The scabies is being treated at a hospital. I am worried about post-hepatic neuralgia and itching that puts her at risk of infection. Memory care can manage the basics, but I am advocating for skilled nursing until she is past the itching that can last 4-6 weeks after treatment. Her fingernails are long and dirty. Needless to say she is not returning to the former memory care facility, and we're scrambling to find a new place with limited resources and no chance for medicaid assistance. The hospitalist can't push for skilled nursing because she can't "predict" that my parent will become infected while recovering in memory care.
When it comes to nails, I have always been told that aides are not allowed to cut nails or toenails. I do think in this situation, though, it should be done.
Dermatologists can cut fingernails, but it seems like a massive over-qualification for simple nail clipping. There is nothing to say that other people aren’t allowed to do it, eg beauty practitioners, mom, your next door neighbor etc. ‘Competency’ is the only requirement in some places, which seems pretty reasonable. We now have 'nail technicians' in the local shopping mall, but they aren't in the aged care market.
There is no special training for cutting nose hair either, so there are some questions about who is OK to do that as well. Apparently it’s not part of hair dresser training, not surprisingly.
Nail cutting isn’t in the training of most care workers, so back to the insurance liability issues and the can't/ won't argument. What seems reasonable is for staff to cut normal nails (though dermatologists think the clippers should be sterilised), but to get a medical professional to do it if there is infection or damage to the nail. But what is ‘normal’, when old people’s nails can be so thick and horny?
Whoever would have thought that fingernails would be such an issue? However it may explain why these nails are in such a bad state. It may not be as simple as negligence in the facility.