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In my experience, residents in an ALF can get out of bathing. My mom certainly did. The tended to want to assist her bathing when she wanted to do other things, and so she usually said no. You know, it isn't so much the lack of bathing. It is the lack of personal hygiene, as in she didn't wash her hands. And she liked to hold hands with me. I think ALFs could do a better job of promoting hand washing to their residents, frankly. At least that part of the body would be clean. I also think that elderly people do not need to bathe as frequently as the rest of us do. For one thing, they often have very dry skin. That's another thing ALFs should do; they could assist their residents with skin protecting lotions.
Meds are not optional though. If the doc prescribes them, they are dosed on schedule. Even if the resident protests, as my mom did, staff will persist until they get the resident to comply. They dose each pill separately to encourage residents to drink water. So many of the elderly forget to drink, and they can be dehydrated.
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Originally Posted by plantress
Jesseco, according to the workers in my dad's assisted living wing and then nursing wing, he could refuse and was within his patient's rights to do so.
He could refuse to get out of bed, to attend meals, to bathe and to accept medicine. Even though the psychologist deemed him depressed he could refuse medication for depression.
Imagine having to sit by while he cried and said "I just want to die" while also saying he did not want medication. It's tough. Coming in and seeing his face crusty and his clothing stained, we would be frustrated with the staff who would say, " he refused to be changed, he refused his bath, he refused to use his walker or wheelchair". Then dad would say, " no one has been in all day". Turns out dad was lying and also making their shifts unpleasant. One of those DO YOU KNOW WHO I AM!!!??? Moments. Yes, they knew he was a difficult patient!
By the end he had the very last room on the hallway, I assume it was because he was so difficult.
Thank you, Silibran and Plantress, for answering my questions about Assisted Living Facilities (do the residents have to bathe and do they have to take their medications?). I made this a different thread so that I wouldn't hijack KA's thread on "Adventures with Mom".
Plantress, I am going through a similar sad situation with my mom, though she doesn't live in an ALF. A sibling lives with her. I wondered if it would be better for her to be in an ALF for medication and bathing help. Looks like that might not be the case. And maybe it varies by state, and/or by facility. So sad.
Thank you, Silibran and Plantress, for answering my questions about Assisted Living Facilities (do the residents have to bathe and do they have to take their medications?). I made this a different thread so that I wouldn't hijack KA's thread on "Adventures with Mom".
Plantress, I am going through a similar sad situation with my mom, though she doesn't live in an ALF. A sibling lives with her. I wondered if it would be better for her to be in an ALF for medication and bathing help. Looks like that might not be the case. And maybe it varies by state, and/or by facility. So sad.
I would assume that one major difference would be if the resident was cognitively aware or not.
If a person is of sound mind they can refuse medications and baths and anything else that they do not want to do. Look at it this way, would you want to give up your rights to decide how often you take a bath or if you need to take your medication? What if you like to take a shower every day but the rules say you only get a shower twice a week (or vice versa) would you be happy? I know that I do not want to give up those rights.
However, if the person has an activated power of attorney for healthcare or are under legal guardianship they give up the rights to make certain decisions. I can force my husband, who has an activated POA for health care, to take his medications, whether by just asking him or by trickery or even by having an IV inserted (if it came to that). No one can do that to me (at least at this time) because I am cognitively aware and able to make my own health care decisions.
Now, it may be easier if an aide is helping mom take a shower vs. her own child. I have heard about enormous power struggles where the adult child says "Mom, you need to do X" and Mom refuses but if an outside person or a paid aide says "Mrs. Smith, it is time to do X", and they will agree.
I just reread your post where Mom lives with a sibling. Heck, even worse than my son or daughter telling me to take a shower would be my brother or sister telling me to do that! Also, if Mom is elderly I would guess that her sibling is too. What if they both fall & break their hips when sibling is helping sibling in the shower?
There are also other factors such as some people with Alzheimer's develop a fear of water and many seniors get cold very easily and have very dry skin (so limit bathing) and others are very afraid of falling in the shower or bathtub so try to avoid showers or baths. Some people are very shy and embarrassed and do not want others to see them naked.
So, it is not really a cut and dry issue.
Last edited by germaine2626; 01-18-2017 at 05:37 PM..
I agree with everything you wrote! And I wasn't very clear. It's MY sibling that lives with Mom. Mom is elderly and has dementia, but no one has medical POA. Siblings do not agree on care. Very painful situation.
I went through it with my mom. It was okay until my sister got the idea to move her. Don't move them once you find a place they like. It was a disaster.
Hi Jessico, thanks for the new thread. When my dad was in an assisted living facility he was checked on but not made to go to meals even though the cost included three squares. He allowed a foot wound to become infected in between the time he knew he was moving from Goldsboro, NC. to Wilmington, NC. because he fell between the cracks and was convinced that the Doctors were not as smart as He. I think he felt that it would be attended to, to his approval, once he got to the new, superior, facility.
He got to the new place, which we LOVED, and was almost immediately sent to the hospital for the untreated infection. From there, it's off to rehab, where, if you won't do the work you are discharge...a short hop, skip and a jump to nursing home. Don't do the work there and your PT is pulled. You get the idea.
Do I still sound bitter? I sure don't mean to! Loved this man, my dad. Still mad at how it all went down. ALF should be nearby and pls stay very involved. Maybe that last sentence should have been my whole post! ��
I went through it with my mom. It was okay until my sister got the idea to move her. Don't move them once you find a place they like. It was a disaster.
I have heard that and it makes sense. My mom is still in her home. I don't know that she likes it very much, but I think she is more comfortable there than she would be anywhere else. I hope that she can stay there because she greatly fears going to a care facility.
Hi Jessico, thanks for the new thread. When my dad was in an assisted living facility he was checked on but not made to go to meals even though the cost included three squares. He allowed a foot wound to become infected in between the time he knew he was moving from Goldsboro, NC. to Wilmington, NC. because he fell between the cracks and was convinced that the Doctors were not as smart as He. I think he felt that it would be attended to, to his approval, once he got to the new, superior, facility.
He got to the new place, which we LOVED, and was almost immediately sent to the hospital for the untreated infection. From there, it's off to rehab, where, if you won't do the work you are discharge...a short hop, skip and a jump to nursing home. Don't do the work there and your PT is pulled. You get the idea.
Do I still sound bitter? I sure don't mean to! Loved this man, my dad. Still mad at how it all went down. ALF should be nearby and pls stay very involved. Maybe that last sentence should have been my whole post! ��
I'm so sorry that it did not go well because of your dad's infection (and his stubbornness, too maybe?), and I understand your anger and sadness.
If my mom ever has to go to an ALF, I would be able to be more involved than I currently am, due to my sibling situation. But going to a "home" is her greatest fear, so I hope that she can stay at her own home even though there are problems with that. If she does end up at an ALF, it would be into a memory care unit. They are what I usually think of when I think of Assisted Living, but now I'm realizing that there is probably a big difference between regular assisted living and memory care assisted living.
Thank you, Silibran and Plantress, for answering my questions about Assisted Living Facilities (do the residents have to bathe and do they have to take their medications?). I made this a different thread so that I wouldn't hijack KA's thread on "Adventures with Mom".
Plantress, I am going through a similar sad situation with my mom, though she doesn't live in an ALF. A sibling lives with her. I wondered if it would be better for her to be in an ALF for medication and bathing help. Looks like that might not be the case. And maybe it varies by state, and/or by facility. So sad.
At most ALF's including my mom's they gave her a verbal test to see if she was capable of taking her medicines by herself or needed them dispensed by the nurse (they asked her what each was for, what the dosage was, etc) and she was allowed to. If she proved incapable of taking it herself, they would have put her on a schedule for meds. if she refused them, I don't think she'd still be there. They are not going to chance a child suing because a home knew his parent wasn't taking medications and didn't do anything. They do have a liability. There would probably be a procedure, from having the doctor speak to her to getting her a psych eval, but I don't think they would allow her to stay if she were refusing meds that were ordered (especially now that she's there on Medicaid after 3 years of private paying). As to the showers, many elderly only take sponge baths, that is no problem, however if someone doesn't bathe at all and start to look and smell dirty, residents and staff are going to complain and again, they are going to intervene.
ALFs don't have as strict rules as nursing homes, but they don't just let you do whatever you want. It's licensed by the state as being a residential health care facility, not an apartment building.
At most ALF's including my mom's they gave her a verbal test to see if she was capable of taking her medicines by herself or needed them dispensed by the nurse (they asked her what each was for, what the dosage was, etc) and she was allowed to. If she proved incapable of taking it herself, they would have put her on a schedule for meds. if she refused them, I don't think she'd still be there. They are not going to chance a child suing because a home knew his parent wasn't taking medications and didn't do anything. They do have a liability. There would probably be a procedure, from having the doctor speak to her to getting her a psych eval, but I don't think they would allow her to stay if she were refusing meds that were ordered (especially now that she's there on Medicaid after 3 years of private paying). As to the showers, many elderly only take sponge baths, that is no problem, however if someone doesn't bathe at all and start to look and smell dirty, residents and staff are going to complain and again, they are going to intervene.
ALFs don't have as strict rules as nursing homes, but they don't just let you do whatever you want. It's licensed by the state as being a residential health care facility, not an apartment building.
That makes sense to me. I also have a feeling there is a pretty big difference between a memory care unit in an ALF and the regular ALF rooms.
That makes sense to me. I also have a feeling there is a pretty big difference between a memory care unit in an ALF and the regular ALF rooms.
My mom is not in memory (in fact they do not have a memory unit), or she wouldn't have been allowed to dispense her own meds. Yes, it is different, they can do more invasive things in memory care -for instance in a memory unit I worked in, one woman had a very needed medicine but she'd try to bite when they tried to give it to her, so with the daughter and doctor's written permission, they were able to get in a topical cream form, and just gently rub it on her arm when they were talking to her...they would never be allowed to do that with an alert and oriented person.
But even in a regular place like my mom's that has no memory unit, they still cannot just let a resident commit suicide or harm their health on their watch, and that includes not taking needed meds. Again, ALF is not a residential apartment, it is assisted living. When a resident dies, they have to report it to the state - if the state comes in and finds out the person dies because they weren't taking their meds and the facility knew it, they would be in real trouble.
An alert and oriented person IS capable of talking to their doctor and asking for a med to be discharged, which my mother has done, but again liability trumps all.
There is a pretty intensive interview with the prospective resident and family before they accept someone, btw, which includes someone from admissions, someone from nursing, and social work...they will look at all her medical records and her doctor will have to sign a letter stating she is appropriate to be there. If she has a history of being non-compliant or she tells them she's not going to take her meds or wash herself when those topics come up, they would probably refuse to accept her.
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