I'd like to hear how you all find the best way to make suggestions to carers or to question what they are doing. I would hate to lose this agency who are all really lovely with Jon but I find it hard to make any suggestions or question anything as they seem to think that their years of experience and wide range of patients makes them much more expert than other professionals or me.
On one occasion I questioned the mode of delivery of some medication which had been modified following his aspiration pneumonia. It was our favourite carer but he didn't come back for weeks because he had felt crticicised. I hadn't been criticising just wanting information.
Recent example. At Jon's wheelchair assessment the occupational Therapist pointed out that his tendency to sit with his hips rotated was the reason he was tending to lean sideways in his chair. She said to check hip alignment when he was lowered into his chair, by feeling the top of the pelvis on both sides and if the one side was forward to rehoist and adjust. This should avoid him leaning to one side. Sounded good to me so I told the carer. But the response was that he had developed his own way ( basically propping up with cushions ) and it worked well. He did the same with another similar case and it worked for her too. Now I've had time to think about it I will insist on checking the hip alignment next time myself and see where we go from there. But I think if I had peristed in the first place he would have taken offence.
Another situation regards washing. Jon doesn't shower or bathe so he just has a bed bath in the morning and a wash at night and I'm not sure how thorough it is. His beard often is stiff with food or drink. Sometimes his tremor leads to him scratching repeatedly at his beard and results in loads of dry bits down his shirt front. Ive mentioned it once but been told they use a dry tissue first and then a wet wipe and what else can they do? But its still the same. Any time I fondle his beard (yes of course i do!) it's crusty. A good scratch and a wet cloth sorts it. As for the bed bath, the door is firmly shut behind them so I dont know what goes on. It usually takes them 20 minutes to change him, wash and dress him and transfer him to his kitchen chair for breakfast.
I know I'm not the most diplomatic of people so I would like your advice as to how to approach these things, what language to use etc.