'Lansley must listen to nurses on the front line' care, health policy, mental health, nursing, older people, RMN
waking up residents in care home
Posted in: Independent sector | Main nursing areas
9-Jul-2010 0:43 am
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does anyone know if there are any guidlines/standards for how early residents with dementia in care homes should be woken up by care staff (is 5.30am too early) i think that it is but i want evidence to back it up
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30-Dec-2010 8:46 pm
I wouldn't like to be woken up at 5.30. A care home should be a persons home where they are treated with love and respect, not subjected to such task orientated practice. You probably wont find any guidelines but you can have a look at that particular care home's philosophy and mission statement. Difficult I know. but you could also ask the advice of the Care Quality Commission, and this could be done anonymously.
14-Jun-2011 11:13 pm
i agree i wouldnt want to be woken up that early and residents need to be woken up slowly give them time to adjust to there surroundings 530 am is far to early i use to work in a residential home and we would never wake our residents till after 8am and if a resident decided she wanted to stay in bed and there was no particular reason for this she or he just decided they wanted a lie in then we would take up breakfast and maybe encourage to get up later residents have rights and also choices residents with dementia need time when woken but they also need good sleep and to wake so early becomes along day for them and prevents orientation so yes if u not sure why ask yr manager after all you are the voice for yr residents
17-Jun-2011 8:47 am
why are you waking people?? If the team ie both nights and days are doing person centred care then your routine should reflect the changing patterns of peoples natural waking ie more residents ready to get up in the summer and less in the winter with corresponding changes for dark nights etc in the winter.
waking anyone with or without a dementia is likely to trigger aggressive responses !!!!
19-Sep-2011 6:14 pm
Look at evidence based practice around waking patients with dementia in care homes, also sleep hygiene. Recruit as many of your colleagues as you can that agree that the current practice is abusive and not patient centered. Have a meeting with your managers and present your findings in a calm and rational way, suggesting changes that are beneficial to the residents. Refer to anything that that the home has written in its mission statements or promotional material and point out that these documented standards are not being met but your proposals could change this. Advise a trial period and evaluation after 2-3 months. If nothing changes then you really do need to seek advice from the NMC and your union to protect yourself and the Care Quality Commission.
19-Sep-2011 7:53 pm
Thank you, that is my intention. However, having spoken with the current members of staff (I have just joined the team) this has been discussed earlier on number of occasions and nothing changed. As I do not agree with this poor practice I feel very uncomfortable to allow the members of my team to carry on with this during my duty. Not sure where I stand with this. I have worked in many elderly care settings and have never faced such an early start.
19-Sep-2011 9:14 pm
Try the approach suggested- you may find that previous conversations and suggestions are not as strong as yours. Also others feel as you do so that makes for a more cohesive approach. If you still come up against a brick wall then the situation really is awful and the only redress is the CQC. You would be are totally within your professional rights to go down this path as you are being obstructed from following the NMC code of conduct to safeguard the rights of your patients. Whistle-blowing is a hard thing to do but there is obviously evidence that this poor practice has been discussed before and needs to be dealt with. The dignity of the patients should be paramount and protected.
19-Oct-2011 3:04 pm
I have been a care giver for many years in nursing homes. I have always disagreed with the practice of pulling residents that are sound asleep from their warm beds. Most of them are not spoken to or explained that it is morning, they are just greeted with bright lights, someone throwing some clothes on them and tossing them in a wheelchair, usually in less than 5 minutes time. It is the practice of every home that I have been in to do this, starting at 5am and sometimes earlier if they are short of staff. It upsets me and makes me feel helpless, as there has been no resolution for it, even after working with senior services and other state agencies.
19-Oct-2011 6:54 pm
It is abuse if you wake anyone up purposely before 0600, it is as simple as that. (There are obvious exceptions for those who wake up naturally or request to be woken.)
Best practice is this, refuse to wake ANYONE before 0600, and those who you do get up, give them enough time to wake up, allow them enough time to do things as they want to and wash/dress themselves if they are able. Always ask if they want to get up and allow people who can decide for themselves to sleep later if they so wish. This is true patient centred care. What is not done, gets handed over. This is 24 hour care.
You WILL come up against a brick wall of management who want a production line mentality, regardless of what they say, and you WILL come up against a lot of whining and bitchiness from day staff, especially HCAs who will start putting little digs and complaints in saying 'night staff aren't doing anything' or 'night staff are supposed to get x amount of people up' etc, which are both crap. (I will say there will be some staff who actually agree with you, Nurses and HCAs, but we seem to be in the minority and many HCAs don't know how to speak up, but that still does not mean we shouldn't do things we know to be right). It may not be a popular thing to say, but it is true, and I think anyone who disagrees knows it too. Stay strong, and fight against this culture.
I would flat refuse to allow anyone on my team to carry on with this practice whilst I am on shift, as I would be responsible. Remember, YOU are the staff Nurse, YOU are in charge, not the HCAs, regardless of what they think.
So start by changing things on your shift, do things the RIGHT way; when the inevitable whingeing starts, go to management and say this is what is happening now, you will not accept any excuses about timetables or breakfasts, and will go to the CQC, UNISON or the RCN and even the NMC with your concerns just to cover your own back if it happens again, because at least then it would be on record.
29-Oct-2011 7:57 am
does anyone have a link with confirmed legislation on this they can send me? i have worked in care for several years but have only recently come into elderly care (EMI) where the start times are such an issue. I also have just started mental health nursing training so wish to bring anything i can to promote patient well being... The main argument thrown back on me is "duty of care", i.e., they argue "well, they've been sleeping all day... they need personal care... it's not like they don't get adequete sleep between the day and the night... they need to get up and stop bedsores... they've been in bed since 6pm!" etc etc... I agree with personal care but feel that is not excuse to get people up AND i feel it is a failure of the day routine that there isn't enough stimulation that they must fall asleep... The avergae support worker is encouraged to start seeing if anyone is ready to get up from 04:30!!! I refuse to do this but will check on personal care needs plus individuals desire to get up or not. Any help would be appreciated!
