Student Nurse with LTC question RE: clothing

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We are currently doing clinicals in a LTC facility that has 2 floors, 3 wings, and from the looks of it, is understaffed most days. In our skills lab they talked a lot about the bathing process and how to look under folds of skin for rashes, etc. So working with my patient yesterday, I noticed that none of the female patients wear bras of any kind. Is that a safety thing or just lazy on the part of the staff? My patient had visible redness from her shirt rubbing on her breasts and causing soreness. A bra would go a long way to keep that from happening. Obviously I haven't been at this very long but our instructor didn't have an answer since she's mostly worked cardiac in the past. If it's just a matter of too lazy, then I'm going to advocate for those poor women. How miserable. If it's a safety thing, then there probably isn't much to be done.

Thanks!

Specializes in Hospice/Palliative Nursing.

:twocents: IMO, a cotton sports bra is the best choice. It wicks away the moisture, has no tight bands, has no hooks, easy on, easy off, nothing to bunch or irritate their delicate skin. PLUS, it provides some modesty, so they are not "out there" for the world to see.

Dear God, please put one on me when I'm in that predicament! :plsebeg:

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Specializes in psych, addictions, hospice, education.

another problem with powder is if the next day's shift doesn't clean it off, if it gets sweaty, it's a set-up for a party for bacterial and yeast infections...

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Specializes in CV Surgical, ICU.
another problem with powder is if the next day's shift doesn't clean it off, if it gets sweaty, it's a set-up for a party for bacterial and yeast infections...

Another thing!

If they're too lazy to wash it off and just pour more powder over the old crusty powder, creating a huge yucky powder mess!

Saw that a lot at the place I did my clinicals :uhoh3:

As for the bras, it is totally up to the resident. Just try to encourage another layer like a tank top or something.

For the dementia patients, if they are mobile enough, the sports bras work better than anything else. Take the patient's comfort into consideration. I work with a very immobile woman, who would just be way too uncomfortable if I was shifting her back and forth struggling to get a bra on her. It's not laziness on an aide's part, it's just that the costs outweigh the benefits.

Like others have said, just clean and dry thoroughly and there shouldn't be any problems. :)

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Specializes in acute care and geriatric.
The only problem with not wearing a bra is if the shirt causes the person to have breasts exposed, maybe not just skin, but showing nipple through the material...but it is up to the resident or the residents POA about whether or not to have on a bra. They should decide...nipples or not!

This is their biggest problems???

Puhlease....I have had nipples protrude even with a bra.

Some patients want a bra and some dont- some sleep in the nude, some wear a few buttons opened etc. If the patient is alert and can express an opinion- you should always ask. And respect it!

Some patients cant talk for themselves- you should then ask the family. In general if the family provides a stack of bras with the clothing- you should use them. If it is hard to get them on and properly fitted- if they are too tight or uncomfortable- dont.

most CNA;s would prefer to skip them, I can always tell a good one by the way she respects the patients requests for difficult things.

Like Someone mentioned, this isn;t our biggest problem here.

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Okay...when I was young, started LTC as a CNA/ nursing student, I would never dream of going braless..even at night, LOL (yes..I'm large chested)

I noticed this alot and probably thinking the same thing you are..lazy or what.

First...try putting a bra on some of these ladies. (things give in to gravity after the years...Heck..I see this now and it ain't purty after nursing 4 and soon to be 5 kids)

Second...look at some of the bras that the family left them...some of them are 10 yrs from being the right size) For the dementia pts...maybe the struggle to put them on (even proper sized ones) isn't worth the agitation it can cause the resident. As the families about this one too...maybe they didn't know mom needs new bras.

Third.....many of these ladies don't want to be subjected to wearing a tight fitting contraption that they were forced to for many yrs or alot of them are wearing shirts, sweaters and maybe a blanket, etc and don't really feel the need to cover up.

As far as the cleanliness issue..proper am and pm care is always needed. We notice a good bit of rashes in the summer months..sometimes it is avoidable, but with others it isn't. (TMI....I wear a bra, keep myself clean, but it still happens)

for that, we use nystantin power...nurses apply and it just a bit after cleaning and drying the are really helps.

As far as the brief changes..we do q 2-3 hr changes depending on the person.

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Specializes in Geri, psych, TCU, neuro--AKA LTC.
The only problem with not wearing a bra is if the shirt causes the person to have breasts exposed, maybe not just skin, but showing nipple through the material...but it is up to the resident or the residents POA about whether or not to have on a bra. They should decide...nipples or not!

Peek-a-boob in the Dining Room--- not pretty. :eek: :omy:

If it's a matter of fit, extenders for the band are $.97 at Wal-Mart. Has anyone other than me measured a resident for a bra so that family can get the correct size? I prefer the soft cotton sports-bra type of bras with the hooks either in front or back d/o whether the woman can dress herself with the front hook. Decreased shoulder ROM and pull-over sports bras don't go well together. We have undershirts for our ladies who prefer to abstain from wearing bras.

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good point...undershirts. I forgot about this one...a lot of our residents dress in layers, so in a sense...they are wearing undershirts and coving up.

Peek a boob.....LOL...yep...they somehow wonder down into the lap and sometimes creep out when changing positions in the W/C...that is my biggest fear when I get old.

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Specializes in acute care and geriatric.

You reminded me of this email I received a while ago:

Julie Andrews Turns 69

To commemorate her birthday , actress/vocalist, Julie Andrews made a special appearance at Manhattan's Radio City Music Hall for the benefit of the AARP.

One of the musical numbers she performed was 'My Favorite Things' from the legendary movie 'Sound Of Music'. Here are the lyrics she used:

> > > > > > > > > > > > > > > > > > > > > > >> > > > > > > > >

(Sing It!)-If you sing it, its especially hysterical!!!

Maalox and nose drops and needles for knitting,

Walkers and handrails and new dental fittings,

Bundles of magazines tied up in string,

These are a few of my favorite things

Cadillacs and cataracts ,and hearing aids and glasses,

Polident and Fixodent and false teeth in glasses,

Pacemakers, golf carts and porches with swings,

These are a few of my favorite things.

When the pipes leak, When the bones creak,

When the knees go bad,

I simply remember my favorite things,

And then I don't feel so bad.

Hot tea and crumpets and corn pads for bunions,

No spicy hot food or food cooked with onions,

Bathrobes and heating pads and hot meals they bring,

These are a few of my favorite things.

Back pain, confused brains and no need for sinnin',

Thin bones and fractures and hair that is thinnin',

And we won't mention our short shrunken frames,

When we remember our favorite things.

When the joints ache, When the hips break,

When the eyes grow dim,

Then I remember the great life I've had,

And then I don't feel so bad.

> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> >

(Ms. Andrews received a standing ovation from the crowd that lasted over four minutes and repeated encores.) Please share Ms. Andrews' clever wit and humor with others who would appreciate it.

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Specializes in ICU.

I always respect the patients wishes and sometimes the family. a quick example, a family member got upset with me for putting butter and gravy on the residents mashpotatoes. When mom is a 98 years old, 98 pounds, she is welcome to be extravigant. In the same turn, I believe wearing a bra is a concept devised by the devil. I surely hope no one puts me in a tight uncomfortable bra when i'm 98 just so my " nipples" wont show. Heck the men have nipples to. Our society is strange.

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I totally agree. The lack of care that our elderly receive really disgusts me. I also think it's really a shame that most LTC facilities don't or aren't able to pay competitively enough to attract quality nursing staff, etc.

I beg your pardon.

We do not use powder. It is a safety hazard if it spills.

Many of my ladies prefer to be brassiere-free. If they are busty enough, or have a pannus (belly) with big folds we will use ABD pads to absorb moisture and an anti-fungal if they are prone to candidiasis.

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Specializes in CV Surgical, ICU.

I've seen women with bras on still get rashes beneath their breasts, it's not a matter of wearing one/not wearing one, it's an issue of proper care!

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Specializes in Gerontology, Med surg, Home Health.

It's not always an issue of improper care...old people get rashes...they have saggy, sweaty skin. They get rashes when they live at home and they get rashes when they live with us. Who cares if they don't want to wear a bra? Just because all you Puritans are offended by nipples...they always have at least 3 layers of clothes on....I can't believe how all the students who think they are going to change the world pick on the minutia of underwear. You do the best you can with what you have. And for those of you who say LTC doesn't pay well enough to attract good staff....I graduated at the TOP of my nursing school class and I work in LTC. I'd put the assessment and time management skills of the nurses I work with up against most any nurse from the local hospital.

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