Showers in nursing home

Specialties Geriatric

Published

Is there a rule/law/guidance/statute that dictates how many showers a week a resident should get? At my nursing home we have to give 2 showers a week to each one but my Dad is in a nursing home in another state and he practically has to beg to get one every other week. Today, again, he did not get his shower. The CNA told him she "forgot'. I told him he should report it to the nurse but he doesn't want to complain and cause trouble.

I'm hesitating to call the home cause I don't want to make any accusations until I know what the rules are. I know there must be some governing body that determines these things but I'm not sure what it is.

Thanks for any feedback!

Update: Thanks everyone for all your comments and suggestions. Things have worked out well. I never had to call the DON as my dad has been getting his showers every week, as scheduled. It turns out I didn't have to worry after all (but who doesn't worry about their elderly parents, right?). What made me jump the gun in assuming this would turn out to be an issue is the excuse from the cna "I forgot", and it was a red flag to me so I got on hyper alert. Just as I would be if one of my cna's where I work said that. And as many of you mentioned, residents will sometimes forget or inaccurately report things, and he is almost 88 years old! So I had to take that into consideration. And besides, LTC has been my career just about my whole life and I know only too well what the staff are going through so I tend to want to give a wide berth. But it's good to get professional opinions when I'm on the "other side" for once. Thanks again to all!

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Specializes in retired LTC.

Thank you for the comeback info.

Sometimes you have to follow up twenty thousand things just to get to bottom of the story. Just some investigation.

Glad things seem to have worked out OK for y'all.

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while some states may have a set minimum number of showers/baths, i suspect your facility policy and care plans dictate twice a week and that is why you are held to that number. The least I've seen is once weekly (outside of individual residents with major problems with bathing-i did have a schizophrenic dementia patient care planned for monthly showers preceded by haldol/ativan/benadryl.) AFAIK my state just requires that LTC residents have care plans which must be followed and be "sufficient" to maintain the health and dignity of the individual.

I'm sure you're aware that LTC residents are famous for refusing baths, kicking and screaming, then raising hades with their family and POTUS that they haven't had a bath...

If there are he-said-she-said issues or you believe he isn't bathed adequately, a friend or relative should make it a priority to be present on shower day (make sure staff understand you don't want them to delay or skip any care due to your visit). If there is a long term or severe problem its worth missing a half day of work or finding ride. If he showers while you're there but refuses for staff then ask to be called upon refusal-then meet with staff to ensure showers are scheduled at times you can be available(in person or by phone).

For someone fearful or aggressive with bathing a psych consult and/or premedication may be in order. Their care plan should be showers/bath as infrequently as possible with good but quick hygeine care often. Consider shampoo caps that wash hair without being in the shower and other no-rinse products: cleansing lotion applied with a dry cloth or dry shampoo. This may need to be purchased by family with personal funds.

OP it sounds like you handled this very reasonably. You are correct that it doesn't do Dad any favors to be seen as a complainer or impossible to please. Don't be a doormat but always get both sides of the story, work WITH staff to find a solution, and start with direct care staff escalating up the chain of command only when necessary-and remember to tell the bosses the good stuff too!

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Specializes in Gerontology, Med surg, Home Health.

Back in the day before twice weekly showers became common place, all the residents would get a thorough bed bath twice a day. I had a 96 year old woman come up to me and ask "Mermaid, do you take two baths a day?" I told her usually I just take one unless it was really hot out or I had been to the beach. She said "I'm 96 years old. How dirty can I get. I don't want two bed baths a day! I don't really want any, but one will be fine." I changed her care plan to reflect her wished. No one had any issues with it. We have to remember, we're supposed to be giving RESIDENT CENTERED care. It's not always easy but we need to do what the residents want...especially when it comes to personal care. (PS. This lady was 100% continent and never smelled bad)

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Back in the day before twice weekly showers became common place, all the residents would get a thorough bed bath twice a day. I had a 96 year old woman come up to me and ask "Mermaid, do you take two baths a day?" I told her usually I just take one unless it was really hot out or I had been to the beach. She said "I'm 96 years old. How dirty can I get. I don't want two bed baths a day! I don't really want any, but one will be fine." I changed her care plan to reflect her wished. No one had any issues with it. We have to remember, we're supposed to be giving RESIDENT CENTERED care. It's not always easy but we need to do what the residents want...especially when it comes to personal care. (PS. This lady was 100% continent and never smelled bad)

Advantage of working somewhere where the RNs are actually allowed to develop and modify the care plan for the benefit of the patient/resident.

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Specializes in Gerontology, Med surg, Home Health.

The DPH is really looking more closely at care plans so we make sure ours are reflective of each resident. A good care plan has saved me more than once from a citation.

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