Failure to Provide Adequate ADL Assistance for Resident with Dementia
Penalty
Summary
A deficiency occurred when a resident with diagnoses including dementia and acute osteomyelitis did not receive adequate assistance with activities of daily living (ADL), specifically related to face washing and shaving. The resident's care plan indicated a need for assistance with bathing, dressing, grooming, and hygiene, and noted impaired decision-making and a tendency to refuse some care. Despite this, multiple observations over several days found the resident unshaved, with dry, flaky skin and food debris on his face and beard. The resident was also noted to have red corners of the mouth and skin flakes on his shirt collar. Interviews with staff confirmed that the resident required extensive assistance with ADLs and was usually shaved on shower days, but there was no indication that he refused face washing or shaving during the observed period. Staff interviews revealed that while the resident sometimes refused certain aspects of care, such as deodorant or showers, he was not known to refuse face washing or shaving. Observations consistently showed the resident in an unkempt state, with visible hygiene concerns that were not addressed until a later intervention by the Director of Nursing Services. The failure to provide regular and necessary grooming and hygiene assistance as outlined in the care plan led to the identified deficiency.