Fostering Independence

[cardiweaver]

Our Assisted Living facility has a resident who is capable of assisting with showering, but he does not want to do any part of his shower himself. He can do quite a bit of his shower, but does have some arthritis in his hands and in one shoulder. He does not ever exercise, moving only when he has to (come out to meals, go out of facility to Dr. Appt, etc). He still drives, has no cognitive decline, does everything independently. He likes being nude, and wants our CNAs to wash, dry and put powder and lotion on for him. He recently had a complaint of sexual harassment from a female staff member. He does have problems gripping a bar of soap, but liquid soap and a wash cloth could work. He is very resistive. He does have a history of exertional angina and of asbestosis. This, linked with his chronic back pain and arthritis do make some motions difficult and painful for him. His Service Plan lists "minimal assist" help with showering....but he wants staff to do every aspect of his shower care. (Total assist). He can manipulate silverware, drive his car, sign his name, play computer games all day. He absolutely refuses to have a male care for him. My approach has been to tell him that we want to assist him with things he needs help with and have him do the rest. If his medical condition warrants, we can increase how much we help him, but that needs to be outlined specifically by his doctor. He is really angry now, saying we are taking away from what we used to do for him, and we are trying to force him out. We are actually trying to keep him as independent as possible, for as long as possible. Any suggestions?

[ktwlpn, LPN]

He is paying for a service....You can care plan all you like but he is going to do exactly what he wants to do,no more,no less.Maybe have two staff deliver hygiene at all times if they are uncomfortable and feeling harassed .

[jschut, BSN, RN]

I agree with ktwlpn. Have two staff in the shower room with him and with all personal care.