Some suggested answers are in italics.
‘Yes, Nance?’
‘I’m wet.’
Without a word the cot-side was lowered, the bedclothes were pulled back and an inspection made. Yes, Nancy was wet. The fact being established, Pauline pressed the buzzer for a few seconds, a prearranged signal, and several moments later one of her colleagues joined her.
‘Nancy’s wet.’
1. If you woke up in the middle of the night and found that you had wet yourself, how would you feel about it?
• I would feel -
• Embarrassed. What am I going to say to my partner, my parents?
• Worried. Is there something wrong with me?
• Shocked. I can’t believe it!
• Panicky. Do I need to see my doctor?
• Puzzled. What’s going on?
• Annoyed. Now the mattress is going to smell!
2. How might Nancy feel about wetting her bed?
• She simply accepts it as part of growing old.
• She no longer cares about what she does. This includes wetting her bed.
• She feels embarrassed and bad about it, but staff seem to accept it as normal behaviour.
3. In January 2001 an official report condemned the use of cot• sides. There had been some nasty injuries and a couple of deaths caused by their use or misuse. Do you feel that their use is justified, or do you agree that they should be banned?
• Your answer.
• Although frequently referred to as ‘cot-sides’ the correct term these days is ‘bed-rails’. The word ‘cot’ is deemed inappropriate when used of adults.
My opinion is that a risk assessment should be carried out for each resident who needs to use them. Carers should be aware that the misuse of cot-sides may cause injuries. Padded ‘bumpers’ should be used with them.
4. List all that Joan did for Nancy as she got her up, ready for breakfast.
• Joan -
• Greeted Nancy by name.
• Asked her if she wanted to get up.
• Sat her on the commode.
• Undressed her.
• Explained what she was going to do.
• Chatted all the while.
• Washed her.
• Brushed her hair.
• Dressed her.
• Put her watch on.
• Cleaned her dentures.
• Put an incontinence pad in place.
• Stripped and remade the bed.
• Made a visual inspection of Nancy’s skin condition.
‘Sleeping tablets were given to a dozen or so residents and proved to be helpful to some and ineffective for others.’
5. One of your residents is unable to sleep tonight. What could be the reason?
• They’re worried about a relative, friend, neighbour or pet.
• They’re frightened of dying.
• They’re upset about the death of a friend, relative or another resident.
• They have a stomach ache, arthritis pain, toothache.
• They’re disturbed by noise from another resident’s television.
• They’re hungry or thirsty; too hot or too cold.
• The light has not been turned off or left on.
• They’re spending too much time sleeping during the day.
6. What are you going to do to help this resident sleep?
• Find the time to talk to them and ask them why they can’t sleep.
• Use common sense to ascertain the problem.
• Offer words of comfort, a warm drink, paracetamol tablets, to switch the light off or on, fetch another blanket, etc.
• Consider if this should be reported to senior staff.
• Ask that they be kept occupied during the day.
• Consider if a visit from a church minister might be helpful.
7. What alternatives to sleeping tablets could you suggest for your insomniac residents?
• A warm, milky drink.
• Watching television, listening to the radio or to music.
• Tea and toast.
• A covered hot water bottle (if allowed).
• A drink of whiskey or brandy, possibly in warm milk, after checking with senior staff.
• Reading a book, newspaper or magazine.
• Doing a crossword puzzle.
‘Elderly people and young children seemed to get on well together, at least for short periods. These youngster’s visits had become popular with the old folk and had become a regular feature.’
8. Why do elderly people and young children often get on well together?
• Your answer.
9. Why might older people only be able to tolerate young children for short periods?
• Your answer.
10. Why would the children have been warned not to sit on the lounge floor?
• There could be wet patches caused by urine from incontinent or confused residents.
• Drinks might have been spilt on the carpet.
11. In what ways might elderly people in your care home be treated like young children by carers like you and by their own relatives?
• They are not asked about or involved in decisions being made concerning them, eg the clothes they are going to wear today, the foods they are going to have for lunch.
• Childish expressions are used in speaking to them.
• ‘Stand up for me, there’s a good girl!’
• They’re told off when they have done something wrong, such as wet themselves. - ‘You dirty boy!’
• They’re spoken down to or threatened.
• ‘You don’t want me to have to tell your daughter, do you?’
• They are given bibs to use at mealtimes.
• Their medications are not explained to them.
• They are told to ‘eat their vegetables’.
• ‘Just one more spoonful for me! There’s a good girl!’
• They are pushed around the home in a wheelchair when there is no need for this.
12. Why might you be treating them like young children?
• They sometimes behave and talk in a similar way to young children.
• They make a mess at mealtimes.
• They wet and dirty themselves, wear nappies and have to be toileted.
• They can’t talk and make themselves understood.
• It’s easier to control them.
• They don’t object to being treated this way.