How do I get across to the bath aides to keep my mother covered during her bath?

This REALLY infuriates me! After my mom passed away and I was her live-in caregiver for a year, I took a CNA class and hoped to join a local hospice to "give back" in Mom's honor and for the hospice's CNA wonderful care.

We are taught to bathe one area of the body at a time, keeping the remainder of the body covered and dry and warm and to maintain the person's dignity. Period. To force a person be essentially all-over naked and wet violates training and, I have no doubt, the standard procedure for the facility. This is offensive to me on so many levels.

The only thing I can--almost--understand is the aide trying to get your mother bathed before she's fully awake. Most facilities don't have enough aides and there's just no extra time. Since this is a small ALF I would hope they'd wake everyone, if needed, than return later when the client is more awake.

I'd get photos or video of these occurrences for documentation, then meet with the DON (Director of Nursing) and complain like crazy, then threaten to contact the State. Even if the aides are overwhelmed, the clients deserve--AND NEED--to be warm and dry and to allow them their dignity.

Side note: The ALF where I took my practicals had a fluid schedule and allowed the elders to sleep until they woke up (aides often checked on them), then they were assisted with dressing if need be, bathed, and wheeled to breakfast, et al. This facility was Native American-owned and their clients were treated as the honored elders that they were, which was SO beautiful. How the aides performed and how the elders were treated should be freakin' national standard.

I have steam coming out of my ears. If these people were on my team they'd get a piece of my mind - and my line manager would rip them each a new one.

From "Skills for dementia care" from the Michigan Coalition for Dementia:

2.8 Recognize that every person has a need for: 
• Relationships with others 
• Inclusion (being part of a group) 
• Occupation (having things to do) 
• Individuality (feeling unique) 
• Dignity 
• Feeling secure emotionally 
• Privacy 
• Intimacy and touch 
• Socialization (being with others) 
• Meaning 
• Physical comfort 
• Meaningful activities 

So - don't these people get training? I'm sure they do. Whether or not they are given the leadership that reminds them to make it part of daily practice appears to be a different question.

I'm too cross just now to find the right words to suggest you might put to the manager - in your position I'd be too apoplectic to speak.

Does your camera record these images? You might make an appointment to see (or Zoom, or MS Team, or whatever) their manager at hospice, ask them to observe what you've seen, and tell them you'd like to hear their comments.

As the previous answers indicate, there are better ways to handle this. Just being suddenly awakened with bathing is cruel, the not covering up added to it is wrong. Please speak with the employer of the aides, request a different time and better attention to keeping her modest and warm. If you don’t get a favorable response know that there are choices in hospice care. Your mom is blessed to have you looking out for her

When the CNA from Hospice had to start giving my husband bed baths she was VERY careful about how she did it. And this in my/our home. She would start with him completely covered. She would expose only the part of the body she was washing at the time when she was done and that part was dry she would cover it back up and move to another part of the body, exposing only that part.
Even when we were bringing him to the handicap bathroom down the hall, I would get him into the shower wheelchair and she would make sure he was covered with either a sheet or a throw before we would leave the bedroom.
I would talk to the Care Manager of the Hospice Team you have and request that she be covered.
I also suggest that when the Aide comes in she begin talking to your mom and begin to get the items she needs before talking off her nightgown. This will give mom a little bit of time to wake up.
The CNA that bathed my Husband would also talk to him the entire time and tell him what she was going to do before she did it so that (if he could comprehend) he was not surprised about a movement or touch. (I did the same thing before Hospice was even involved, I think it calmed him just having the conversation. He was always calm and compliant.
If there is a way you could be there when the Hospice aide comes to give mom a bath that would be great.
Have you talked to the aide about how you would like her bathed?
Is there any possibility of moving her bed away from the AC vent? The beds are not affixed to the floor so moving them should not be a problem.
If you have talked to the aide and your request has been ignored I would call the Team Manager.

When my husband was under hospice care in our home and completely bedridden, when the aides would come to bathe him, he always wanted 1 bath towel to cover his top half and 1 to cover his bottom half, as he was always cold as well. Now of course I was always here to make sure that it was done the way he wanted, but honestly there is no reason they couldn't do that as well. I would call your hospice agency and ask to speak to your teams supervisor, and make your wishes known. They are there to serve you and your mom, so that shouldn't be a issue. I'm sorry that thus far though it has been. Good luck.