Morning wake up time for aged care residents

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Waking aged care residents in order to get them showered before the end of the night shift is a vexed issue which continues to attract attention here on Nurse Uncut, since we posted about it in April 2011.

Some of you have asked about any regulations or standards you can use when you’re worried your relatives are being woken too early for a shower or as a nurse you are being directed to get them up too early.

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The Department of Health Circular No 79/77, issued in April 1979, which we don’t believe has been superseded*, is a good guide for acceptable practice.  It recommends that breakfast is not to be served before 7am and residents cannot be sat out of bed more than one hour before that. If they need to be changed or bathed earlier than that, they should be put back to bed and not left out in a chair for hours. (*Please let us know if there is anything more recent.)

Sometimes residents want to wake and be showered early, or it may help to settle them, but that is their choice.

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The standards for the Australian Aged Care Agency also talk about the right of a resident (or their guardian or relative, if they are not able) to make a decision about the service they receive and to exercise choice, as long as it doesn’t interfere with the rights of other residents.

Nurses who are being told to wake up residents very early to get them showered because the nursing home doesn’t have enough staff should be questioning this practice through their nursing staff meetings and through the union branch – or use the Work Health and Safety committee to assess the risk of having too few staff to properly care for their residents.

This is their home and we all want to see the residents enjoy it.

Currently NSW is holding a Parliamentary Inquiry into Elder Abuse. We encourage aged care nurses to make a submission before Friday February 12. Read all about it and access the online submission link here.

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4 COMMENTS

  1. Yes a shower at 2:30 in the morning seems ridiculous and is giving an example of how nursing homes have been made to run almost like factories and that time allocations are very strict. If residents have to be woken up at 2:30 in order for all residents to be attended to and ‘all tasks completed’, then more staff is required, it is as simple as that.

    Residents are people too… I agree there have to be time allocations in place because it helps with a flow and order of the day, but I feel these are very strict and don’t allow for flexibility. If I was pressured for time and struggling to get through, then wouldn’t the quality of my care decrease?

  2. What is the ratio for aged care specifically in relartion to a hostel with aging in place? I currently work in a 99 bed hostel. Overnight we have 3 PCAs and 1 Rn. Within that 99 beds we have a dementia specific unit. Leaving 2 PCAs responsible for 86 residents.
    Our current workload is as follows in the end of our shift.
    •4 showers at least for each of the PCAs
    •BSLs (amount varies day to day, NIDDMs only)
    •medications
    •a final safety check
    •answering call bells
    •attending paperwork

    My understanding is that if a resident wishes to be woken for a shower prior to 0700hrs on a regular basis, they must sign a letter of consent stating as such and if so cannot be commenced earlier than 0500hrs.
    My understanding is also that at least one PCA must be on the floor at all times to attend call bells.
    Further problems occur if a resident does refuse, as morning staff mentality becomes “couldn’t you have done someone else”. When we say no we are told we aren’t doing our job. Yet it is completely acceptable for residents to refuse care on other shifts.
    If we miss a resident who has just only just only just breached their incontinence aid then we are reported for “intentionally” leaving resident in that state.
    Rather than fight for more staff, which I have also advocated for, we are left with a blame game. I also find it deeply saddening that it seems to have have become an acceptable form of bullying of staff and clear form of elder abuse. I love what I do, I have done this job for nearly 13 years. I can’t see myself doing anything else yet I find myself hating what it has become.

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