Got a bit of a dilema - and need to know what you would do.....

[HRHQueenOfQuotes]

please

OK short version is this. I work in a Care Home - on nights. Part of our job is to get some of the Residents up in the mornings. When I'm on with my 'pal' (as the manager calls her) we usually get about 6-8 people up. Whenever Night Supervisor or other new girl is on there are usually about 11-12 up.

Thing is - they do this by getting them up from any time from 2am onwards - basically if they're awake on a room check they'll be asked if they want to get up - many will say yes - but then many of them have dementia too.

I think it's wrong, and apart from the odd one or two who do often get up very early. We have one lady who when she first arrived said she liked to get up about 4.45 (no dementia) , one lady who's body clock is completely out of sink and who generally gets up (for the last time and comes to the lounge) around 3-4am (she has dementia) and another man who also often wakes up early and 'wanders' (usually into other residents rooms - with his trousers round his ankles ) so he sometimes gets up early (he has dementia). Another man usually gets up about 5.30 (well we get him up).

The manager has said to me on numerous occasions "think about how you'd want your own parents to be treated - you want the best care for them". And I agree entirely - and I would be absolutely mortified if they were got up in the middle of the night "because they were awake and agreed to".

Part of the pressure to get so many residents up is "because the days are very hard these days and it really helps the day girls out" (18/25 are Dementia so it is pretty hectic there). But I really do feel that it's wrong to force them to get up through manipulation, and I think it's also a form of abuse as many that are 'persauded' (or "agreed") to get up have dementia and if they didn't I suspect many wouldn't get up that early.

This is the dilema - I worked monday Night - with the Night Supervisor) and we got 9 up

my "pal" worked on Tuesday night with the NS - and got 11 up

I worked with the other new girl last night and we got 10 washed and dressed - 1 was put in his chair with his dressing gown on (it was his bath day), bed made etc etc, and 1 got up on his own - so effectively 12.

Tonight I'm on with my "pal" tonight and there's been a fair bit of criticism about our (well mine particularly) work when we're on together - a lot of this is down to how many residents we get up.

What do we do?

1. Do as 2 of the other night girls do and start getting them up from 2-3am - even if we know they may well go back to sleep - meaning we could get anything from 8-14 up

1. Stick to our guns and only get up the 'usuals' (who've always been early risers) plus anyone else who wakes up while we're still on - which would mean 6-9 residents up????

who has been criticising you?

If it were me I would carry on as usual and just get up the ones who normally get up early and anyone else who wakes.

If your manager asks about this then tell her what goes on.

I would speak to your Manager. Say you are concerned about this criticism, that you don't want it to look like you are being lazy and so give her the explanation you have just given here.

I agree with you, it certainly wouldn't look good on inspection if residents were up at 2am would it?

thing I also should perhaps have added is that she's had me in her office 2 times in the last month with "concerns" (all completely unfounded and false) about my work and I'm still on probation - so she could let me go without any warning.........

Sorry, QOQ, I have no experience whatsoever of this type of thing but it seems quite bizarre to me that people should be got out of bed to start the day at 2am?

What time do they go to bed?!

Why don;t they employ enough staff to get them up at a normal time of day?

I was just thinking it's abit like the staff at DS nursery saying, oh, we put them all to bed because we couldn;t cope with them.

How bizarre would that sound?!

Do you ever have staff meetings? I think you should raise this in one when you do.

I have worked in lots of care homes and things like that are jsut not on. What would their relatives also think of their loved ones getting up in the early hours. It can't be right for them to be sat in the lounges on their own with no company or stimulation in the middle of the night and anyone who thinks it is has a screw loose!

Do you ever have staff meetings? I think you should raise this in one when you do.

I have worked in lots of care homes and things like that are jsut not on. What would their relatives also think of their loved ones getting up in the early hours. It can't be right for them to be sat in the lounges on their own with no company or stimulation in the middle of the night and anyone who thinks it is has a screw loose!

who does inspections of places like that? maybe you could anonymously tip them off?

Do what you think its right for the residents.

And discuss it with the sensible supervisor person.

Frayedknow - some of them go to bed as early as 6pm (voluntarily) others like to stay up a little later - the 'average' seems to be between 7-9.30pm.

The odd things is that we often come in to find a minimum of 2/3 residents still up - usually they have been changed for bed but are just watching TV in the lounge - but I remember once in January we came in to find 9 people still up - some of who hadn't been changed yet (there are a few who are very indepedents and do it themselves) - yet thats "ok" (because we've got all night to do it I guess.....)

If the Manager is happy with this, I'm sure they wouldn't mind the local press being informed of the home's policy. Sounds like downright cruelty to me, and if it was my parents, I would want to know!

Have been working in nursing and residential homes for 16 years on and off and I would not personally ever get anyone up at 2am!!!! Some of these people may drift in and out of sleep during the night so getting them up because they are awake is absurd

Not directed at you I promise but if one of my relatives was got up at that time I would be really upset and angry at the level of care they were getting.

There is a big difference between a person who doesn't have dementia and has always been an early riser and a person who is got up because it makes it easier on day staff.

I have done nights and days and it's the responsibility of the home to employ enough staff

Rant over

You don't feel happy about it obviously so it shouldn't be a dilema it should be you doing your job in a way you feel is caring, responsible and professional.

You're all saying what I know I should (and want) to do - but I really don't want to lose my job, although I am starting to look for another one (see others threads in the employment issues topic about that) I can't afford to be kicked out.....

I think this is just desperately sad. Where is the dignity in being confused into getting up and dressed at 3am or whatever?

I understand why you don't want to blow the whistle - is there perhaps a more creative way we could think of to precipitate and inspection? Do they do spot inspections? EG could a few of the children of the ones being made to get up be informed anonymously?

we had a spot Inspection about 1 month ago - and have just had a "stunning" report back .

One example happened last night. I changed one mans pad about 2.30 (I think - can't remember exactly now). and he went back to sleep (I know he did as 10 minutes later I realised I'd left my pen and cardigan in his room and went back to get it). At 3.30 (ish) the girl I was on with went to do a check - and I guess he must have woken up as she opened his door - as he was washed and dressed and sat in his chair by 4am. Usually I get him up about 5-5.30 as he's often ready to get up then, but sometimes it can be after 6.

Thing is although he does have mild dementia, he's mainly here for other things (Parkinson's) and is such a gentleman, he has on occasions asked to get up, but usually I just ask him if he's ok (when he's awake obviously) and he'll say yes, occasionaly ask the time and if it's still early often says "oh a bit early to get up yet". or something alongs the lines of "time to get up then" - if it's a bit later.

I haven't been there that long but I've never known him to ask to get up that early.

To get them up "because it helps the day girls out" is outrageous. That's not about the residents' needs at all. If it was "because the resident prefers going to bed early and getting up in the early hours" that would be a completely different matter. Sorry you've been put in this position.

I think we'll just continue 'as normal' tonight - and I'll see what happens next Tuesday when I'm on the wiht NS again - this week could have been a 'one off' in terms of people lying awake, or wandering, but if I'm still not happy by the end of next week I think I'm going to contact CSCI.........

Crikey. Have no advice whatsoever but am so sad about the idea of people being got up at those ridiculously early hours. Mostly sad in a selfish way as my grandmother is 90, has dementia and is reaching the stage where my mother is looking into residential care.

Hi,
I've worked in homes with people with dementia for years, and this is an issue in many places. I have to say 2am rising is rediculous, and I wouldn't do it unless the reident really wanted to be up that early.
Do you write in their records? If so, I would record that " x was clean, dry and sleeping at 6.30" or "y was assisted as necessary to get up at 6 as usual"

I would only have a problem if the residents were in bed and wet/dirty - obviously neglectful.
I hope you feel you can stick to your guns and continue to give good care....good luck

Well I just thought I'd update. We had a decent shift - managed to get 8 residents up, one just sat in her chair in her dressing gown as it was her bath day.

Earliest we got anyone up was 4am - and he most definitely wanted to get up as he was found trying to get out of bed and get his clothes off the chair.

2 more were wide awake and wanting to get up at 4.30 (one with dementia grabbed my hand and led me off towards her clothes and said "That's it - do it" LOL) and the lady she share a room with (we have one double occupancy room) who has no dementia decided she would get up then too.

Everyone else was got up between 5.30-6.30 - all at their request. Two were asked, and refused - and then went back to sleep