Failure to Maintain Resident Dignity and Proper Use of Incontinent Products
Penalty
Summary
Staff failed to ensure a resident was dressed in a dignified manner and that incontinent products were used appropriately. The resident, who had diagnoses including non-Alzheimer's dementia, anxiety disorder, and diabetes, was dependent on staff for lower body dressing and toileting hygiene, with a BIMS score indicating moderately impaired cognition. Observations and staff interviews revealed that the resident was brought to the dining room after a shower wearing only a nightgown and a lap blanket covering her legs, and on another occasion, with only a shirt, a brief, and a blanket. Staff acknowledged this was a dignity issue and that the resident should have been dressed in pants before being brought to the dining area. Additionally, staff were observed and reported to have applied more than one incontinent product to the resident, such as a pull-up with a pad inside, which was not in accordance with appropriate care practices. Staff indicated this was done because the resident was a heavy wetter, but acknowledged that the correct approach would be to change the resident more frequently rather than using double products. The Director of Nursing was not aware of these incidents at the time of the interviews.