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Mom is 80. She has dementia. She is somewhere between stage 6 and 7. She uses a walker to keep from falling. I requested 3-4 showers a week because sitting in a urine soaked diaper can cause UTIs and she has a belly fold that will get the fungus rash if not washed several times a week. We have an aide assist her with a shower 5 days a week to ward both off and she has not had a UTI or rash since last October. She came home after a 16 day stay in respite where they assured me my requests were noted on her chart. She had the absolute worst fungus I’ve ever seen. Deep purple, from side to side. Dripping in slime. About 6-8 inches in vertical length. This tells me she most likely got no showers. She looked and smelled dirty. She’s been there several times before and for longer stays and this didn’t happen. I took her to the ER because the fungus rash was very painful and had spread to her outer labia. Should I have to pay for this full respite visit?

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I should start by asking the facility what they've got to say for themselves. When you collected her, did they provide you with a care journal or similar notes from her stay?

My guess would be that your mother declined help with washing and showering, and it wasn't taken further. I expect that is what the facility will say. In the light of the agreed care plan, written down in advance, though, that's not good enough. Regardless of withholding all or part of the fee, and/or claiming compensation, this is certainly grounds for a formal complaint.
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Shexhaustsme Jun 5, 2019
They are suppose to be doing a full investigation. Director is on vacation so no idea when or if they will reach out to me.
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In my opinion, if they don't have the staff to meet my additional request for showers, then they should have stated that and not led me to believe it was
going to happen. If that was the case, they could have washed her down and
dried her with a wash cloth to ensure she didn't get the rash. I wish I could show you pictures! You would be shocked!
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There are some good suggestions on this thread. You can follow up and see if you can get more answers, but, I might try to find a different place to use for future respite care. And, address your concern for hygiene problems in advance with details in writing with the facility.
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Shexhaustsme Jun 5, 2019
Thanks, just for clarification, it was in writing and on the forms I signed and the director and admissions person both told me they took care of it and it was noted on her chart so the nurse would know. I feel like I did what I needed to do. In addition, this was not her first stay with this nursing home and previous stays have been longer and the same request for additional showers were also made on the previous visits.
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She could have been bathed, but not dried completely. My Mom got those rashes under her boobs.

I agree with Willie, this should have been something the Nurse took note of. I would say something.
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No facility has the staff to give showers that often, once or twice a week is the norm. And unless the aide is familiar caring for someone with skin folds it is possible that she was showered superficially but that was never addressed, in many cases shower assistance is merely help getting in and out and supervision while the person washes themselves.

My mom's two respite stays left me furious, but in hindsight I realized a lot of that was due to my ignorance. Respite stays are difficult because neither side knows what to expect, even those moving into a facility permanently often have a rocky few weeks while staff get to know them and their needs. And we as family members don't know exactly what is available or who to ask to get what we need. In my opinion her skin care should have been a nursing not a bathing requirement, and daily care of her skin folds should have been listed and detailed on her medical chart.
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You can use her visit to the ER to report this to the agency that oversees facilities in your state. You can find this agency by googling. Have the ER make a copy of their notes and send them in your report to the agency. Send a copy to the facility's administrator.
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In a place like that, your demands are merely requests. The staff must prioritize the biggest problems.

To ensure great care (even in the hospital), you have to be there all the time.

She is leaving that place — I’m sure that some aren’t that lucky.
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