Published Mar 21, 2011
purse
86 Posts
I work as a PCA at a ALF, yesterday the daughter of a family member called and was extremely upset, she said that NOONE has washed, dressed, showered, or changed the linens of her father in OVER A MONTH. He is Very HOH and can barly see at all, but he is capable of getting himself dressed, and in AL thats what I was advised to do. We are suppose to let the patient do as much as they can for themselves. As for his shower, we have been low on staffing, and my boss is just finding random PCAs to come in a cover the 7 to 3 shift (i work 3 to 11) Well this random PCA said that he gave this man a shower, signed it in the ADLs, and on our report. I know I gave the man a shower two weeks ago, because the fill in PCA didnt say they did, so I did it when I came in. However, 2 weeks ago, I didnt change his linens, I didnt have time because he is scheduled shower on the 7 to 3 shift. He is a very aggitated patient, might I add, and why I am 'talking' to him I have to scream so he can hear me. I find myself being very short when trying to talk to him, because he cant understand ANYTHING. Also, I went in last night to help him into his PJs, and 'wash' him up, etc, etc. He was already in bed, not in his Pajamas. I tried to get him to change into his pajamas, he got irritated and started yelling at me! I'm not going to FORCE someone who REFUSES. Do you think this could be considered neglect or abuse?? If he blantley refuses to get into his pajamas?
I think the daughter might try to put a hidden camera in the room. Is this legal? We have cameras pretty much everywhere else except in the residents room. It just makes me feel weird knowing someone can see me all the time like picking my wedgie or my nose or something lol.
SweettartRN
661 Posts
My understanding is that it's technically their "home" and they are allowed to do with it as they see fit.
LPNweezy
188 Posts
Yeah, I'm sure they can put as many cameras in there as they want.
IHeartPeds87
542 Posts
If it's their own home then yeah they can legally put in cameras.
My suggestion to you and the other caregivers for this person? Document, Document, Document. I mean how does the daughter know that no one has washed or dressed or changed the linens in over a month? How does she know that those things aren't being done in her absence?
I can NOT reiterate how important it is to document in these situations. Documentation is vital!!
Thank you for your advice!
I will start to document and keep a record for myself, because we do have the ADL book with peoples signatures of doing the stuff, and after i heard she thought this I did look to see if people initialed showering him, they did, but who really knows.. I just want to know if I am doing anything wrong by him refusing! Am I suppose to FORCE him?? Or just let him go.. I know patients can refuse medications.. but can they refuse ADLs? I just dont want to get in any trouble for anything, and I want to know if what I am doing is right. I feel bad that his daughter is upset because she is usually VERY nice and thankful for everything we do. Maybe I will talk to her next time I see her. I think she called my boss today about this already and probably freaked out. I dont blame her for caring about her dad...but I think the issue with me, and the other PCAs on the floor is that...HE CAN GET HIMSELF DRESSED, so let him.... because there is a million other things we have to do. My theory is that if we help people that are ok helping themselves, it will make them decline faster. I dont care about the workload, I care about the resident. Ahhhh sorry I am just rambling.
OldNurseEducator
290 Posts
Thank you for your advice!I will start to document and keep a record for myself, because we do have the ADL book with peoples signatures of doing the stuff, and after i heard she thought this I did look to see if people initialed showering him, they did, but who really knows.. I just want to know if I am doing anything wrong by him refusing! Am I suppose to FORCE him?? Or just let him go.. I know patients can refuse medications.. but can they refuse ADLs? I just dont want to get in any trouble for anything, and I want to know if what I am doing is right. I feel bad that his daughter is upset because she is usually VERY nice and thankful for everything we do. Maybe I will talk to her next time I see her. I think she called my boss today about this already and probably freaked out. I dont blame her for caring about her dad...but I think the issue with me, and the other PCAs on the floor is that...HE CAN GET HIMSELF DRESSED, so let him.... because there is a million other things we have to do. My theory is that if we help people that are ok helping themselves, it will make them decline faster. I dont care about the workload, I care about the resident. Ahhhh sorry I am just rambling.
Sounds to me like this patient doesn't belong in assisted living, but more long term care where he will be bathed and dressed. I think the daughter may be denying the fact that her father is going downhill and probably needs more help. Would you agree??? Just my .
KimberlyRN89, BSN, RN
1,641 Posts
About 3/4 of my residents at my ALF belong in LTC.
evolvingrn, BSN, RN
1,035 Posts
It sounds like she should
Yes, he is declining a lot.. 6 months ago he could make his own coffee and now he just sits in his chair...ALL the time. I try to get him to go to activities such, but its hard for him to understand anything you say, he cant hear well, he cant see well, he is just going downhill. The thing is there is 6 people I have to dress and put to bed, ontop of 'keeping an eye' on the other 9 residents who are pretty independent, if youre not in his room at the right time he will help himself to bed. They all want to go to bed at 8 and its hard to be in all their rooms when they ALL want to go to bed at the same exact time. I actually just got word that he fell last night, and was sent to hospital this morning for fever and low pulse ox. He was bound to fall, he is an OK walker, (uses a walker) but is still veryyyy shakey. I disagree people like this should be in AL.
I think A LOT of our AL patients belong in nursing home. I am the only PCA on the floor, with normally 16 residents, there is one man that we have to SPOONFEED him his food, ontop of serving 15 other people their meals. AND the man cant stand up AT ALL. so he basically just sits in his chair all day, hes at least a 2 person transfer. I cant pick him up by myself, nor am I going to try and break my back, so what am I suppose to do! Just ****** me off that noone knows how these people are...referring to the "Big Dogs" in the company, yet they are the ones approving them for AL!
Well, maybe now that he's hospitalized, the family will (and/or doc) will see that he belongs in LTC and not AL when discharged. Sounds like the daughter has been in denial that Dad is going downhill. Happens all the time. It's hard to accept that your parents are getting old...but they do. He proobably has memory loss and cannot remember when he last had a shower.:)
Yeah he mind is definately going, he is a a wandering resident too, with dementia. He definately doesnt remember showering, or anything. I feel horrible, because hes at the hospital now, but they will bring him back in skilled and then back to AL, like they do WITH EVERYONE I SWEAR. its all about the $