Question

CASE STUDY Mrs. Joan Jeffers is an 86-year-old woman who suffers from dementia. She has been a resident at your facility for 5 years. She does not have any family that visits her on a regular basis. She has recently become combative and refuses to take baths. She says that "people are spying on her." You have noticed other staff members keeping her in bed for long periods at a time, and when she refuses a bath, they move on to the next resident. Mrs. Jeffers is beginning to have an odor, and today is bath day 2. Does Mrs. Jeffers have the right to refuse a bath? Explain. 3. What could you do to help Mrs. Jeffers feel more at ease about bathing? Answer the following questions: 1. What is your next appropriate action? ADDITIONAL LEARNING ACTIVITIES 2. When you visit the nursing center, ask if you could speak with the director of nursing. If available ask the director of nursing how he or she ensures residents' rights are met on a daily basis. Describe his or her answer below. 1. Visit a nursing center and ask for a copy of the Residents' Rights. Compare it with the information in this chapter. Was it the same? Was it different?

Answer 1

Ans1) Behaviors during bathing. People with dementia may become resistant to bathing. Such behavior often occurs because the person doesn't remember what bathing is for or doesn't have the patience to endure lack of modesty, being cold or other discomforts.

Next appropriate action:

• Try to understand how they feel
• Ask questions
• Be patient
• Give choices
• Take it slow

2) Yes, Mrs. Jeffers can refuse to bath, document it in nursing chart, inform charge nurse. Patient has right to refuse. Forced bath would be battery.

The legal term for a harmful or offensive touching without permission is battery.

3) 7 tips to get someone with dementia to take a bath:

• Establish a daily routine
• Make the bathroom warm and comfortable
• Use positive reinforcement and don't argue
• Say “we” not “you”
• Use a hand-held shower head to reduce fear
• Make sure there are no surprises or guesswork needed

1. Use extra towels for comfort and warmth.