Should I report a sad experience at nursing home?

[Curlystars]

By the way, have name-changed for this.

A couple of days ago, I went with my DS (9) and his small rural primary school choir to a local retirement/nursing home so the children could sing carols to the residents. All very lovely and the children had been rehearsing for weeks.

While they were singing an elderly resident, wearing only a tee shirt and a nappy, wandered in and came up to me.

Bless her. She hung on to my arm and would not let go. Poor lass was trying to say something. I couldn’t understand what she was saying and just hugged her.
There were no members of staff around at all.

I know this retirement home charges a lot of money for the care of residents. Perhaps all care homes do, I don’t know.

Should I report this care home for the total lack of respect shown for this poor woman’s dignity?

My mum was diagnosed with Alzheimer’s last year and the thought of her living in a care home with only a handful of overworked carers looking after numerous vulnerable and unpredictable residents worries me tremendously.

I’d report it, but as above someone should’ve been in the communal areas with or near by you at all times. Dementia causes unpredictable behaviour and sometimes this can be extreme and alarming or physically dangerous.. seriously I’ve had a walking frame over the head and flung like a rag doll from the same resident who loved braiding/playing with my hair. We also had a lady who flashed and physically jumped onto male staff/visitors laps screaming with zero warning.. she’d sit holding her “baby” and stroking ladies hands for ages before an outburst...

Secondly yes she shouldn’t have wandered around in that state of undress but proper staffing would’ve helped that. Or a pressure mat set at her doorway so she can roam her room however she pleases but someone knows that Mrs X has left her room and as she refused to be dressed this morning someone should try to assist her.

But more than likely you’ve been in a home with a manager who’d rather we figured out mitosis on the night shift than spent an extra penny on staff or aids to help residents.

It's a distressing thing to witness, especially the late stages of dementia but I don't think there is much you can do unfortunately.
I use to work in a care home thar specialised in special needs. One lady there would constantly strip naked and did so on the day of our cqc inspection.
Me and another staff member begged and pleaded with her to put some clothes on, brought down her entire wardrobe almost but she flat out refused and walked straight down the corridor to the cqc inspector.
We apologised to the lady and she just shrugged it off and said "yeah that is normal". The thing is is that all we could do in that situation is provide as much dignity as possible, even if that means running after her with a towel to block others view and encourage her to put on clothes but if we had forced clothes on her, kept her restrained in one area when she wanted to leave then we would have been in deep shit and rightly so.
I would definitely speak to the manager though, this is probably a common occurrence with this woman and staff should try (although you don't know how busy they are) to keep an eye on her for this.

No one in their right minds wants to be waking around in their happy.

If this was my nan I’d be so upset. Where is the dignity in this.

Yes I’d make a complaint

if we had forced clothes on her

I have heard horror stories about homes where this is the norm, 2 or 3 'carers' holding each limb or holding the resident face down on the bed as if being arrested they only get in shit if there are injuries caused, assaults and residents being shouted at or put into clothes they CANNOT remove because of the fastenings being sewn closed after dressing.

There are lots of things that warrant complaint but a wandering resident with her 'bits' covered but no skirt/trousers wouldn't be an emergency or even unusual unless there visitors and it wouldn't be taken seriously.

@Swirlygirl She likely didn't know or have the capacity to care that she wasn't dressed. OP didn't mention that she seemed bothered

the dignity of their clients Isn't "dignity of the client" a concept that applies to the client only to the extent to which they understand it? If you've lost the concept of what is appropriate or inappropriate, then it's not your dignity that is at stake (you no longer have that concept) it's the feelings of other people that are being protected.

Depending on that ladies DoLs assessment depends whether they can redress her. It is deprivation of liberty to make a resident redress if they have the capacity to decide they don't want too. You also cannot force said resident to stay in one area. Yes there should have been a member of staff with you at all times, but you dont know if there was an emergency with another resident on the opposite side of the building. The room would have had a call bell that you could have used to alert staff help was needed.

It's probably a regular occurrence with this lady and nothing they haven't heard before. Ring the manager and speak to them, CQC will have seen a lot worse. Unless you've worked in a residental/dementia home you really don't know the goings on inside of one. Even visiting regularly doesn't give you a true picture.

Raspberrytruffle, you speak the absolute truth, anybody unfamiliar with aged care/nursing home residents might be shocked at this incident, but it happens every day. Depending on the staffing ratio to patient numbers it can be very difficult to prevent a resident with dementia from behaving in an inappropriate way, that is why the resident is in an aged care facility.

What would worry me is the lack of staff visible/available to help.
You are quite within your rights to speak to the facility manager about this from a staffing angle, Personally I would.
Did the other residents look clean/well cared for in your opinion?
Was the facility clean, bright, well decorated and well furnished and equipped?
It might be the best facility available, with the most caring staff, but the staff cannot be in three places at once.
Best wishes

I'm inclined to think as there were children there the lady being calm and content in her t shirt and incontinence wear was preferable to a distressed, confused lady being escorted out and scaring the children. Alzheimer's and dementia are not just becoming a bit forgetful and doddery. Sufferers can often become violent when distressed.

Maintaining dignity is a balancing act against unnecessary restriction. Confining someone to their room or following them around continuously to ensure they stay dressed can make for a grim day for a person with dementia, and that's before you consider staffing limitations. It's also worth remembering that it can take 30-60 minutes to dress someone with dementia but 10 seconds for them to strip. Did she look cold?

It is concerning that no staff were around during a children's performance, however. I'd give the home a ring and speak to the manager, or send them an email. If you aren't satisfied with their response alert the CQC.

Your local authority will have a care quality team that will be interested, more responsive than CQC - ours in the LA I work in are out at homes all the time and will log this and report it through and monitor improvements. CQC are too hands off for this, they go in on a inspection and dont go back for years unless co-ordinated concerns are raised.

I work in a care home at the moment and I can understand how this could look from an outside point of view as I also have a relative who lives in a care home. Yes it may be the residents home, they can walk around how they see fit, but staff do also have an obligation to uphold dignity & respect, compassion, support and wellbeing, responsive care and to be included. You also have to take into consideration, staff can be busy, but at the same time if there is a large number of resident in one area there should always be a staff member present. Another aspect is that depending on the residents medical conditions, such as dementia, if a resident refuses personal care, staff do have to respect that unless there is a best interest decision careplan in place. Residents can't be forced to do something or wear something they don't want to do as it is classed as abuse. The best thing to do is contact the care home manager, to try and resolve the issue, as the manager has a duty of care to residents even if they are not on the unit working. Let the care home try and sort it internally before contacting any external bodies. If it was just the one resident who was like this, it could be for a number of reasons, such as the ones I have mentioned.