Are the memory care caregivers able to apply a band-aid, icepack, administer aspirin/Tylenol when needed? Normal health care we do at home, our morning routine, clean our ears, provide Kleenex to blow our nose, trim finger nails, toe nails, to prepare ourselves for the day, or do you need home health care professional to carry out these instructions?
"band-aid, icepack, administer aspirin/Tylenol when needed." Can't be done by an aide working in a facility. These are done by an LPN or RN. Unless a medtech, medication can only be given by an LPN (and that depends on the state) or RN. And only under orders of a Dr. So if a person wants Tylenol, a Drs. order has to say "when needed".
An aide can give a resident a tissue. They cannot cut fingernails or toenails. For toenails a Podiatrist is called in. Aides are responsible for getting a person up, dressed and down to meals. They take the person to the bathroom and change Depends. They bathe. They get the person ready for bed.
In home care are usually CNAs. As is pretty much most aides. Some people can be aides without certification but not in a facility. What an aide does in your home is between you and them. Some will do light housekeeping if there is not someone in the home who can do it. State law, though, makes it so they cannot give medicine. I think they can remind the client maybe had them the pill planner. But I don't think they can touch the pills.
Then on to LTC on Medicaid. By this time I was used to things not always going the way I would have liked. By this time Mom was in the last stage of Dementia. She was actually kept cleaner (if u know what I meam) So were the other residents. Everyones clothing was really clean. No smells. They still couldn't do her hair. I was upset that they didn't use Moms special brush so her hair wouldn't fly all over. They kept using those plastic bristle things. The bra thing, they were in the drawer with her socks. It was in the paperwork I supplied that she needed to wear one because she would break out in a yeast infection if she was allowed to be skin on skin. Thats when my daughter told me about the head down. So I started putting her bra on the hanger with her outfit. Still wrong colored socks and shoes. I supplied 3 pair, blue, brown and black. You know where I am going.
My brother told me I was my own worst enemy. But I wanted my Mom to look nice. So I do know where you are coming from. But sometimes things are just out of our hands. My Mom passed 2 years ago. I don't know what I would have done if she was still alive during this shutdown. Her LTC was just 15 min away so I was there all the time. Maybe when this Virus thing is all over, you can make sure she has her lipstick on and her nails are done. But I do understand where you feel that that should be part of the aides job.
The following is how it is in my state of NJ and Del. were my daughter worked.
DON - Director of Nursing, She is over the RNs, LPNs and CNAs
RN - Register Nurse - State test to be licensed
LPN - Licensed Practical Nurse (other states may have a different name)
They take a test with the State to be licensed.
CNA - Certified Nurses Aide - put thru an 8/10 week course to get
Certification. Certification filed with the Nursing board.
As I replied to Worried, this is my State of NJ and Del where my daughter worked. At the one facility my daughter worked, the staff had different colors for what they were. Ex: Navy Blue was an RN, Maroon was an LPN. But all staff should have their ID on so you know who you r talking to at that Moment. RN, LPN, or CNA.
We had a man who posted regularly named Old Sailor. His wife passed so he doesn't post as much. He, like, you was very good to his wife. Maybe hecwill chime in.
I read this and my first thought was, your expecting too much from a CNA. My daughter is an RN and for 20 yrs worked rehab/LTC facilities. This is how she described a CNAs job to me, after I complained about Mom having no bra on, for those coming in on 7am shift:
First thing is toileting the resident. Changing the Depends. Brushing of teeth. Then CNA has to dress the person. Thats removing their night clothes and dressing them from the top down. With little help from the resident. So its the bra on first. Then the top, then the pants, socks and shoes. CNAs are not hairdressers so Moms hair never looked all that great. I carried a brush and a small bottle of hair spray and fixed her hair. Then its on to the next resident. There is no one on one. She may have a few more residents and they all have to be done and down to breakfast by 8am. There's no time to put jewelry on. Let alone lipstick. Some CNAs may help with feeding but its usually making beds and cleaning up while residents are at breakfast. Baths are usually given later and not everyday. Before you know it its lunch time. Manicures are usually an activity. Then will take a day and do the residents. They are not allowed to cut nails or toenails. Its against the law actually. CNAs are responsible for all the dirty work. Cleaning up after accidents and vomit. Abuse from residents. Taking them to the bathroom every couple of hours. Changing multiple times of the day. Nurses do not do this work.
Nurses, there is usually a DON. Under her are the RNs, under them the LPNs and then the CNA who has no medical training. The DON and the RNs are few. They mostly do the Administration part. Not much hands on. Actually an LPN does that. They can do med passes and in some States give shots. My daughter specialized in woundcare so more one on one than most of the RNs.
I understand where ur coming from but most of these places are understaffed. The CNAs do what they can when they can. But you can't expect them to make sure your wife is picture perfect.
And when it comes to something like lipstick, they should not be using the same tube on all the residents. Thats very unsanitary.
I went thru so much when Luz was in either the hospital or rehab. I found that I really needed to be there for just about everything until I learned just how much and how well the staff provided what was needed.
I gave up on trying to dress her up. I provided her with some of her good T-shirts. I did her laundry. I kept at least three sets in her ward robe. Her slacks were too long to wear since she used platform shoes before. So I bought her some lounge pants and shortened them for her. That worked good until I came in one morning and Luz had tried to dress herself. She had both of her legs in one leg of the pants. She gave her help me moan. We both had a good laugh over that one.
Luz quit wearing bras because we could not find one that fit correctly and they were all too tight. She did develope the yeast infections.So I found maternity/pregnancy bras. They need some adjusting with safety pins since her breast would slip out. She seemed to like them. Infection problem solved.
I learned how to shampoo and blow dry her hair using one of those plastic hair brushes. I was actually getting pretty good at it.
When in rehab I did use the beauty shop for hair and nails. And scheduled the podiatrist for her feet. He was good. He provided cheer and a flower to all of his patients.
Luz hated pills. they had to be crushed. Well the nurses did their best but s soon as the nurse would leave, Luz started spitting out all of the little chunks of the pills. I think Luz was smarter than the nurses. We fixed that by crushing the pills into a powder and continued to mix that dust into the pudding. No apple sauce. she hated that stuff. Another problem solved. Only had one instance of an RN not crushing the pill and tried to get her to swallow a whole pill mixed in with the pudding. Luz spit that out just as soon as she left the room. I told her what happened and she said sshe could not give her another one that it would kill her. I never saw her again.
Hygiene at home or in rehab was done very well. Washed and dried and medicated with creams by all attending. Most hospitals and rehab in this are no longer used protective underwear. Instead they used two pads. one length wise and one cross wise. The length wise one was brought up between her legs. Worke very well until she had a BM and urinated at the same time. That created a big wet brown spot the width of the bed and just as long. Still a very good job of cleaning her.
If there was a need for some additional meds the RN or DoN wold call the doctor and get verbal approval. Or if I noticed something I would talk to the doc when he/she came in that night and it would be addressed. The staff was very limited in what they were allowed to do.
I did have to explain to the RN that Luz could not be given the little test shot for TB because she had had Renal TB back in the 70's. It took a little bit of explaining this to her before she learned I knew what I was talking about. And other arrangements were made.
I should also explain that I was there seven days a week from about 7:00 AM until after dinner. And at home I was there even more and did everything for and with her.
No otc meds without medical approval.
I did learn that hospitals should be watched more than rehab staff. Home health care is restricted on just what they are allowed.
Luz actually worked in that field for awhile and would tell me what she was allowed to do. Mostly it was monitoring the patient, providing the meds prescribed, preparing small lunches, escorting patient to various medical appointments, maintaining personal hygiene.
I hope there is some help for you in this. I wish you the best and try to relax.