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COTA Thoughts

Gender Differences with Patients

Published September 18, 2008 11:19 AM by Tim Banish
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As a male, I guess I've experienced more issues with completing ADL's with some female patients. It makes me wonder if females have the same issue with some male patients. I can say I've had a few, but very few, males request another male complete personal care.

I always respect a patient's decision to have assistance from someone of their own gender. Modesty is often lost in places where there is continual flow of nurses, doctors, ministers, transporters, dietary staff, social workers, therapists, housekeeping, etc. etc. walking in to your room at any time to complete their job.

Many times happening upon the person in a "less than respectable" appearance.

If I remember back the first time as a new COTA being scheduled to complete a shower with a female patient. I know I was nervous, but approached the task as I had been instructed. Fortunately, she was quite open minded and was able to adapt her routine to become safer.

Toileting is almost another separate issue. It seems easier to maintain a bit more modesty during this task, at least depending on the person's abilities. When it comes to the hygiene issues, this is another place where it will depend on the person's level as to how much modesty will be maintained.

Finally dressing skills are the next area where it may be hard to maintain modesty. Sometimes I ask the Nursing Aides to dress the females in their bra and panties/brief then I take over in order to maintain some modesty. With higher level females, dressing behind the curtain or in the bathroom are options. However I never allow a patient to complete anything out of view that we had not already practiced in the gym. I like to use old clothing articles for practice of dressing skills. A large pair of shorts can go over the patient's pants or slippers easily enough. A spare pair of those slipper socks is nice to practice with the sock aid.

So have any of you had gender problems? Have you found any other solutions? What do you do if there is no one of the same gender available?

Until next time, hope all your thoughts are good,

Tim

posted by Tim Banish
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Thanks Alan-

That's pretty much what I do, it just seems like as of late more and more of my female patients seem to have an modesty issue. I do respect that, and use "simulated" dressing and bathing tasks. Just have to be a little more creative!
Tim Banish, LTC - COTA/L October 19, 2008 6:57 PM
Cincinnati OH

Hi Tim,

Having done this a dozen years including SNF, Acute and outpatient roles I would have to agree. The patient's perception and comfort is always the rule.

I follow a strict rule of thumb with my female patients in need of ADL bathing and dressing. I always give them the option of having undergarments and hygeine assistance provided by female staff. I will simulate bathing and dressing if there is a need to insure training or have patients dress over existing clothing using tools and adaptive techniques.

Frequently there is no issue, but when there is, I always respect the patient's request.

As a rule, when possible I also take a strategic position and stand to the side or behind the female patient when donning bras and panties. I will frequently occupy myself with other setup tasks in the room when safety permits unless the patient needs assist with balance or some other direct physical intervention.

Frequently, setup and leaving the room where there is no need for specialized tools or direct step by step instruction is also a possibility. This time is not billable - but it does evidence that the goal is met. If the patient is able to manage without anyone else assisting the task has been accomplished independantly. STNA's, familiy members and nurses need to be waved off to insure this works and checking back is essential.

Patients who have had strokes or suffer from a disease like Parkinsons frequently require too much help for anything resembling that technique to be viable.

God Bless,

Alan
Alan, Phys Dis - COTA/L, UHGMC October 17, 2008 12:25 PM
Chardon OH

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