My mom has been in memory care for approximately fourteenth months. She can be very difficult when it comes to brushing her teeth and cutting her fingernails and toenails. Her toenails have become very long, and my father mentioned it twice earlier this week to the staff. Her nails and toenails haven't been cut. I file her nails sometimes. Is this an issue where my father and I should be unhappy with the staff? Again, I realize that my mother doesn't make it easy.
When my Husband was on Hospice for a while the CNA would cut his nails then she said that there was a change and they could no longer cut nails.
If the facility has a podiatrist that makes the rounds (most do) make an appointment for the podiatrist to do them .
It is possible that the person in the salon that does hair can do fingernails if the staff can't.
The longer explanation; there are restrictions in care facilities regarding nail cutting, particularly if the patient has any diabetes. Only certain certified persons are allowed to attempt this, such as a nurse. This is because of the complications associated with accidental cutting of the skin.
In your mother's case, because she is difficult, and resistant (I know, my husband is the same way - he pulls his hand away when I attempt to trim his nails, or kicks if I try on his feet) it can be dangerous for a staff member to attempt. Your mother could get cut. One time, my husband jerked his hand as I was cutting, and I cut his finger. I couldn't believe how much blood there was from this tiny cut on the tip of his finger! And trying to clean him up and bandage him was also a fight, with his hand flailing around, flinging blood everywhere, and once I finally got it bandaged with a large gauze pad, it soaked through quickly and I had to replace it twice within a 30 minute period before the bleeding finally subsided.
I'm just saying - you may attempt to trim her nails, but please cut the staff some slack if they don't do it, and ask what their protocol is, that is, what they are allowed to do.
Staff does NOT CUT NAILS in Assisted Living, nor do you want them to. One little nick and an infection can ensue. Mom was taking blood thinners so it was dangerous for anyone but a podiatrist to cut her nails.
First is that Original Medicare does NOT cover podiatrist provided routine healthy foot care, like toe nail clipping, corn/callus work, foot hygiene issues. However Medicare will cover podiatrist if the person has a medical issue related to the condition of the foot. Like if they have diabetes, podiatry is routinely covered as diabetics often have neuropathy and ulceration, so a once a yr podo visit at a minimum is covered by Medicare. If you have a hammer toe or heel spurs, its is covered as it’s a podiatry visit related to a medical condition. If mom can be diagnosed as having foot circulation issues / peripheral artery problems, then it can be covered. Basically routine food care not covered but disease related foot care covered is covered. You get my drift???
2nd issue is that she is in Memory Care. Most MC are actually licensed as an “Assisted Living facility”. Not licensed as a skilled nursing facility aka a Nursing Home. So as it’s AL, it means the residents technically are viewed as totally still being able to do for themselves with some limited degree of assistance. ((Oftentimes the residents are realistically beyond this stage but continue to live in the AL as their “assistance” is manageable by the AL and the AL likes the resident; this often becomes problematic as the residents becomes more frail.)) So if it’s AL licensed and if they need a podiatrist, it’s on them or their POA to arrange for this either by taking them to a podiatrist office or finding one who does “house calls”.
It’s very different that what a NH does for podiatry, as there is usually a podiatrist who regularly comes to the NH as so many of the residents if not the majority have diseases or conditions that can be billed to Medicare.
The 3rd issue might could be your mom’s disposition. If her MC has an outside nail tech that does routine maintenance (mani & pedi) on their residents nails AND mom tells them she doesn’t want their nail service, they won’t bother with doing it. Ditto if her MC has a podiatrist who comes in regularly. They will happily go to the next resident.
There are other residents at the MC who get podiatry work done. Ask around as to how they deal with getting this done. If mom saw someone 15+ months ago before she moved into the MC, maybe get her out of the MC for a return appointment with them.
If they have a podiatrist available can he visit and try in the early morning hours when sleeping. My uncles facility has a podiatrist come in and he prefers to make visits between 5-7am due to the patients less combativeness during those hours.