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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

is this wrong? Family and Care Workers views

38 replies

Anarchyinateacup · 07/12/2016 13:21

Client F has severe disability in regards to movement and speech, but can understand and respond to yes or no questions. Client F gets PJs on but has been refusing to change out of this and into fresh nightwear at bedtime by shaking his head and responding no when asked if he wants fresh nightwear(usually no to the top half only) on. He is often extremely tired and is falling asleep as you are moving/handling.

Family want client Fs changed regardless of his wishes/mood etc. Of course I will carry this out but I feel very uncomfortable with it, employer has basically said tough its the family wishes, and I'm wondering what the views are from other families with loved ones receiving daily care? Should someone be forced to change an already clean top for another, just because they've had it on for a few hours, even though they are showing signs of refusal and are extremely tired and sometimes in pain.

OP posts:

Leanback · 07/12/2016 13:24

Ubless he has a DoLs then I don't think it's acceptable to change him against his wishes.

kateclarke · 07/12/2016 13:36

You need to assess his mental capacity, or get a professional to do it. If he has capacity then obv don't but document very well. You may want to look into getting him an IMCA.

Original poster

Anarchyinateacup · 07/12/2016 13:38

Everything is documented, including reasons when he has not had a top change, but this isn't good enough and they are insisting. If top was dirty or unsuitable it would be a no-brainer in regards to changing it. Only information I have is next of kin are PoA.

OP posts:

kateclarke · 07/12/2016 13:39

Are they poa for finance or care as well ?

JCo24 · 07/12/2016 13:42

How old is the individual?? I would not change him if he has said no. You do not work for an institution and he has rights.

kateclarke · 07/12/2016 13:42

Thinking about it, I would involve the safeguarding team at your local council either way. Get it all official. You could be accused of abuse either way and he is in a very vulnerable position.

Original poster

Anarchyinateacup · 07/12/2016 13:43

I'll err on the side of caution and say both as client is literally unable to do anything for himself due to the disability he has ended up with but he can clearly demonstrate a level of understanding and will always answer yes or no questions, he can no longer speak so this is the only real means of communication.

OP posts:

kateclarke · 07/12/2016 14:00

If they have poa over care they need to prove it. However if he has capacity it makes no difference. Look at the mental capacity act. Have you recived safeguarding training?

Feilin · 07/12/2016 14:10

I work with people with dementia and as far as we possibly can we get them to make their own decisions. So for instance he can answer yes or no so in that circumstance I would check his top is clean if it isnt I'd really be encouraging him to change . If it is I would say ok and reapproach later . I'm aware that your client is not one of mine but the key important thing here is that he is able to express himself via yes or no .

Original poster

Anarchyinateacup · 07/12/2016 14:10

Only basic safeguarding training if I'm honest.

I just feel like it's quite cruel to force someone into something, that isn't really benefiting them. I'd have thought ensuring he was transferred safely, medication taken properly and clean/comfortable would have been more important than changing an already clean top against their will if it makes their nighttime routine just that little bit easier for them to cope with.

OP posts:

Trifleorbust · 07/12/2016 14:12

You're not a nanny; he has a right to refuse to change. You seem to know this is wrong. It doesn't matter who is paying.

Original poster

Anarchyinateacup · 07/12/2016 14:18

Apparently nodding and shaking for yes and no is not a form of communication. Poor man, this is his ONLY way of communication, that and facial expressions which he clearly uses to try and explain his feelings etc happy,sad,tired...

OP posts:

Trifleorbust · 07/12/2016 14:20

You should speak to your managers about this. I assume the family don't employ you privately?

Leanback · 07/12/2016 14:26

Op I think you know that forcing him to change is not right. Even if he didn't have capacity I can't see why forcing someone to change a clean shirt is necessary.

Sugarlightly · 07/12/2016 14:46

In his own home or residential care?

Original poster

Anarchyinateacup · 07/12/2016 14:46

I work for a company, the family has brought this up with my employer. It isn't just aimed at me but others who cover the same run and are faced with the same issues.

OP posts:

Trifleorbust · 07/12/2016 14:47

Well, as far as I am aware their having POA doesn't negate all his choices. You would be within your rights to say you're not going to change him if he says no.

DancingDinosaur · 07/12/2016 14:55

I would get on to the safeguarding team. If he has capacity then he has the right to say no. He sounds very vulnerable to the demands of his family.

DancingDinosaur · 07/12/2016 14:57

The thing is, if you force him to change, when he has said no, then technically this can be seen as assault. So you need to protect his interests and your own.

typedwithcertainty · 07/12/2016 15:04

Has he been judged to have capacity? If he has no DOLs in place then carers are acting against his will.

If nodding/ shaking head are his only forms of communication, then fine, he is communicating and should be listened to.

I would involve a social worker/ care manager individual and family together and hold a meeting to discuss the issue.

It's really common for families to try and overrule decisions and choices, and most of the time it comes from a good place, but as a care company it's your job to advocate the clients wishes IMO

Whoamiwhatami · 07/12/2016 15:15

If he has mental capability to say no you cannot force him regardless of the families wishes.

I'd attempt to encourage but if it's a no then you cannot force. Document the situation, report to management.

If they are backing up the stance that they should be forced you may need to esculate it above them and report up the line and consider reporting the issue to the cqc.

Kiwimiri · 07/12/2016 20:51

Yes and no is absolutely a legitimate form of communication and is sufficient legally for competency if he's understanding the question. Look at www.communicationmatters.org.uk and get your manager to refer to the local Speech Therapist either at the ALD team or ACE centre if you have one near.

RedHelenB · 07/12/2016 21:01

Maybe his family think the carers are being lazy by accepting the no. I know the carers of my grandma would often put client refused to let us do x,y and Z but when she went into a home these things were done routinely so they must have persuaded her somehow.

51howdidthathappen · 07/12/2016 21:08

It is heartening to hear a carer standing up for a clients rights, wish there were more like you, OP.

Our safeguarding team, is absolutely dire. Hope you strike lucky with your area.

Whoamiwhatami · 07/12/2016 21:08

As someone has done home care ad well as worked in a home. Gaining consent for things is not often gained. You are forced to assist people to do things against their will. It was so against my views.

I'm not lazy but I accept no means no.

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