Hi, my aunt recently started to reside in a skilled facility. She is pretty young, probably about 55, but in a lot of pain. Because she is in so much pain, she it is very hard for her to get to the shower to bathe, but the issue is she HATES people to touch her so can't have a bed bath. What they've come up with is that she cleans up in her room. She does her whole body with wash rags and towels (sort of giving herself a bed bath if you will). She is very clean, she just likes her privacy. She washes her hair either in the sink or in one if the basins designated for that.
The issue is, she has very fine her and it has always taken a long time to dry. Along with some other factors (large windows, high humidity, other residents heat on full blast) it takes her hair probably about 4-5 days to dry completely. And they want her to wash it every week.
Recently, the administrator and the don came to see her. I guess some aides had decided to tell them that she wasn't washing her hair and that it was oily. (I guess drying hair looks a lot like oily hair). Although my aunt repeatedly told them it was just wet, they didn't believe her. The DON told her that people have reported her "behaviors" to her. She said she was going to make her talk to psych whether she wants to or not. Also, unless she starts going to the shower or getting a bed bath and she was going to make her go to a behavioral hospital aka psych ward. Now, my aunt does not want this but there seems to be no way to change her mind.
My question is: What is the process of this? My aunt hates psychologists and will absolutely not talk to one. What will happen if she doesn't? Will they just seem get incompetent and ship get out? Can they do this? I know the DON is important but my aunt has all of her rights. She's sound of mind and is her own guardian and doesn't have POA. Her rights shouldn't just be negated because someone chooses to believe something that isn't true. It isn't right. If anyone has any insight into how these psychology issues work please let me know. It feels like the DON is out to get my aunt and will do anything possible to send her to a psych ward. I'm pretty scared for her and would like any help possible.
Why is she in a SNF at that age? It might be time to ask another relative exactly how old she is. She might be much older than you guess.
What is her diagnosis to get her into a SNF? Who is her POA? Does she have a guardian? Are you the only living close relative? Who takes care of her finances and medical decisions? Did she contact you because the other relatives agreed with the SNF and she wanted someone to agree with her to keep her from being being checked out by a specialist?
When is the last time you saw her in person? Can you visit multiple times a week to check out her story?
How do you know she is correct when she says she is bathing often?
You don't get total privacy in a SNF. They are there to make sure you are taken care of.
If she has dementia, yes, she should be seen by someone that specializes in the brain. It's not cruel or unusual. That's what they are there for.
As others have said if it is dementia she probably has a problem discerning time. She may think she washed her hair recently, but it's oily because she didn't wash it. If she has not been tested for dementia, now is a good time for it.
Are you scared of her going to a psych ward? It's not the 1970s. They are not nightmare places. My mom spent two weeks in psych wards last year. They were a tremendous help in getting her on the right meds for her condition.
No one's hair stays wet more than 24 hours. I live in the South with high humidity. I have long, thin hair. It's dry in hours unless I put it up and the air can't get to it. You need more facts and less fear.
"The issue is, she has very fine her and it has always taken a long time to dry. Along with some other factors (large windows, high humidity, other residents heat on full blast) it takes her hair probably about 4-5 days to dry completely."
I live in the South...in a very high humidity state. Our humidity AVERAGES between 75-80%. And even currently it is more than 40% on a relatively cool day. We also don't deal with SUPER cold weather well lol. So we tend to run our heaters a lot during the fall and whatever "winter" we actually have.
Just recently I took my fine hair to the beach a few weeks ago. So amp up the humidity. Large oceanfront balcony doors opening and closing. I showered at night (around 7pm) and if my hair was damp when I went to sleep (which it rarely was) it was completely dry (and frizzy) when I got up the next day.
Is your aunt maybe spraying something on her hair to make it smell better, potentially using dry shampoo, or even wetting it down to make it defrizz or make it easier to manage flyaways? My thick-haired daughter can run a brush through her hair and it goes back to "normal". I frequently have to use styling tools or products to get my hair manageable.
Especially the more extreme the environment is (humid or dry). Think touching a Van de Graff generator and hair standing straight out.
Copilot advises that thin, fine hair can take 1-3 HOURS to air dry.
Time dilation is a real thing. My FIL used to believe that he didn't see another living soul in his room for HOURS. We knew this wasn't true. And we could literally test it. He could look at the clock and see 12:00. And then look a few minutes later and it would say 12:05. He would say it had been 5 HOURS. Or he would say it was 5:02. Or 2:05 or even 1:20.
Is it possible that she is misremembering or even possibly exaggerating how long her hair takes to dry? And is there any way to even confirm that she is actually bathing herself? Is she wetting her hair to make it look like she cleaned it?
There are a lot of variables that could be at play here. I just don't believe that her hair is still CLEAN and WET after DAYS. If she's not getting conditioner or shampoo out....it will look dirty. And wet or oily.
A move to a handicapped-accessible apartment and homecare aides coming in may be a better option for her than a nursing home.
It simply means to me that a psych hospital is probably in your aunt’s best interest and I think you should not run interference with what is about to happen here.
When was the last time you saw her, in person?
Best of luck to her.
Is your Aunt special needs? And the hair, I have fine hair and its almost dry by the time my stylist is done cutting my hair.
Seems to be your Aunt needs a POA or she puts someone on her Hipaa forms who can talk to the staff.
A DON is in charge of the RNs, LPNs, and CNAs. She can recommend that Aunt be sent to a Psychiatrict facility but the facility Doctor would have to write up the order.
I think this is something that you can only address with the administration. I would cooperate with their request and take this a step at a time hoping there is some satisfactory resolution. I am so sorry for all the woes encountered here and wish you luck.
My daughter has a ton of thick hair - to the point where the bottom 4 inches at her nape she does an undercut on for most of the year so its not so heavy. It is very long, thick and it takes her using a hair dryer for nearly an HOUR to get it all dry. And her hair if air dried, may take overnight (somewhat damp still the next morning after a mid-evening shower) and by the 24 hour mark it is FULLY dry. (our hairdresser rarely dries my daughter's hair, usually just french braids it and she can take it out and wear it curly the next day while it completely dries)
I don't mean to be disrespectful of your aunt, but damp hair and oily hair look different. Fine hair gets limp and oily very fast. If I don't wash mine every other night, I typically have to use dry shampoo to get me through an extra day because it starts to get limp.
If all of this information you have is based on her words to you via the phone- you have to take it with a grain of salt. Frequently people with any level of dementia come up with confabulations. Perhaps she thinks she is bathing herself more often than she is?
As far as the psychiatric facility - I want to caution you - she wants to avoid this if she doesn't really need it and just isn't cooperative or meeting hygiene requests by taking better care of her hygiene. No one wants to go to a psychiatric ward. If they are suggesting that - its not likely because she is not hygiene compliant, but perhaps there are additional things they are seeing that you are not aware of.
Why doesn't she have an assigned POA? That person is only invoked if she is no longer competent. And they are to act on her behalf based on how she would act for herself.
If she is misrepresenting how often she is bathing - and I use that term loosely because if they are not overseeing, you don't really know what she's doing - she can get infections - really bad infections if she has any open wounds or sores. And honestly if she already has problems with being touched, she really doesn't want to have to go through infection and wound care.
I'm afraid I have some bad news for you - that is, no one is accepted into a "skilled facility" because they are in severe pain only. Please understand, I am in no way trying to make light of your aunt's pain, but in and of itself, pain is not enough to get admitted into a facility such as that. So that leads me to believe there is something more going on with your aunt, either that you are unaware of or don't wish to acknowledge. Either way, you do your aunt a disservice if you don't, at the very least, find out if what is being said here is 100% the truth.
You must understand that the behavior you're describing here - reluctance to wash/bathe, not wanting anyone to touch her, insisting her hair was "just wet" instead of oily (which if employees of the facility were being told this by your aunt in person is a very easy thing to verify through a simple touch of the hair), this could all be indicative of some sort of cognitive decline.
Now, let's say for a moment that you are 100% correct here, the DON has it out for your aunt and wants to send her off to a psych facility when there is absolutely nothing wrong with her, what do you suppose happens then? Unless you think the psych facility is "in" on this, they will evaluate her, come to the conclusion there is nothing that warrants her being is such a facility and release her. They are not in the business to keep people in a psych facility who need no help, because insurance simply will not pay for it. Then she will have a "clean" mental bill of health to wave in the face of whatever administrator is telling her she needs psychiatric help. THEN you will have a reason to complain to the powers that be about the staff and DON.
If you haven't been there in person to see all of this and are simply going on whatever your aunt is telling you, my advice is, before you carry this flag into battle, go to aunt's facility and see for yourself what is going on IN PERSON. And please, try to go in as objectively as you can, with your eyes open, and believe what you are seeing in real time, not what you want to believe based on emotions.
Often mentally ill people get put into nursing homes. People whose behavioral 'issues' get them thrown out of their group home also get put into a nursing home. Then they get tossed back to their group home or into whatever mental facility has a bed for them. It is a sad reality.
What is she in the SNF for at such a young age for, and why is she in so much pain? Pain is much more controllable now than it used to be.
I'm glad you care about your aunt, but how often do you see her and how much time do you spend with her? It sounds like she does indeed have some psychological issues and some treatment to help her get them under control would make her life better.
Does she currently take anything for the pain? If not, why not? If so, maybe it is not enough, or she needs more on the day of her washing.
Why isn't she using a hair dryer??
I have a lot of fine, shoulder length hair. In no way does it take *days* for it to air dry. If I'm not sweating or doing anything dirty I wash it every 4 days and it's pretty greasy by then.
If your Aunt is rejecting all reasonable solutions then maybe she does need to be in a psych ward.