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Elderly parents

Why would four staff be needed for personal care in dementia?

228 replies

IDontLikeMondays88 · 30/04/2026 10:27

Dad has late stage dementia. We are being told he is so agitated when receiving personal care ie toileting that he is needing 4 members of staff attending to him to do this.

can anyone explain why 4 staff members would be necessary? I just don’t get it unless they are restraining him which I assume they shouldn’t be doing.

from my point of view I just am thinking well no wonder he is agitated with there are 4 of them at him.

OP posts:
todayImstruggling · Today 00:32

Ayarreet · Today 00:24

Not as rude as you, dismissing the torment that people with dementia suffer.
'No rhyme or reason' most certainly does not make it 'bloody clear' what you meant.
In fact it diminished the struggle of people with dementia.
'Their distress' is triggered by the fact that their brain cells are being overtaken by plaques that prevent them from functioning.
With regard to you last sentence, I refer to my previous statement.
I would like a chemical cosh. ALL the drugs. Take me somewhere else, baby!

WOW! Just Wow! At no point have I ever done that!

todayImstruggling · Today 00:33

Ayarreet · Today 00:26

She hasn't said what year she last worked.

So? 🙄 Whether she is working now or retired two decades ago she still not wrong!

Ayarreet · Today 00:37

todayImstruggling · Today 00:33

So? 🙄 Whether she is working now or retired two decades ago she still not wrong!

2014 'A gilded cage is still a cage'. And that was just about supervision in a comfortable cage.
You cannot. Cannot. Restrain, most especially in the circumstance of intimate care, without strict application of the regulations.

todayImstruggling · Today 00:38

Ayarreet · Today 00:26

OK. I'll hold you down against your will and no one will help. How's them apples?

A few minutes of being confused and distressed in order to keep me clean and free from painful sores, skin breakdown, infections and possible sepsis would be far preferable than the horrors of later options.

There are no good options. There is no perfect solution or a happily ever after. Dementia sucks. It is a vile vile disease.

Ayarreet · Today 00:39

todayImstruggling · Today 00:32

WOW! Just Wow! At no point have I ever done that!

'No rhyme or reason'
You did. You ignored the brain disease.

Ayarreet · Today 00:40

todayImstruggling · Today 00:38

A few minutes of being confused and distressed in order to keep me clean and free from painful sores, skin breakdown, infections and possible sepsis would be far preferable than the horrors of later options.

There are no good options. There is no perfect solution or a happily ever after. Dementia sucks. It is a vile vile disease.

This is you speaking with a fully functional brain.
Imagine if you felt you were being attacked.

todayImstruggling · Today 00:40

Ayarreet · Today 00:37

2014 'A gilded cage is still a cage'. And that was just about supervision in a comfortable cage.
You cannot. Cannot. Restrain, most especially in the circumstance of intimate care, without strict application of the regulations.

Who is suggesting that the rules are not being followed? You have no proof or evidence that the carers are not doing things by the book.

todayImstruggling · Today 00:42

Ayarreet · Today 00:39

'No rhyme or reason'
You did. You ignored the brain disease.

No I didn’t! Not at all. I had explained in detail what I meant. But you spin yourself into some ridiculous narrative if you want to. It’s your blood pressure you’re raising!

Ayarreet · Today 00:42

todayImstruggling · Today 00:32

WOW! Just Wow! At no point have I ever done that!

And you also tried to shift the burden to the family being unable to accept the reality.
'combative' Yeah, they want their loved one looked after properly.

Ayarreet · Today 00:46

todayImstruggling · Today 00:40

Who is suggesting that the rules are not being followed? You have no proof or evidence that the carers are not doing things by the book.

'who is suggesting the rules are not being followed'
The man's daughter.

todayImstruggling · Today 00:53

Ayarreet · Today 00:46

'who is suggesting the rules are not being followed'
The man's daughter.

No. The OP hafs no idea if they are following the care plan or not because she has not asked them! There is NOTHING WRONG with needing 4 carers to assist someone with toileting if that is what they need. The Op does not at the moment know why 4 carers are needed. Until she has that information she cannot know if they are following the care plan.
The OP does not have POA for her father. The care home do not have to ask her permission for there to be 4 carers present.

Ayarreet · Today 01:01

todayImstruggling · Today 00:53

No. The OP hafs no idea if they are following the care plan or not because she has not asked them! There is NOTHING WRONG with needing 4 carers to assist someone with toileting if that is what they need. The Op does not at the moment know why 4 carers are needed. Until she has that information she cannot know if they are following the care plan.
The OP does not have POA for her father. The care home do not have to ask her permission for there to be 4 carers present.

She has every right to ask them to specify exactly why his right to dignity, that she also thinks is a reason for the escalation in behaviour, is being breached by the presence of four people.
You don't seem to understand the fundamentals of the issue at hand.
That's a you thing.

Ilovelurchers · Today 01:02

This thread is an uncomfortable read.

I am really worried how many people are insisting that OP should not query this and simply accept that it must be right, appropriate and in dad's interests, simply because the care home are doing it.

Do you honestly believe that there is never abuse (either intentional or through incompetence?) in care homes? That it's right to advise the families of loved ones in care homes to ignore any concerns they have about their loved one's well-being, because the care home is always right?

The way some of you speak of those with dementia is also quite distressing, to be honest. As if they are simply a problem to be solved, by any means possible. No consideration or regard for their well-being, or sense of privacy and dignity.

You are also ignoring the fact that OP was one of her dad's main carers. Better than almost anyone, she knows him and his needs. If the care home has truly had such a negative impact on his wellbeing, that he has gone from a man who could mostly go to the loo independently, to a man who requires 4 people present while this happens.... Then she needs to ask why, and whether this is an appropriate placement for him.

I don't have experience of patients with dementia in general, and nor did I need it. I had detailed experience of my own father, a dementia sufferer. While he was alive, I was his carer for ten years, and thus an expert on his needs. I was able with total confidence to assess care he was given by others, and judge whether it was appropriate or not, an unnecessary afront to his dignity or not. Much more so than strangers on the internet, and more so too than care workers who had only known him a month or two.

I would suggest the same is true of OP. And she needs to act to protect her father. While dementia patients may have a whole range of cognitive and physical struggles, which may in some cases provide challenges to others, they have just as much right to privacy, dignity, consideration and kindness, as any other human.

todayImstruggling · Today 01:08

Ayarreet · Today 01:01

She has every right to ask them to specify exactly why his right to dignity, that she also thinks is a reason for the escalation in behaviour, is being breached by the presence of four people.
You don't seem to understand the fundamentals of the issue at hand.
That's a you thing.

at no point have I ever said she doesn’t have a right to ask. In fact I have said the exact opposite. She needs to talk to the care home and find out why four carers are needed.

You clearly are not remotely experienced in social care and the realities of it. I am. I run 3 businesses all of which solely aim at providing high level care and enhancement of skills for adults with dementia. My entire working life has been dedicated to providing care and promoting wellbeing in those suffering with dementia.

GarlicMind · Today 01:16

I'm going to query you last comments, @Ilovelurchers.

may in some cases provide challenges to others

This is a weaselly way of saying patients may assault and seriously injure their carers. You might, perhaps, choose to call extensive poo-smearing a challenge - although, if it can be avoided, I'd support the measures used to avoid it. I would not call breaking carers' bones 'providing challenges'. They're not in a boxing match!

they have just as much right to privacy, dignity, consideration and kindness, as any other human.

Not all humans have the same rights to the same versions of those things. An elderly person shitting himself cannot have privacy and dignity at the same time. Leaving him in his own shit may be considerate but it's unkind.

You're just issuing words without thinking properly about their meanings.

Ayarreet · Today 01:21

todayImstruggling · Today 01:08

at no point have I ever said she doesn’t have a right to ask. In fact I have said the exact opposite. She needs to talk to the care home and find out why four carers are needed.

You clearly are not remotely experienced in social care and the realities of it. I am. I run 3 businesses all of which solely aim at providing high level care and enhancement of skills for adults with dementia. My entire working life has been dedicated to providing care and promoting wellbeing in those suffering with dementia.

Good god.
My friend, I have lots of intimate and ongoing experience with adult social care.
44 years, involving lots of manifestations of profound need.
Still ongoing.
My entire life has been taken up 'providing care and promoting well being' in those suffering with learning difficulties, acute and chronic medical conditions, autism and, sadly, dementia.
Don't try to teach your Grandma how to suck eggs.

Ayarreet · Today 01:22

GarlicMind · Today 01:16

I'm going to query you last comments, @Ilovelurchers.

may in some cases provide challenges to others

This is a weaselly way of saying patients may assault and seriously injure their carers. You might, perhaps, choose to call extensive poo-smearing a challenge - although, if it can be avoided, I'd support the measures used to avoid it. I would not call breaking carers' bones 'providing challenges'. They're not in a boxing match!

they have just as much right to privacy, dignity, consideration and kindness, as any other human.

Not all humans have the same rights to the same versions of those things. An elderly person shitting himself cannot have privacy and dignity at the same time. Leaving him in his own shit may be considerate but it's unkind.

You're just issuing words without thinking properly about their meanings.

You have no knowledge of the subject you're talking about.

todayImstruggling · Today 01:26

GarlicMind · Today 01:16

I'm going to query you last comments, @Ilovelurchers.

may in some cases provide challenges to others

This is a weaselly way of saying patients may assault and seriously injure their carers. You might, perhaps, choose to call extensive poo-smearing a challenge - although, if it can be avoided, I'd support the measures used to avoid it. I would not call breaking carers' bones 'providing challenges'. They're not in a boxing match!

they have just as much right to privacy, dignity, consideration and kindness, as any other human.

Not all humans have the same rights to the same versions of those things. An elderly person shitting himself cannot have privacy and dignity at the same time. Leaving him in his own shit may be considerate but it's unkind.

You're just issuing words without thinking properly about their meanings.

Totally agree. So many on here just don’t seem to understand the realities of what caring for someone with advancing dementia can be like. How strong people can be. Everyone is assuming immediately that 4 carers automatically means restraints are being used it doesn’t! Sometimes more people are needed to move people in a way that reduces pain and discomfort the most. Sometimes it helps provide a distraction. And other times it purely is to keep everyone safe.
The only way of knowing what is going on and why is by talking with the home to try and find out.

GarlicMind · Today 01:27

Ayarreet · Today 01:22

You have no knowledge of the subject you're talking about.

🏆 Here's your award for Most Experienced Expert and Only Truly Knowledgeable Contributor. Congratulations.

todayImstruggling · Today 01:28

Ayarreet · Today 01:21

Good god.
My friend, I have lots of intimate and ongoing experience with adult social care.
44 years, involving lots of manifestations of profound need.
Still ongoing.
My entire life has been taken up 'providing care and promoting well being' in those suffering with learning difficulties, acute and chronic medical conditions, autism and, sadly, dementia.
Don't try to teach your Grandma how to suck eggs.

🤦🏻‍♀️🤣 ok dear!

Ayarreet · Today 01:35

GarlicMind · Today 01:27

🏆 Here's your award for Most Experienced Expert and Only Truly Knowledgeable Contributor. Congratulations.

Thank you. I think the OP qualifies too. She knows more than any of us on this thread.
I accept the award and would like to thank my mother. She taught me everything I know.
Cheers Mam!
Stay strong OPFlowers Ignore the people who've yet to personally experience it.

Ayarreet · Today 01:37

todayImstruggling · Today 01:28

🤦🏻‍♀️🤣 ok dear!

'3 businesses'😂😂😂

todayImstruggling · Today 01:56

Ayarreet · Today 01:37

'3 businesses'😂😂😂

Yes I am a director of 3 businesses. A Homecare business, a CIC providing day centre services and a dementia resources, skills and activity based CIC. It’s a lot. But all are directly based on dementia care and wellbeing.

IDontLikeMondays88 · Today 05:57

@todayImstruggling no i don’t have POA but my mum does and she is also unhappy about this just fyi. She hasn’t been asked or explained to.

OP posts:
IDontLikeMondays88 · Today 06:04

@todayImstruggling also find it mind blowing that you’ve basically said the home don’t need to explain to me what is going on as I don’t have POA. I’m his daughter. My mum has POA and has the same concerns - she just isn’t on mumsnet.

@Ilovelurchers i think this is a good summary

OP posts: