I want this pt showered...and a bunch of other questions... - page 4

We have a resident who hasn't showered in months. He stinks so bad, at one point the smell saturated all the way from his room, down the hallway, to the nurses' station. He also hasn't been taking his medications, he refuses... Read More

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    as w/any mental illness, i do think the key to success, is earning their trust.
    as i've stated, we've had many pts who refuse or are unable to adequately keep themselves clean...
    and just would not trust anyone.
    then along came a Godsend of a tech, who was blessed with many gifts and established meaningful rapports w/these type pts.

    as with most pts, these pts need to know they're in control.
    a big part of compliance, imo, is babysteps, being truthful (which means never, ever trick/deceive them) and involving them in the process every step of the way.
    sit them on a shower chair, keeping them covered at all times.
    let them feel the water on their leg/arm, so they know what to anticipate.
    do not ever, ever spray their face.
    when it's time to wash their hair, give them a washcloth to hold over their eyes and keep shower nozzle only on their head.
    explain to them, what you're doing/washing, encouraging them ea step of the way.
    go as quickly as possible, yet making it therapeutic.
    when it's over, dry them completely and dress them quickly.

    when they recall the (positive) experience they had, they just may not be as resistant the next time around.

    even though are techs are the ones who do the showers/baths, i often will do it myself, if i need to see their skin, or, are known to be labile.

    but before any of this transpires, the pt is going to have to trust you in the first place.

    if all else fails, then chemical sedation may be necessary, but certainly not on a weekly basis.

    finally, document your proverbial behind off, at all attempts to intervene and subsequent refusals.

    they're a tough bunch, and decidedly, for good reason.

    Jarnaes and Melinurse like this.

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  2. 2
    sorry I haven't been in AN.com for a long time so I haven't updated but now I'm back and I remembered this (looking through my old posts).

    So anyway...

    What happened to the man was we got him psych referral and got him some IM Haldol which is a once-a-month shot, the drug started working about some two weeks after it was given to him...it was my day off when they gave him a shower, haircut, nails done, changed everything from beddings to clothes. So the next day I came back to work I seriously did not recognize the man...I thought he was a new admit...CNAs told me it took three of them to get him squeaky-clean.

    The man then remained on the facility, he would eat his meals and take his showers and let nurses give him the shot, he rarely talks to me when I visit but he used to wave at me when I work at his hall...

    and then one night some months ago, he slid on the floor, cracked his head open and passed away.

    Thanks to everyone who gave responses to my inquiries, I learned so much from this experience. :spin:
    leslie :-D and lamazeteacher like this.
  3. 0

    I've never known a fall like that, to cause such disastrous injury.

    Perhaps his journey became complete when he accomplished his goal to be socially acceptable.

    Good job.
    Last edit by lamazeteacher on Jul 13, '09 : Reason: addition
  4. 0
    Thanks for the update. Glad to know he got the needed care.

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