It can seem like it from the outside.

Thing is, there's a lot of trust and some degree of habit. First, if someone is a nudist, you get warned before starting the case, so that's not a factor in this. Most people aren't stripping down day 1. Some do! But that's largely because of trust too.

You get used to having strangers around and trust that they're not going to cross any lines because most in home caregivers won't. There's always assholes and creeps in any job, and home health isn't immune, but it isn't super common because you'll get weeded out.

Then, if the same caregiver is there a lot, they cease to be an outsider. Me? I was spectacular at integrating into a household with low friction. That, my wound care chops, and physical strength were my calling cards. Once a given caregiver integrates, people go back to whatever their default habits are. Nobody can be on 24/7, and staying on at home is even harder to maintain. So people get comfortable and if they're usually casual about nudity, they'll treat you the same as any member of the household.

The classic story I bring up is the daughter of one of my patients. First week or so, she was in makeup, hair did, dressed for public before I would get there. I want to say that it was day 10 that I rolled up and she's back in her house robe, with only a tee shirt underneath, having climbed out of bed only when she heard my car crackle the gravel in the driveway. It was all business one day, the next it was Sleepover Sally a couple of days later, she stopped even greeting me at the door and stopped getting dressed at all until she'd had coffee and a shower. That was her real habit: wake up, coffee, bathe, then dress.

Wasn't even a nudist, just slept naked and she was at home. My job was to make their lives easier, not bring external pressure into their safe place. She followed her pattern when we weren't there, and stayed clothed when a caregiver would object, but it was something we were aware of before accepting the case.

Some folks just aren't bothered by being naked around close friends and family. Others aren't bothered by it around anyone at all, even if they're not nudists.

And it was cool for most of us workers. The only time nudity even registers to most hands-on caregivers is when it's weaponized or sexually presented (or both). I mean, on my end, I was there to see someone naked and do things to their body. The nudity was mandatory for most cases because you can't wash someone's ass if they have pants on. Not very well anyway. That there was extra nudity was like there being exotic pets in the house; as long as I didn't have to pet their python, why would I care? The alliteration was for funsies, I actually like snakes and think they feel pleasant to touch.

But there were also plenty of people in your frame of mind as well. Hell, I had patients that resisted care in general and avoided accepting care whenever possible because they didn't want to be naked with someone. A handful wouldn't move past it no matter how I was.

What's funny is that in my personal life, I've become very nudity resistant to medical professionals because they're not on my list of "my" people. That's despite knowing that no doctor gives a damn about seeing my junk. I just don't like sharing my body with people I barely know; it has nothing to do with them, it's about my body autonomy. I wasn't always like that, it happened after the disability stick hit me.