to think my aunt, in a care home, should be allowed more than one shower a week?

[LuluBlakey1]

My aunt is 92 and has been in a care home for 4 weeks for respite care. The fees are £1300 a week. It emerged this morning that residents are only bathed or showered once a week. She washes herself with a flannel and soap every day- no help is available for this.

I asked the question of the 'senior' on duty and was told it is all they can manage and there is a rota. Some residents have alzheimers/dementia and can be difficult and some have medical conditions so must have more baths/showers. In the month she has been there she has never had a bath- not enough time for that and has only had 4 showers.

I was horrified. I thought they must be short staffed but apparently not.

AIBU to think if you are paying £1300 a week for a care home, you should have the choice of a bath or shower every day?

What also doesn't help is the current narrative of "they've worked all their lives why should they pay" that's running through society. If you want something funded by and run by the state expect it to be done of a very shoe string budget! Yet we expect top class treatment by the NHS - at least in terms of drugs and treatment if not in terms of waiting times, hospital food etc. We expect, although we don't necessarily get, good education for our children.

I do not wish to live with dementia. I do not wish to be kept "safe" in a home against my wishes, I certainly object to people using my money to keep me alive against my wishes. And I object totally to people using my money to top up the funding of those who are being supported by public funds.

I also hate the unfairness of my children having no inheritance when my neighbour's children, by sheer chance of what illness carries their parents off, inherit a considerable sum. We're not all saving "for a rainy day" - we're also saving to give children and grandchildren a good start. But it can all be wiped out by an unfortunate old age. Other disasters (eg house burning down, loss of earnings through illness etc) can be insured against. Being kept alive at a cost of £5000 a month cannot.

I am so with this. I have an advance directive, though apparently the Scottish legal system can choose to ignore it; for me, loss of mental faculty is the nightmare, as at that point I would have zero control of where I lived etc. just shoot me, please.

Do people stop taking their medication though as they grow old or with a disabling diagnosis in an attempt to hasten the end? Over thirty years of nursing tells me no. Most choose not to. The will to live is very strong.
If our savings have to be spent therefore to sustain the consequences of that choice and others are lucky enough to fare better health wise with less need for paid help, that's just unfortunate.

If I honest, I find it a burden. She is never suited for more than a few minutes and expects people to be at her beck and call. She will ring at 9pm because 'the outside light is flickering' and just expects me to go round immediately, even though the light is enclosed in a case screwed to the house and you have to get her housing co-op to sort it. Or she'll decide her bedding needs changing late at night (it doesn't- it is checked every day)and expect me to go round and do it there and then.
She becomes very sharp if I don't do what she wants.
I have developed techniques for managing her - greying out any criticism, or I just don't answer phone calls after 6pm now. She has a care call button so if she was unwell can ring that. Sometimes though, if she can't speak to me or her sister she starts pondering and then ringing 111 for advice about medical issues. She'll ring 4 or 5 times within a couple of hours. Then, because of her age they send someone out but they are frustrated by her because there is very little wrong with her and if she took her pain medication there would be no issue but she won't take it and she just keeps ringing them. It's a waste of their resources.

This is what I think it should be like.

I worked in care a long time and this, unfortunately, is not uncommon.

It's what happens when care is a profit making business first and foremost and the staff bill is one that can be cut with little in the way of concequences for the people making those decisions - when things go wrong it's the care staff that take the fall, sometimes the management but very rarely the people refusing to provide the resources needed to provide a decent level of care.

This sounds harsh and sarcastic and I don't mean it that way, but, we can expect and even demand standards improve as much as we want, when the resources aren't there to deliver those standards it's impossible.

There's no legal minimum for staffing levels, it must just be 'safe', ie the residents needs are assessed and then staffing levels decided from there, but, the people with a vested interest in keeping the wage bill low because they are looking at profits, are usually the ones making those decisions.

Unless it's glaringly obvious that it's unsafe then usually, a home will get away with it as long as nothing goes seriously wrong. I worked somewhere with 2 staff on shift and 16 residents, at least half of those residents needed 2 staff for moving and handling or because they exhibited challenging behaviour, so when both staff are delivering care to one of these residents, there's absolutely no one to respond to other residents, or they do that care on their own as the other person responds to the other residents. Neither is acceptable however with those resources provided, what exactly are the staff to do?
This home was inspected as all are and rated 'good' - staff levels and residents needs via their care plans as well, and it was flagged to managers and had also been raised with the CQC in inspections by staff. So they were aware of staffing levels and residents needs. But it was only when there was a serious incident that suddenly the inspectorate decided that the staffing levels weren't adequate and the care provider told to improve it. Too late by then because someone had already come a cropper over this and the owner & management tried to throw the staff on duty under the bus by insisting they were in the wrong - for once the inspectorate didn't buy it and the real reason was seen.

Horse, bolted and stable door springs to mind though.

In reality most care homes are under staffed as in there aren't enough staff to provide the level of care that's required, and then when those staffing levels fall again because there's a lack of care staff in general and positions are hard to fill and keep filled, well you have the staff that are there fire fighting constantly and responding to each situation as it arises in order of priority, rather than being able to respond to everyone in a timely fashion.

And those, like the OPs aunt, who have people to strongly advocate for them, do usually end up getting better care - but then it's at the expense of someone who doesn't have anyone to complain and kick up a fuss. Because homes don't want complaints so I suspect if OP complains loudly enough, then it'll happen, but not because it could have all along, or because they'll put more staff on, but because a corner will be cut elsewhere.

It's this that pushed me, and others I know out of care. Because we do care but we cannot deliver what's expected because profit is the main driver, not people.

I don't think that's a convincing argument. What will happen if I stop taking medications? I don't for one minute think I'm going to drift into unconsciousness and not wake up again. Most likely the unpleasant symptoms I take them for will return, my life may be shortened by x years, but I will need care x years earlier than otherwise, and life will be more unpleasant than it would otherwise have been. But how do I find out? Will you or any other medical professional tell me? Of course not, because that would be "assisting suicide" which is illegal, even though suicide is not.

Yes, lots of people commit suicide very successfully. But even more don't manage, and many of those firstly make life a lot worse than it would be, and secondly, making one attempt usually makes it much more difficult to make a second attempt.

But for most of us, the fear is dementia, and that creeps up slowly, usually without the victim being aware. And by the time we are aware, our capability has gone. So has our ability to make decisions, which is why we are not allowed to give Power of Attorney, or to change our Attorney. But it's difficult to make anyone heed our previously given instructions that life should not be prolonged (sadly we cannot give instructions that life should be shortened).

Sorry, posted on the wrong thread

But it wouldn't take 40 mins with carers. Patient sits on stool in shower cubical. Carers use hand held shower head to wash patient. Its quick. It has to be to ensure patient doesn't get chilly. I care for my husband. I shower him twice a week. From getting his clothes off, showering him, washing his hair, drying him, putting his creams on, and dressing him it takes me about an hour. That does not include the time shaving and using lift etc to get to and from the bathroom. So yes it does take longer than you think.

This is restrictive practice and falls under deprivations of liberties. I would raise a safeguarding with the LA the care home is situated in and report to CQC. As a former nurse I'm appalled! I'm so sorry x

It’s always “we don’t have the staff”.

It’s true, they don’t have the staff.

The real issue is they don’t want more staff. Because its costs money and reduces the care home’s profits.

When I worked in a nursing home the management were always looking at ways to cut staffing, even placing staff on compulsory annual leave it the unit was “over staffed”.

£1300 pw works out at £7.74 per hour. Allow approximately 10 hours per day for sleep + naps the cost for actual time the residents can ŕequire care as opposed to simple monitoring is £13.27 per hour. Most care homes are businesses.Even the ones catering for people with dementia and other complex illnesses who require actual nursing as opposed to basic care and supervision.
Getting an immobile resident ready for , into and out of a bath or shower and dressed for the day can take up to an hour for 2 members of staff even when they have the use of a hoist and properly adapted facilities. Then there's dealing with incontinence in a dignified manner in addition to basic needs for supervising medication, applying dressings or topical medication, feeding , monitoring fluid intake, human interaction and in some cases protecting the person from themselves .
A large number of families now need 2 working members to meet basic living costs which is why having a parent to stay permanently often Would we isn't a practical option. Local authorities are struggling to balance their budgets including providing even a contribution towards care for the elderly or infirm. National insurance /NHS , at its inception promised care for all from cradle to grave. I think its time to stop using national insurance as a tool for buying votes and reexamine the original concept.
Something needs to change. But what ? Would we (should we?) be willing to pay more ?

£1300 pw works out at £7.74 per hour. Allow approximately 10 hours per day for sleep + naps the cost for actual time the residents can ŕequire care as opposed to simple monitoring is £13.27 per hour.

If the resident had her own one to one carer who never left her side for all her waking hours, that would be the case. But she doesn't. That carer will be working with many other residents. So your maths is entirely irrelevant.

Sorry, I was pointing out that this is what her care costs her /her family/the local authority ie. Its what the home is charging per resident per week. That the home IS run as a business , at those rates its not as expensive as the headline figure would make us believe. So, no I don't think my maths is irrelevant but you are certainly entitled to your opinion.

Horrible