transition from mid level to higher level dementia care

[unioncityblues]

My mother has recently returned from a respite stay at a local care home that she has attended a few times before. She was given an exit interview for want of a better word and the impression my father left with was as her speech has now deteriorated and she was now deemed high need that they could no longer accommodate her for future visits.
My father was terribly upset by this news as it was always assumed that my mother would in time move to this care home as she was familiar, we were familiar and comfortable with the arrangement there and it was close enough for my father to visit in failing health.
My question is is there a duty of care with care homes to keep their clients (is that the right word?) with them throughout their dementia journey ? A friend of mine called the care home with a new patient enquiry and was told that they do look after dementia clients with high needs so the information they gave my father was a lie. I understand that priority is to be given to clients who are already living there above respite only clients but can they effectively block my mother in lieu of another client ? Can a letter / referral from my mothers GP support a place on the waiting list or is it up to the care home ?

 

[Violet Jane]

Care homes are private businesses and they appear to be largely able to do what they want. It is not uncommon for people to be asked to leave / given notice. The home just says that they can no longer meet the person's needs. Social Services have block bookings in many homes and they may be able to exert some pressure on those homes.

I'm wondering whether the home's criteria are different for respite and long-term placements i.e. they only take people in the early / earliest stages for respite. If that's not the case then it does seem very strange. If your mother is being funded in whole or in part by the LA then it could be that the home only wants self-funders who pay far higher rates. Alternatively, could it be that the home was trying to 'spare' your father in some way regarding behaviour that they didn't want to mention?

Whilst I would want to get to the bottom of this, if a home didn't want my PWD I don't think that I'd want to place my PWD there. You need to have a good relationship with the home for the placement to work as you need to be able to work together constructively when problems and issues arise.

 

[Weasell]

My mother has recently returned from a respite stay at a local care home that she has attended a few times before. She was given an exit interview for want of a better word and the impression my father left with was as her speech has now deteriorated and she was now deemed high need that they could no longer accommodate her for future visits.
My father was terribly upset by this news as it was always assumed that my mother would in time move to this care home as she was familiar, we were familiar and comfortable with the arrangement there and it was close enough for my father to visit in failing health.
My question is is there a duty of care with care homes to keep their clients (is that the right word?) with them throughout their dementia journey ? A friend of mine called the care home with a new patient enquiry and was told that they do look after dementia clients with high needs so the information they gave my father was a lie. I understand that priority is to be given to clients who are already living there above respite only clients but can they effectively block my mother in lieu of another client ? Can a letter / referral from my mothers GP support a place on the waiting list or is it up to the care home ?

I think you need to return to the home with your father.

You need to establish if the behaviours cannot be managed in the respite capacity or in the permanent resident capacity.

They are actually quite different, complex conditions can be managed by staff that know the person, but continually changing clients, in particular ones with no verbal communication cause far more problems. Most have a care plan but the reality is the people at the coal face, have almost no time to read them.

If there are behaviours that cause problems you need to know exactly what there are, so you can ensure she only attends a placement where they feel they are equipped to cope.
I hope you get it sorted as I can feel your concern for your father.

 

[Jessbow]

In Short, no they dont have a duty of care to keep their clients.

When clients needs do not fit with what they offer, for whatever reason, they can give notice.

High needs can be all sorts ofthings- feeding , toiletting etc etc
but maybe not non verbal and not aggressive, not 'walkers'
All will have different criteria

 

[Mumlikesflowers]

I am learning but these places don't seem to put themselves in our shoes sufficiently. This course of events sucks but I guess better to know now. Of course you can go back and get them to justify themselves if you have the heart for it. But maybe do some homework about other ones you could feel happy with and who are clear at the outset about how far in the journey they will go. I had the opposite where they said no to me and then when my Dad ended up in there instead they were saying maybe we can have her. Since when I think we need somewhere that is up for it all and geared up for it all from the outset.

 

[SAP]

As already stated, care homes have no obligation to keep a resident if they feel the placement is no longer manageable.
I wonder what they meant by high need, does your mother have nursing care needs? Many care homes will care for PWD but not if they have medical needs that require a nursing member of staff to be present.
To my mind, this is a bit of a red flag that they do not have the staffing capacity to look after your mum properly and I would definitely be looking around to see what else is a available and be very thorough in asking about the care provided.

 

[canary]

Many care homes will care for PWD but not if they have medical needs that require a nursing member of staff to be present.

This is absolutely true. My mum was in a care home right up until she passed away, but she never had any nursing needs.
OH, on the other hand, is cognitively not too bad and is a way from permanent residential care. However, care homes will not accept him for respite - they cannot meet his needs because he needs nursing care (uncontrolled epilepsy and a catheter that regularly blocks, among other neurological problems).

I think you need to find out what your mums "high needs" actually are and then use this to find somewhere that can meet these needs. I dont think you will get anywhere trying to insist that this home continues to accept her.