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Husband won't obey nurses - Carers UK Forum

Husband won't obey nurses

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I wonder how others deal with this? My husband has always been a difficult man and is now 79. His legs have been causing problems re oedema and he has had cellulitis which resulted in 4 courses of antibiotics.

He developed blisters on both legs over the weekend and two burst but left raw skin patches - the blisters were around 2" wide and 3" long and the patches longer plus he has other blisters filling up too yesterday. I phoned the Surgery to speak to a nurse but got a GP who was very good and sent out the District Nurse that afternoon. She dressed both legs and told husband he was NOT to have a bath. He has said he will have a bath tomorrow although nurse coming to check and change dressings. He did say he would try to keep legs out of water but he is very doddery and frankly he might fall if he tries to do this. So it is a huge moral dilemma - do I help him take the dressings off, against nurses advice or do I let him try and bath with them on. He struggled to get out of the bath yesterday and asked me to stay with him - I usually weigh him after running his bath then go away but stay downstairs so I can hear if he has problems. He does have the temperature in the bathroom very hot.

He has 'mental capacity' so I guess even though I am his carer, I am not responsible for him if he has a bath against advice. I cannot physically stop him as he may well last out and although frail, he weights more then me. I am quite upset because hte last few weeks have involved visits to Surgery, Wound Clinic and District Nurses so I so want to get his legs sorted.I do not know what is causing the blisters but he does have psoriasis so I shall discuss this with the Consultant next month. He seems to fall between two stools with the GP Surgery nurses and District Nurses saying they are worried about perscribing things as he is under a Dermatologist but they will 'manage' the condition. This seems mainly me applying creams daily which I did until the blisters flared up last weekend and started weeping.

The lactulose remains a problem and he is very forgetful. This means he has a retention of 6-8 days so he takes a lot of lactulose and this causes tummy problems. Again, I have explained and so has the GP, and Consultant. I have spoken briefly to the Consultant about my Dementia concerns although in fairness, he is on a lot of pain killers.

I do not have the medical knowledge to deal with this and am feeling very out of my depth when he does not take medical advice.
helena_1512 wrote:
Tue Apr 17, 2018 12:45 pm
I wonder how others deal with this? My husband has always been a difficult man and is now 79. His legs have been causing problems re oedema and he has had cellulitis which resulted in 4 courses of antibiotics.

He developed blisters on both legs over the weekend and two burst but left raw skin patches - the blisters were around 2" wide and 3" long and the patches longer plus he has other blisters filling up too yesterday. I phoned the Surgery to speak to a nurse but got a GP who was very good and sent out the District Nurse that afternoon. She dressed both legs and told husband he was NOT to have a bath. He has said he will have a bath tomorrow although nurse coming to check and change dressings. He did say he would try to keep legs out of water but he is very doddery and frankly he might fall if he tries to do this. So it is a huge moral dilemma - do I help him take the dressings off, against nurses advice or do I let him try and bath with them on. He struggled to get out of the bath yesterday and asked me to stay with him - I usually weigh him after running his bath then go away but stay downstairs so I can hear if he has problems. He does have the temperature in the bathroom very hot.

He has 'mental capacity' so I guess even though I am his carer, I am not responsible for him if he has a bath against advice. I cannot physically stop him as he may well last out and although frail, he weights more then me. I am quite upset because hte last few weeks have involved visits to Surgery, Wound Clinic and District Nurses so I so want to get his legs sorted.I do not know what is causing the blisters but he does have psoriasis so I shall discuss this with the Consultant next month. He seems to fall between two stools with the GP Surgery nurses and District Nurses saying they are worried about perscribing things as he is under a Dermatologist but they will 'manage' the condition. This seems mainly me applying creams daily which I did until the blisters flared up last weekend and started weeping.

The lactulose remains a problem and he is very forgetful. This means he has a retention of 6-8 days so he takes a lot of lactulose and this causes tummy problems. Again, I have explained and so has the GP, and Consultant. I have spoken briefly to the Consultant about my Dementia concerns although in fairness, he is on a lot of pain killers.

I do not have the medical knowledge to deal with this and am feeling very out of my depth when he does not take medical advice.
Helena - my wife is a District Nurse and its not uncommon. Its the bain of their lives that patients think they know better. BUT, if nurse has said not to have a bath then he shouldnt.

But as you say, you can't stop him. All you can do is have a word with the DN.

Unfortunately, when it gets worse because hes not listening and the DN can't fit him in at a moments notice to sort him out (they are SO busy) he might have to learn the hard way. Hope he can see sense before that happens of course.
Thanks Paul - glad it is not just him! But I am terrified of the cellulitis coming back as it took so long to get on top of last time and also the risk of septis given his general health......they were talking about hospital and intraveneous antibiotics when the Duty GP came out end Feb so I have been really hoping that would scare him enough to co-operate. Nurse coming out later as we were told to call if the very large blister on one of the legs burst and it has plus his other leg feels 'tight' and we have loosened the bandage after calling for advice, and it is quite messy.

We can only try and I can imagine your wife's job is very hard.
Helena
Just because Hubby was deemed to have mental capacity at one time doesnt mean he has it now, or would pass tests now.
For example if he insists on having a bath against medical advice and then causes his legs to get worse or gets stuck , then that is good evidence that his capacity is 'unsure' at least
I understand it's a fine balance between stopping him doing it and letting him get on with it, but ask yourself if , with the best will in the world, by helping him you are inadvertanly covering up for his difficulties?
Helena,
it's very hard to care for someone who is so obviously going against medical advice. Keep making sure the professionals are aware. Personally, I think I'd reiterate what the medical advice was and then let him get on with it or are you worried he would be physically aggressive?
(You could mislay the plug, I suppose?!)

Further to what Mrs A said, when I did training in mental capacity, we were taught that having/ not having capacity was decision specific e.g. it's possible to have capacity to make some decisions but not others. I think the medics need to be accessing his capacity on each of the various health issues. Unwise decisions aren't always a sign of lacking capacity, but medics might make some best interest decisions on his behalf.

Melly1
It's an absolute minefield, and every single person I meet has a different interpretation. Yet again, with staff changes, M is being allowed to spend what he wants, and I'm going round the same old circle yet again.
Sorry to hear that BB, why am I not surprised??!
Helena, do you think your husband forgets what he has been advised?
Pet, from everything Helena's told us about her husband it's nothing to do with 'forgetfulness' and everything to do with knowing better than everyone else and only thinking what he wants to think.

I think Melly's idea of 'losing' the bath plug is brilliant.

Helena, I don't think you should 'aid and abet' your husband in ANY way to have a bath. Don't undo the dressings, put out a towel, don't put the water to heat. TELL him loud and clear he has been told NOT to have a bath, and that you will NOT be flouting that! You answer to the NURSE, not to HIM, when it comes to his health and well being.

Tell him if he wants to be a fool, that's his choice - you won't be sharing in that. And that you credited him with more intelligence than his determination to have a bath against medical advice demonstrates!

Of course he'll get angry etc, but why should that bother you? He is quite tyrannical enough as it is. His anger and displeasure are HIS problems, not yours.
Thanks - good advice. I do not think he 'forgets' - I think he is naturally a very dominant man and yes, he could lash out if he felt he was being 'challenged' . Sadly losing the plug is not an option as I have spares - er....the cats have been known to walk off with the plugs!!!!.

I have now found that health professionals seem much happier to be dealing with me than there were a few years ago although in fairness he threatened to sue medics who did talk to me! He has been a little easier since his deafness has got worse and he will quite often pass the GP onto me - he did it yesterday a second time with one of the partners, so I do feel I am at least getting somewhere with his surgery......

Yes BB the whole 'Mental Capacity' thing is a minefield - I went through this with my late father and his GP was fantastic talking me through why my letters to the Surgery were 'ignored' although they did have a Surgery meeting about my concerns.

I think I will just reiterate that the nurse said he MUST NOT have a bath and suggest a strip wash. I won't help by taking the bandages off. I do agree Mrs A - in a way, if I do this then I am 'colluding' but it is a toughie. If he gets stuck in the bath, then I will HAVE to call 999 as there is no way I could help him get out.

I guess I do feel guilty though as his GP and the District Nurse s have gone the extra mile. Nurse came out again today and was very very good. One of the large blisters burst and he was complaining of pins and needles and 'pressure' so I was told to call the nurses direct. Hopefully someone is coming out tomorrow. I do not think he will have a bath tomorrow - the nurse today was very nice and she did explain again plus we both suggested to him that he could have a strip wash. The one yesterday did not like cats so that frankly was a nightmare trying to herd all my lot into the spare bedrooms....

So thank you - I did my best by writing to his GP explaining that she must not ask me questions re his 'confusion' whilst he was around as he would go ballistic. She was very good and the next time pressed a piece of paper into my hand, thanking me a saying my concerns re dementia had been noted. I cannot see how this can be progressed easily at this moment in time but it is on file and I did also mention this to the Geriatric Consultant, I really cannot push too far or husband has said he will go to a solicitor and get it on file that he does not have 'dementia'. This could cost a huge amount of money as all any good solicitor could say is that he has 'mental capacity at this moment in time' and I really cannot afford to challenge him and for him to get 'expert witnesses in'. So I am doing the best I can.

I do feel that the blisters could be a sign of heart problems or circulation problems and will ask the Consultant (Dermo) to rule out psoriasis as a cause and ask him to write to the GP - I think then further tests may be done via the Surgery or the Geriatric Consultants - I do find dealing with 2 Consultants, a GP Surgery and a District nurse confusing at times but think I am wading through it. Nurse today said that anything to do with blisters to call them and they are 24/7 if needed, and if they think we need to see a GP or go into hospital they will tell us. I am not saying NHS is perfect but I am very pleased with his GP GP who did the phone consultation yesterday and was so very nice, and the nurses. I am very grateful for this support.
Maybe him getting stuck in the bath is exactly what does need to happen? I just hate this whole business of being so dependent on others, the whole quality of our lives depends on what they do/don't do. Just wish they'd remember we didn't ask to have a disabled relative, we'd far rather be independent and normal!