Would you move homes?

[Fattywatty]

sorry in advance for the long post but really could do with a second opinion

Moved mum into care last October to a lovely small care home but due to escalating difficult behaviour had to move her in March of this year. She has settled very well there in general, they seem to be able to manage her much better and even though she is now back on an antipsychotic drug regularly she seems in the main fairly settled. She was on the same drug at the other home but wasn’t responding well at all.

Anyway she was doing well until I had a holiday mid May, on return I called the home to see how she was to be told she had had an altercation with another resident resulting in a fall to her bottom. I was told she was fine but the incident had been reported. I had left my husbands contact details, as they had specifically asked for an alternative contact whilst I was away (he stayed home) but he had not been told about the incident. When I visited the next day she was in a wheelchair, I asked a carer if she was ok to be told she was fine and had just chosen herself to sit there, even though she was strapped in. I helped her out of the chair and she couldn’t walk, I was then told by another carer that no she wasn’t alright and they had called the doctor to come visit her! I was quite upset at being told different things and made it known. When the doctor came he couldn’t find any problems, she had bruises on her upper thigh, wrist, forearm and back.

A week later still unable to walk properly she was X-rayed and found to have a fracture to her pubis minor. Her bruises were not properly documented, I asked to see her hygiene sheet which had only been completed for the first 9 days of the month (now on the 18th) and there was no evidence of a bath or shower in that time. I have up to now had to ask twice for clean bedding and have changed her bed myself, this weekend her pillow was stained with urine. She has been prescribed pain relief through a patch, but today it was missing and no one was aware and she has also stared to develop a pressure sore which again no one had spotted.

I am beside myself with worry about this whole situation and am seriously considering moving her again. I have complained to the manager of the home and am awaiting a report but things are constantly giving me cause for concern. I looked at a lovely home today which comes highly recommended and they have beds, she is self funding. Having said all this she does seem okay in herself but she is clearly not being looked after. I don’t know what to do!!

 

[Shedrech]

hi @Fattywatty
from what you describe, no wonder you are concerned

I baulked when I read that your mum was strapped in to a wheelchair .... and that was only the start

I'm glad you have complained to the manager

myself, I'd be asking the manager of the new home how each of these incidents would be dealt with ... then if satisfied with the responses, ask them to begin making arrangements to move

 

[canary]

Like Shedrech, I gasped when I read that she had been strapped into a wheelchair.

You have tried two unsuitable homes now - quiz the manager of homes you are considering very carefully about how they deal with various problems. Ask them specifically how they would deal with your mums challenges and find out what they would not tolerate.

Too many places put the money into nice surrounding to placate the relatives and scrimp on well trained staff.

 

[Imstressedout]

If I was self-funded too, I would move her. You’ve lost confidence in the place, so will now notice all the small things. I don’t have much experience of homes yet, but as she has settled well into two homes already hopefully that will mean she will be accepting of another move.

 

[Sirena]

I think you have answered your own question - she is not being well cared for and records are not being kept reliably. In your position I would move her. You say the prospective new home is lovely, but are you also confident they will be able to manage her and provide the right type of care?

The thing which really concerned me was that when she fell on her bottom they didn't take any appropriate action. My mother has had two similar falls which did not appear particularly serious. But the first time she fractured a bone in her pelvis, the second time she broke her hip and needed a hip replacement. On both occasions the CH called an ambulance immediately and had her assessed in hospital.

If you are going to move her imminently you may not want to do this, but I think the situation merits a call to SS safeguarding. If my mother has a fall serious enough to need a hospital visit the CH report it to SS, and Safeguarding then ring me to ask if I have any concerns or if any procedures need to be changed.

 

[Jaded'n'faded]

That's how my mum broke her hip. Another resident pushed her and she went down on her bottom. It wasn't a traumatic fall - staff were there but could not prevent it.

Unfortunately it was enough to break her bone - a clean snap just below the ball joint. Old ladies break very easily. (Which is why us slightly younger ladies need our vitamin D and for some - most probably - HRT.)

 

[Fattywatty]

Thanks for your input everyone I really appreciate it. Unfortunately the home I looked at doesn’t offer EMI which mum needs so its back to the drawing board. I feel like I’ve been kicked in the stomach tonight, just been told by a residents family member how she witnessed my mum begging and crying to be taken to the toilet after I left last night, what the hell do I do with that information?!! She’s a lovely lady who speaks little English and it’s the first time I’ve spoken with her properly, but she tried to tell me in broken english what she saw, I couldn’t get any finer details from her because of the language barrier but have no reason to doubt her. Really need to get mum out of there, another sleepless night ahead

 

[canary]

@Fattywatty
Im going to be blunt here - you need to stop looking at "lovely" homes and start thinking about the care that is provided.
It is very easy to be seduced by nice decor, beautiful facilities and lovely "hotel" like spaces. Your mum doesnt need any of this - what she needs is a homely atmosphere and good, well qualified, caring staff.

EMI homes can be a bit of a challenge to visit, because they dont generally look like the sort of places we would want to live in ourselves and it can be difficult to imagine our loved one fitting in. The home my mum lived in was shabby and needed decorating, but it was exactly what she needed and she was happy there. A good home will have people at all stages of the disease - right up to the end - so there will be people around who are much further advanced than your mum and you will find people snoozing in chairs, or maybe acting in a bizarre way. Do not be put off. This means that they will be able to cope with anything. You dont want to have to move your mum again.

The things to look for are - are there staff always to be seen, how do they interact with the residents, are residents left a long time in distress (you dont want this), is there a high staff turnover (you dont want this either), do they deal with things without fuss, do they provide activities and trips out for the residents who can cope with it, how will they deal with your mums behaviour, what cant they cope with?

 

[Fattywatty]

@Fattywatty
Im going to be blunt here - you need to stop looking at "lovely" homes and start thinking about the care that is provided.
It is very easy to be seduced by nice decor, beautiful facilities and lovely "hotel" like spaces. Your mum doesnt need any of this - what she needs is a homely atmosphere and good, well qualified, caring staff.

EMI homes can be a bit of a challenge to visit, because they dont generally look like the sort of places we would want to live in ourselves and it can be difficult to imagine our loved one fitting in. The home my mum lived in was shabby and needed decorating, but it was exactly what she needed and she was happy there. A good home will have people at all stages of the disease - right up to the end - so there will be people around who are much further advanced than your mum and you will find people snoozing in chairs, or maybe acting in a bizarre way. Do not be put off. This means that they will be able to cope with anything. You dont want to have to move your mum again.

The things to look for are - are there staff always to be seen, how do they interact with the residents, are residents left a long time in distress (you dont want this), is there a high staff turnover (you dont want this either), do they deal with things without fuss, do they provide activities and trips out for the residents who can cope with it, how will they deal with your mums behaviour, what cant they cope with?

Thanks for the advice Canary, but really I do understand all of this. Mums been through the mill but through no fault of mine or hers really, bit of background I feel I need to explain myself

Her first home was quite small and shabby and that’s what initially attracted me. I didn’t want a new massive rambling 100 bed place with bells and whistles. This one had a wide mix of residents and was EMI residential, the staff had all been there a good amount of years, I asked all the right questions and felt I had made a good choice. I was completely up front with them about her behaviour and was assured that they had seen and dealt with difficult behaviour and were confident they would be able to manage her. she settled in really well for a good 3 months or so before things started to go wrong and no one was more surprised than me at how calm she was. Then The mental health team she was under decided she no longer needed antipsychotic meds so weaned her off them but within a few weeks she was agitated beyond belief, worse than ever before and was disrupting the whole place. The fact it was so small backfired on us all. The mental health team were called back in and tried her back on the same meds to no avail and Point blank refused to try her on anything else. I was asked to find her somewhere else, the staff at the home tried really hard to help her settle but it seemed the damage had been done and there was no going back. I was told to find somewhere bigger, purpose built to hopefully give her a feeling of space which they hoped would help her settle. I was devastated as I had got to know the staff and mum had been seemingly happy and doing so well.

I chose the next home carefully, had recommendations from some people who I knew had used it and had been happy with it. It is big and modern purpose built but not particularly fancy, which would never sway my decision anyway it’s just I was advised by mental health and her previous home so find her somewhere like this. With hindsight it’s probably too big, the residents are quite demanding which leaves very little time for the kind of interaction with the staff which she benefited from at the other home. I didn’t have a huge amount of time to find her somewhere as she was so terribly agitated I had to move fast and most of the “nice” homes don’t want challenging behaviour and then you also have the added problem of finding a bed free. The problem seems to be you can look and look ask as many questions as you like, talk to as many people you can, but you never really know a place until you’re in the thick of it by which time it’s too late. This place makes all the right noises, activities, trips out blah blah but in reality it’s a sham. I really don’t know how I couldn’t see it and don’t get me wrong it’s not bad all the time, it’s just the picture that is now building isnt a pretty one. I don’t want to uproot her but don’t know what else I can do. I’ll keep looking and try my best to find her forever home, it’s out there somewhere x

 

[canary]

Thank you for your explanation @Fattywatty . Its just that in your original post you described both her previous home and the one that you were looking at as "lovely" and then you said that you had been told to look at EMI homes, which I interpreted as meaning that the ones up till now were not. Im also concerned that you are still talking about having looked at "nice" homes, even though they wont accept challenging behaviour.

It is a sad fact that many care homes claim to specialise in dementia care, but when faced with normal dementia behaviour like being up at night, resisting personal care, difficulties in communicating etc etc they havent a clue. This is doubly true if it is a mixture of both dementia and non-dementia residents. You are right that they will promise the earth and then not deliver, which is why its a good idea to observe what the residents are like (if there is no-one with challenging behaviour or advanced dementia, then probably once they get to a certain stage they will be moved on), look to see how the staff deal with difficult behaviour and ask what they would not accept. Perhaps its time to look at not so "nice" places.

Im sure you will find the right place
xx

 

[CandyCrushed]

"The problem seems to be you can look and look ask as many questions as you like, talk to as many people you can, but you never really know a place until you’re in the thick of it by which time it’s too late"

That is so very true FW.
not only that, but the inevitable evolving and deteriorating aspect of the PWD means a constantly moving goalpost.

I do empathise so very much.
I feel completely out of my depth.

Thinking of you and

Candy x

 

[Fattywatty]

"The problem seems to be you can look and look ask as many questions as you like, talk to as many people you can, but you never really know a place until you’re in the thick of it by which time it’s too late"

That is so very true FW.
not only that, but the inevitable evolving and deteriorating aspect of the PWD means a constantly moving goalpost.

I do empathise so very much.
I feel completely out of my depth.

Thinking of you and

Candy x

Thanks candyCrushed, the feeling of being out of our depth is unfortunately a recurring theme in all of this. Sorry only just replying but I’ve had a very trying week.

Following the original fall mum had (which I wasn’t informed about and she wasn’t checked about) her mobility has worsened to the point she can hardly stand unaided. Turns out Saturday morning she was found on the floor, scooped up dusted down no apparent new injuries. I wasn’t informed again until I visited in the evening and by the time the night staff arrived her pain levels were out of control again. Thank god the night nurse had some compassion and decided to call out of hours doctor. She was grilled as to why mum had not been checked by a doctor as the fall had happened at 9am. She decided to call an ambulance, by which time mum had settled down somewhat, however the paramedics quite rightly pointed out that she could well have sustained more injuries and without an X-ray no one could say for sure. They also weren’t happy that they had only just been called, by now 12 hours after the fall. Off we went A&E where she was X-rayed again and even though there were no signs of any new breaks they have admitted her.

She is on an orthopaedic ward, her pain is being managed properly and she has been assessed by the physiotherapist, more action in less than 24 hours than the home have done in over a month.

I can’t tell you all what a relief it is to see her in a hospital bed with caring professionals. She has slept a lot and her mood and behaviour have been brilliant, even hours in A&E didn’t phase her and the nurses on the ward can’t believe she has dementia. I’m sure her behaviour may change but for now she’s more settled than I’ve seen her months, I can only assume she must be able to appreciate that she is in hospital and feels safe and not anxious.

The nurses who dealt with her admission have completed a body map, there are so many bruises on her arms from where she has been “assisted” at the care home it’s quite horrifying to see.

I work at our local hospital so can keep a close watch on her, and am so proud to say I do. I have seen our service through different eyes this weekend, how we moan and groan about work and the NHS but there are not enough words to describe how grateful I am for her treatment so far. I have requested she not be sent back to her nursing home and the possibility of rehab in an NHS facility has been mentioned which should hopefully give me time to find her a new home. Finally feeling optimistic about her recovery and future care.
Thanks everyone xx

 

[Fattywatty]

Ps can’t believe the home only tried to call me at 7pm today to ask how mum is, I didn’t take the call...