Do nursing homes normally wipe dementia patients after BM to avoid UTIs?

Patient

Q: (Because question is about my mother, I have given her age and medical info below instead of my own.) My mother has dementia and is in a nursing home. She occasionally gets urinary tract infections. The nursing directors have told me that no one is going to wipe my mother after her bowel movements, even though they agree that improper wiping is one of the main causes of these infections. They claim that sufficient liquid intake is more important and therefore I need not worry about the wiping. The nursing home has an excellent reputation and the nurses appear to be well trained, but I can't reconcile this with their blatent refusal to follow what seems to be simple common sense. In fact, some of my acquaintances are Home Health Attendants who work through agencies. They tell me that wiping older patients after bowel movements is abolutely required of them--they always wipe female patients who no longer wipe themselves properly. So my question is this: Do nursing homes normally do this for a client or is my mother's nursing home simply following the norm of of most others in not wiping and cleaning her after bowel movements?

Doctor

A:   Than you for your question. We cannot comment on specific nursing home protocols for cleaning patients who are unable to go to the washroom. However, in general it is strongly advised, and many times ordered by the nursing unit within the hospital to clean patients every time after a bowel movement, by changing diapers, absorbent pads, and cleaning with personal wipes. This prevents the development of recurrent UTIs and other infections of the skin of the genital region. We recommend that you strongly suggest this be done for your mother. Since your mother is at a reputable nursing home, then they should hold themselves at a high standard in delivering the best care possible for your ailing mother. Regardless of what their protocol is, your mother deserves to live her life free of increased risk for recurrent UTIs. You may need to have a doctors order to this affect, if the nursing home does not want to comply with your request. For this, we recommend that you consult your mother's family physician in order to have this performed.

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