Cutting Nails Of A Diabetic Person.

[Tilly2]

My Dad who is in a care home, is always 'mithering' about his finger nails being too long. He has his toenails cut by a chiropodist but she does not do his finger nails. His carers file his nails occasionally when asks enough times. Anyway, I took all my paraphernalia over today with a view to cutting his finger nails.

When I got there I asked for a bowl of warm water so that he could soak his hands and nails before I cut them. I was told by the carer in charge that I wasn't allowed to cut them because he is diabetic.

I asked to speak to the manager who said I shouldn't do it because I'm not trained. I replied saying that if my Dad was living with me I would cut his nails so what was the difference. I was allowed to do it but had to say that I took full responsibility. I managed not to chop the end of his fingers off!

Has anyone else come across this or a similar scenario?

[Tilly2]

Thank you, pixie.

[RATTER15]

I have worked in a few care homes in England, we were never permitted to cut toe nails, only finger nails, we had a visiting chiropodist at one of the homes that also werent allowed to cut the toe nails of the diabetics, they had to have theirs done in the local cottage hospital. Here in Wales it appears things are different, we can do a two day course on cutting toenails and foot care, we are then permitted to cut the toenails of non-Diabetics, the diabetics still need to have theirs done at the local hospital.

[RATTER15]

Pixie, I doubt you will find policies and procedures for any particular care home online, for some reason they are guarded like the crown jewels, when the staff read them they are not to leave the building and are not to be copied, a bit strange really.

You are probably right, if the next of kin was to sign a waver of responsibility then that person would most likely be able to cut the toe nails, It would have to be the next of kin or authorised by the next of kin.

[Tilly2]

Ratter, we are talking about finger nails, not toe nails. I wouldn't dream of cutting my Dad's or anyone's toenails.

[pixie373]

You're right, ratter. I can't really see anything helpful, although there are quite a few blogs and forums discussing it. I suppose there won't be anything to cover relatives anyway, as unless the home gives a direct request/permission, it really is not their problem.
tilly, i would suggest you just continue with anything he is happy for you to do. The home can then supply "written evidence" if they want you to stop (i very much doubt they will). I think they just don't want to officially agree.

[Tilly2]

I only let them know because I wanted a bowl of warm water. Next time, I'll take my own bowl.

[Tilly2]

Thanks for your help, everyone.

[RATTER15]

lol sorry Tilly, I misread it. finger nails should not be a problem.

[Tilly2]

That seems to be the general consensus, Ratter. Thanks anyway. You both o.k.?

[woofgang]

Folks, care homes aren't prisons and residents are entitled to do what they want. The people who work there have rules about what they can and can't do for residents but, provided the resident agrees/requests, and has the capacity, then these rules do not and cannot cover relatives and even other visiting professionals. When I visited res.care as part of my job i used to do my best to keep things friendly with the staff but not if it meant not doing something that my patient wanted done.

[murraymints]

a privately hired chiropodist goes to dad every 6-8 weeks..he also does work for NHS...I would not dream of attempting his toes...but he does have a lot of diabetic related problems with his feet..

[pixie373]

Exactly, woofgang. Thanks, tilly x

[RATTER15]

Totally agree woofgang, that is what I was trying to say, you put it so much better. The staff are limited to what they can do but if the resident OK,s it then legally it is OK but may upset the Managers and her rules. Of course I referred to "next of kin" this would only apply if the resident did not have the mental capacity to make this decision for him/herself.

[Tilly2]

My dad has all his faculties and he asked me to cut his nails. I shall continue to do so. I understand that they do need to be careful with what they do to and with the residents. I am going to speak to the manager again tomorrow.

[Old_Jim]

Here's the scenario. Someone nips one of his fingers or toes with the scissors. Because diabetics often have poor circulation in their extremities, the wound becomes gangrenous and he dies. You then sue the nursing home for millions of pounds (even if you were the nipper). If he was being treated by a qualified professional, their insurance would cover it. However, the nursing home's insurers aren't going to let you give him any kind of treatment in case you're friendly with a firm of ambulance-chasers.

[Old_Jim]

PS They'd probably let you do it if you took him off the premises.

[pixie373]

They can do whatever they like, oldjim. It's just that getting authorisation (even informally) from the home, makes the home responsible for anything that goes wrong. What a resident chooses to do with their relative, is not a problem.

[woofgang]

Old_jim, on or off the premises, residential care staff/management CANNOT stop a relative doing whatever the resident wants. If the reli tried to sue about an injury that the reli had caused, they'd get nowhere.

[Caran]

Many years ago I was in hospital. Because of chemo injections I lost all hair and nails. As the nails died they were very painful, started separating, I asked nursing staff to cut them for me. They refused saying it was against the rules to cut anyone's nails. I stressed the pain was unbearable but still refused. I had to get daughter to do it for me.

[tinkerbell23]

Im not allowed to cut anyones nails with diabetes at work...

Used to not be allowed full stop.

I wouldnt personally have a problem with a relative doing it..x