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

[IDontLikeMondays88]

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.

@todayImstruggling i have not made allegations of abuse at all I have asked mumsnet is this normal and been absolutely torn to shreds.

you have decided I am resistant to the idea 4 carers might been needed I’m not I just don’t get exactly what they are doing and had wanted to understand what they could be doing.

you are far too involved in my thread and just being quite offensive now. I can’t begin to explain what a difficult time my family has been through the last few months and don’t appreciate your comments - please stop.

Also I am not “resistant” to asking the home at all I was asking for others experiences as I am not a carer I don’t know what’s normal. I was asking is this the norm.

also my dad will cover his privates with his hands if naked I can assure you he does still feel embarrassment. Maybe that will also go in time and actually maybe that would be better for everyone.

Yes @GETTINGLIKEMYMOTHER i don’t think I am posting on the right forum 😅

You need to find out more information, Op.

Spend time observing him and ask more probing questions of the staff.

Perhaps your father would like some changes to his routine that you can identify as likely to be helpful?

Whereas so many of the general population like to think they know, and like to give you advice, when they usually haven’t got a bloody clue.

I think you'll find that those of us who try to give useful advice on this board have real life experience of relatives with dementia, or of caring for people with dementia.

And often we can see someone who is not quite as far down the path of experience of dementia, and we try to help them.

OP, you've just said that your DF covers his privates when naked. So I imagine he's resistant to being changed? So, how do they manage that, especially if he is also agitated? One carer holds one of his hands. One holds the other. One changes him. One helps with cleaning him.

I just don't understand the confusion or upset about 4 people...

If the sufferer is violent.. Out of control. Angry.

1 stops the patient punching with left hand

2 stops right hand flying out

3 prepares to stop kicking and maybe biting and spitting

4 does the cleaning part

Maybe more people needed to hand products to person 4 and take soiled pads etc...

When it really kicks off, it really kicks off.

You'd be more upset if the holding arms people turned into 1 person and restrained from behind... Which happens due to staff shortages... But then we are back to a more acceptable 3 staff???

OP, I’m so sorry that your dad is living with dementia. It’s such an awful disease. You and your mum obviously did so much for him for as long as you safely could.

and you’re still doing everything you can for him. Advocating, asking, visiting him with love.

i’m appalled at how this thread has gone. Filled with arguments, insults, belittling and point scoring. There are a number of posters who should try to be a bit more considerate of their posting style and how they interact with others who’s opinion they disagree with.

OP, you rightly question where has the empathy and compassion gone.

i hope you are able to get satisfactory answers from the home. And that you are able to enjoy brief moments of joy with your dad.

Patronising much. I'm guessing it's not your spouse or parent you have 'experience' of.

Sit down when you don't know what you're talking about.

Risible comment.

Assisting someone to the toilet is much more than "wiping his bum". He may need physical help getting on/off and staying put on the toilet which takes a minimum of two people. The third may wipe him and another might hold up a privacy sheet. If he is agitated or aggressive there is a safety element for both him and staff. This decision will not be taken lightly as they do not have a 4:1 staff ratio in any home.

To address the number of people involved four is unusual but not unheard of, two for the personal care, one for distraction and reassurance and the fourth not involved directly but for removing soiled items and for swapping if someone gets injured or the person distracting and reassuring isn’t being effective in the situation.
You need to ask why it’s been deemed necessary, what is written in the care plan, you should ask what has been done to manage distress. Any decent care home will be happy to talk to you about how they are managing the care of a relative and why they are managing it in the way they are.
I have personally been in situations where people would get violent towards most staff members but if I went to them and simply said it's time to get washed and dressed what would you like to wear today, shall we pick something they would happily do it and others who have thrown things at me and told me to fuck off but would happily let others assist them.

OP, have you spoken to the care home yet?

Just to update we said to the care home we didn’t think 4 people in the room with him would be helping him to stay calm and cooperative. This was not a complaint as such it was just mentioned as part of a bigger conversation.

They have now backed off and are saying they are finding that “less is more” as regards his personal care which ties with our own experience.

I have both showered and changed him in the home recently and he was receptive to me directing him a bit and helping with the bits he couldn’t do. I was able to do both these things on my own.

thanks for everyone’s help with this. I am relieved it seems to be going slightly better at the carehome.

Thanks for the update OP, and that's great news that you have been able to open a dialogue with the care home that (from the sounds of it) is helping him get care better suited to his specific needs.

If anyone reads this thread in a similar situation, I hope that what they take from it is that it's appropriate to stay vigilant and curious when a loved one is being cared for by others, and to flag any concerns or questions you may have. It takes time to get to know an individual's needs and responses, and it's easy to imagine how, with the best will in the world, a care home who are needing to cope with many different patients would not immediately get everything right.

But it sounds like they have listened to you and as a consequence your dad will be a lot more comfortable and have his dignity respected more. Well done, OP.

Well done OP. I'm glad you've sorted it out.
An upsetting time for your parents. Stay strong, lass.
You were right.

That's great news OP

If the move from his home to the care home is very recent, he is probably very unsettled, and has become more agitated as a result. It was the same with my dad.