in on this and laid it out flat for me. I must provide them a private place to go and be alone. We had special consents drawn up for the families to sign, this was a additonal measure (risk blah blah blah). All the upper people were involved but there is no need for Q15 min charting ,what are you going to chart? I charted every time they went for private time and the fact that both had consented. I didnt say I agreed with this whole deal, however I do realize that older people need affection as well. Plus You can be slapped with elder abuse if you voilate this right according to the Great State of Texas...
Quote from Chad_KY_SRNAI think that the correct answer is D. It is in my facility anyway. If you witness this you better run to the nursing supervisor. They would STAT page the social worker and start charting q15 or q10. If either one has the slightest amount of confusion or altered mental status they would put them on different units. I am pretty sure that only the married couples in my facility can have sexual relations.
Jun 8, '04Everyone in the LTC facility has the right to a sexual relationship, as long as the adults are consenting. One place i worked at, they would do a social work consult, if there was a doubt that the people involved aren't consenting or might not have the mentality to make such a decision and one pushed the other into it.
LTC facility is a nurse's employer. It's a resident's home. Personally i wouldn't want someone telling me that i cannot have sex just because i live in a nursing home. I may be old when i'm there (or may not), but i wouldn't be dead yet.
Jun 8, '04I think a hospital is no place to have sex. Masturbation I can see.
Seriously, if your spouse was in the hospital would you have sex with him or her? Or if you were in the hospital, obviously having an acute problem of some sort would you feel like sex if propositioned by your spouse or s.o.?
Why do people think it's o.k. to have sex with someone who is ill enough to be in the hospital? Baffles me.
I don't understand, I really don't. I've walked in a sexual act one time and closed the door. I was furious because the man had beat her and put her in the hospital, and she was allowing him to orally please her, but that's another issue.
LTC facilities and nursing homes are another story. People are sexual beings and need to be allowed to express that if they are alert and oriented consenting adults. I agree the answer is see providing what I just stated.
Jun 9, '04Everyone keeps saying "if they are consenting" this is assumed and must be determined. The question says that you have discovered this relationship. We could be accomplices to rape as well as commiting neglect if we assume it is consentual. That is why I feel that it is absolutely necessary to contact the nursing supervisor. If the residents can make that choice I say let them go wild.
The reason for charting q15 is for the residents who we are trying to protect from sexual abuse by other residents. You chart where they are and what they are doing. If they are exhibiting a pattern of sexual abuse which would be reflected in the charting they would be taken to a facility that would better care for that situation.
Just my two cents worth
Y'all please have a nice dayLast edit by Chad_KY_SRNA on Jun 9, '04
Jun 9, '04Good point Chad, it's probably not the CNA's job to determine whether they are a&o and in a consenting relationship, I was not looking at it in the context of a CNA doing their job, and presuming too much. When it doubt always bump it up to the next level.
In these days of law suits, what to stop daughter from suing the nursing home and it comes out that the staff had knowledge of the relationship. Best to have some documentation somewhere it was looked into.
Off topic: You chart q15minutes???????????????????/
Jun 9, '04It's all about considering the whole person. Remember Manslow's Heirarchy of Needs? People are entitled to their privacy, but they're also entitled to your help and respect for their sexual issues if they chose to disclose to you. If this is not within your comfort level, refer them to someone who is comfortable discussing it.
Jun 9, '04Is sex actually a "NEED" or more of a "WANT"? I can't imagine someone's life depending on having sex to keep them alive. Unlike water, food, air, etc.
Jun 9, '04[QUOTE=nursecompassion]You also need to be aware that some residents (if in LTC) may try to take out their sexual frustration on you. There have been many times where a R has tried to grab or grope me. You soon learn which ones to be wary of. Remember, that not all R in LTC are over 65. We have some as young as 40. For R who do this and are alert and in there "right minds," you need to report it to your supervisor. (Even if they are not, I would still report it, because something may be going on with the R, and this behavior could be an indicator). We have a R who is in their 40's and was going around trying to grope visitors! So, they had to have a discussion with him/her.
If a patient is confused/dmented enough they may act out, not intending to be offensive, but in their mental state they may think the caregiver/resident is an old girlfriend/wife/significant other. I ahd a Alz gentleman who was usually pretty well behaved in that respect all of a sudden getting a little too friendly and very complimentary towards my anatomy :chuckle Anyway he was still pretty verbal and the more he kept talking to me and his wife (that he still lived with) we figured out that he thought I was on old college or high school girlfriend. We couldnt convince him otherwise, so the only way around the behavior was to transfer me of the case.
Jun 9, '04When it comes to people with dementia in LTC, I believe strongly that most behaviours are either need based or due to problems with perception. It is up to you staff to figure out how to diffuse the behaviour and allow the person to have their needs met in a safe way. Aggressive sexual behaviours in these people usually have much more to do with errors with interpretation than acuall sexual urges. If you are confused an a women you think you know is in your bedroom and pulls down your pants -- what is the expected reaction?
That being said, there was a situation where a lady I was taking care of seemed to be seeking sexual attention from the male residents on the unit. She would be always touching them and holding their hands. We'd find her in bed with the males every once in a while. Everyone was freaking out and were thinking "we have to stop this or we'll be sued!!!". I had done a lot of reading on the subject and we came to the conclusion that she missed her husband and was just loking for physical comfort and affection from these men. We arranged a meeting with the family and just were honest about what was going on and what we thought was causing it (we still didn't want the family to walk in one day to their mother snuggling with someone and freak out). Surprizingly the family was understanding and accepting of what was going on, and said "well if that is what makes her happy -- we're okay with it". You know what? THe behaviour settled down once everyone stopped making a big deal about it, and it has ceased to be an issue.
Jun 9, '04Quote from TweetiePieRNIs sex actually a "NEED" or more of a "WANT"? I can't imagine someone's life depending on having sex to keep them alive. Unlike water, food, air, etc.
It's obviously not a need like food and water. I'm sure no one's died from lack of sex. But not having any kind of sexual release whatsoever, either with another person or by oneself, for long periods of times would drive a person a little batty don't you think. Kind of puts it in between a want and a need for me. :chuckle
Jun 9, '04Tweety, did it occur to you that this female patient was being abused again? She may not have had any choice. I know it could be embarrassing but did you take a few private moments, after the guy left to ask her about her choice in this matter? This happened to a patient on a unit at a trauma hospital near here, raped and beaten by husband at home, rushed to hospital, given care and admitted, husband shows up 2 days later, held her in bed and raped her again. The nurse who opened the door did not report anything unusual to charge nurse. The facility was sued and it was settled out of court. I know because it happened on the floor my buddy worked on and she was really upset and worried about what she would do if she were in this type of situation. Now, I am not saying this is what happened in your situation, but it does raise questions.