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I'm a caregiver for a lady whose brother is wheelchair-bound with MS anti-spasticity, but has different sets of nurses during the day hours from 8 a.m. to 8 p.m. I've been told by the nurses that the man is in good enough mental health to make his own choices although, they have also told me that his mind is slowly slipping away. For at least 6 months now if not longer, after sitting in the chair all morning they allow him to go to sleep in his wheelchair from 8pm to 8am in urine and even feces. I have heard him moving around and whenever I ask if you need any help around 3 or 4 in the morning he's always soaking wet and urine and the floor is always covered in urine. I usually clean him up and change his soaking wet socks, not knowing how long he's been sitting in them before 8pm. Is this illegal or what are some of the damages that could happen to him that I can address with him while working with my other client? I'm afraid that one day he might fall out of his chair during a spasm or slip on urine in his chair. When it comes to him wearing depends or doing physical therapy, the nurses say that he has refused to wear depends, or do therapy, or get in bed at night when he's, by request I assume, unattended at home and they say legally he can make his own choices for his care. I've offered to give him physical therapy whenever I work. He has agreed to doing small steps to work his way to being able to get into the bed and deal with the spasms. I've only been there for two months and the others have been there for years. It just seems so negligent. Is there anything I can suggest?

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Selahmodel, it's my understanding if a person is in clear enough mind to make choices, then if he refuses to wear Depends or do physical therapy then the nurses have to respect his decision. As you have mentioned the other nurses have been with him for years, so they know his personality.

Maybe a blue sheet on his wheelchair seat might help with catching the urine. As his nurses about that, since he is their client.

Are you licensed in physical therapy? If not, then don't do it.
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I'm glad you are able to get through to him and that he allows you to help. Unfortunately sometimes people won't accept the help that is offered or won't follow through with things that would make their life easier in the long run, and it sounds as though your client was one of those people. I have a distant relative who is a lot like this man, she refused to modify her home, refused to do therapy, refused to go to bed at night and spent 24/7 in her chair. She also slept the day away and roamed the house at night, making her family miserable, and any attempts to change things were met with extreme anger. Unfortunately, despite her physical limitations there is nothing wrong with her mind and she has the right to self destruct.
Over time caregivers burn out, they learn to cope with it all by reducing contact and doing the minimum necessary. Perhaps your client has finally reached a point where he is willing to accept help, or at least is less apt to fight it, unfortunately his caregivers have long ago reached a point where they no longer are willing to give it. I hope his nurses are hired through an agency, the simplest strategy would be to push for a care plan meeting and to ask for different caregivers, at least some of the time. I know that it is seen as beneficial to have continuity, but unfortunately one of the side effects of that can be that people become complacent.
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Your willingness and desire to help this man is admirable. But since he is not your client, it could get you in trouble. Talk to your client, his sister, about your ideas.
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