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My mother has been in the same facility for several years. Since Covid I have noticed she is very unkempt looking. They used to keep her hair shaved off her face and her nails cut. But that doesn’t seem the case anymore. She wears clothes that are not her clothes and are either to large or too small. Do I talk to the nurse administrator about these things?

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I’ve experienced the exact same issues with my loved one, too. I was told that each person’s laundry was done separately, so how do they end up with other people’s clothes? I bought customized name labels and put them on everything, including shoes. There have been grooming issues, too.
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BurntCaregiver Apr 2022
The laundry is not done separately. They do it by floors. They also send the laundry out to be cleaned and those workers don't pay much attention to labels in the clothes with someone's name on them.
When my father was in the NH, I picked up his laundry once a week and did it myself. This is the only way to keep someone in their own clothes and this doesn't always work. Sometimes different people's clothes being worn are not the fault of the staff. In nursing homes or any facility where there are people with dementia, clothes and all kinds of different items go missing from residents' rooms, closets, and bathrooms. They get nicked by other residents.
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Cut them some slack. It's tough to keep up with it all, especially if they're short-staffed.

I did my mother's nails for her when I visited, and brought mixed up clothes to the administrator's attention. I checked her clothes to make sure the labels were in them, replaced missing ones, and acted as a member of my mother's care team, not just the person who pays the bills.
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Yes, talk to the nurse administrator or whoever is the line manager for the staff delivering your mother's day-to-day care. It sounds as if it's time for a good look at your mother's care plan with a view to rebooting it.

How long do you normally spend there during visits? If possible, see if you can spend a whole morning up to and including lunch with her, using this as an opportunity to make connections among her care team and get her possessions organized.

Bear in mind that if it's been several years, there may also have been a falling-off in your mother's motivation and a change of priorities for her. Grooming and dressing are very much part of supporting a person's individuality and are very important but make allowances for anything that *she* can't be bothered with any more.

Regarding the hair removal specifically: if she's on blood-thinners, the aides may be extremely reluctant to shave her (or prohibited, even). If whiskers are bothering her (mine bother me!) consider alternative methods such as tweezers or facial depilatory creams. Waxing would probably be too fierce for fragile skin.
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Where I live, staff in NHs are not allowed to cut fingernails. This is because of maybe clipping the skin and causing infections. Toes are done by a foot doctor who comes into the NH periodically. Medicare pays for this every 10 weeks.

Shaving may not be done everyday but if resident can't do it, then an aide should. I would say there is a shortage of aides. Nails and shaving may not be a priority.
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When my mom was in a NH I was told they can do her nails and shave her but a nail tech would have to come in to trim her toenails because of her diabetes.
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Yes, your question is really for the facility involved. They differ. Bring these concerns to the administration, and ask.
One thing that you can know is that most facilities without medical personnel hestitate to trim toenails. This is predominantly a problem with seniors and poor circulation, difficulty healing small nicks and scratches and the danger of sepsis.
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Hair and nails are done for a fee at my LO’S residence, but honestly all bets are off since COVID, and fact is, if she’s wearing something clean that covers her comfortably I could care less whether the clothing is too large or too small.

If your mother doesn’t express concern, it maybe better to let this go.
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Alva makes an important point about toenails - the difference really is between cosmetic and strictly health-related procedures, and we certainly don't go anywhere *near* anything to do with podiatry/chiropody (hands up, I've never concentrated when anyone's told me what the difference is between those two). Similarly, we can clean under fingernails, we'd happily apply nail polish if only there were time; but we wouldn't be clipping or cutting them and if the nails are fragile or flaking or splitting then we'd even be reluctant to file.

It may seem silly but it's just too easy to do someone a real damage with the very best of intentions.
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Isthisrealyreal Apr 2022
Those terms are the same professional just regional verbiage.
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The same thing happened with my mother during the pandemic. I think it is because they had to put a halt to extra visitors (such as hair stylist, manicurist, etc). I cut my mother's hair and shaved the hairs on her face, clipped her nails, etc. But you could also talk to the administrator there to find out if they have someone coming in to cut hair and do manicures. Some facilities are having difficulty hiring extra staff. Regarding the clothes, this seems to be something that happens in all assisted living facilties. I saw it when my elderly aunt was in rehab, and the same thing happened when my mother was in assisted living. Clothes that were not hers just appeared in her closet (some were items she never would have chosen prior to her dementia). It's even featured in a scene in the movie "Still Alice" about a woman who gets early Alz. I mentioned it to the case manager, but didn't fight to change it. It never changed, even when I bought her a bunch of new clothes in the right size.
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dn1253: Imho, a facility has to be really cautious about nail care in particular. Oftentimes elders' toenails may be thick due to different fungal issues, but please know that I am not implying that this is the case with your LO. Add in the fact that some elders may suffer from diabetic issues, making nail care very difficult and must be done with extreme care, else sepsis occurs. Countrymouse and AlvaDeer have brought up some very valid points. In regard to the incorrect clothing, speak to the DOC.
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Llamalover47 Apr 2022
dn1253: Edit - speak to the DON.
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There's money to be made usually NHs have foot doctors come around to do the nails of the residents and charge the service to insurance, usually Medicare
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Everywhere there is a shortage of workers, especially in healthcare. Yes, your mother should be clean and clothed in her clothes. Hair, nails, facial issues should be addressed but many workers simply do not have enough time to keep up with all of it. I would suggest asking a aesthetician to come in to wax facial hair and do her nails twice a month. Also get a hair stylist in every 6-8 weeks to touch up her hair. This can be a way of giving her gifts she needs and appreciates.
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It couldn't hurt to talk to the nurse or administrator about it. If your mother was well kept before with her nails trimmed, hair cut, and hair removal always done and you didn't pay extra for it, then it was included in her bill.
Chances are the facility she's in has changed hands and been bought up by a different company. Usually when this happens residents have to start paying extra for every service and the new company reduces essential staff numbers to maximize profits.
Ask if the facility is owned by a different company now.
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I take care of managing my mom's clothes, including washing them. I am a bit of a neat freak and like everything to be organized plus my mom's half room is too tiny to have clutter. I trim her fingernails. A podiatrist will take care of her toenails.
I told them to wash her hair every time she is given a shower even if she says she doesn't want it. If I happen to be there at that time, I will put curlers in her hair and use a travel size blow dryer. I have learned how to use every inch of space in her half room.
Nursing home staff are under a great deal of pressure. I would cut them some slack. I got to know all of the staff and if I have a problem, instead of going over their heads, I go to them directly.
You catch more flies with honey than vinegar. I take them snacks and magazines for their break room.
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Depending on the regulations where you are things may have changed. Some places are no longer able to cut nails on the hands. It has been long standing that staff can not cut the toe nails but that has expanded to include finger nails.
Clothing is often a problem.
Either the wrong clothing gets sent to the residents room or the resident runs out of clean clothes and they have to grab what is available either from the room mate or from the "lost and found". One of the reasons I would never bring "good or new" clothes for my Husband when he was in Day Care or for Respite. A trip to the Resale shop for clothes that I would not care if they vanished.
If she does a scheduled visit to the salon ask them to do the facial hair when they do her hair. You could ask them about the finger nails since it is a salon they might be able to do the finger nails
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I have noticed the same thing with my mom's facility. I do her hair and nails. I started doing her laundry. Many of her things have been lost, even though they were clearly marked.
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I paid extra for mom's toenail care, they had a team of foot care nurses that came in to do everyone's every month or so. They trimmed her fingernails during bath time but they did such a poor job of it I asked them to stop (lopped straight across, obviously just one snip of the clippers). I shaved her too, it was easy to see who the other ladies were that didn't have family to tend to this.
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Ohhhhhhhhhh.....

I hope you have your Mom's name on her things. That is very important. In addition, a picture of her stuff is real important if you have to prove it is yours. Yes, by all means, talk to the nurse administrator. In my case, I talk and have talked to the head nurse on the floor.

As for the laundering of items, some places do it and it is included as part of the fee, and some places do not (need to pay extra). As I was interviewing places, it also depended upon the level of care provided and what was included in that level of care.

If you see someone else wearing your Mom's stuff, do not automatically assume that the nursing staff is responsible for mixing up the clothes. In the memory ward, we have been warned that residents sometimes take other resident's clothes and sometimes, the person who owns the clothes just gives it away.

Regarding clothes that are too large or too small, could your Mom be losing or gaining weight while being there? If you can't remember what clothes your Mom actually has, start taking pictures. If anything you will need it to remind yourself of what she has/doesn't have.

Regarding nails and shaving, our state heath department says that nails and shaving can only be done by a RN because it involves the use of a scissors. One of the places that we looked at, had a beauty salon/barbershop on premises for these types of services. In the place where my Mom is now, shaving and nail services are part of the monthly fee, along with laundry.

I would try and find the contract that was signed when your Mom was admitted. If that is too much of a bother, just talk to the head nurse (or salesperson) and they can tell you what is included in the fee.
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