Fuming is not the word!!!!

[1953barney]

Found out from my mum who has alzhiemers that she fell on the floor when she got out of bed to use the commode and couldn't get back up so she spent ages getting herself out of her bedroom and into the hallway. Mum has careline and a buzzer round her neck but didn't want to cause bother. Plus I think she actually didn't remember. Her morning carer came at 7.45am and found her on the floor in the hall, asked her if she needed an ambulance which mum declined and then I assume she has got her up off the floor! I didn't think they were supposed to do that. She never made a call to me! I read the carers notes when I got here after lunchtime in which she has put that mum kept saying she had been on the floor all night and wanted to go back to bed. She took mum into the living room, gave her her morning tablets and cereal and a cup of tea, then asked if she was going to get washed and dressed to which mum refused and said she wanted to lay down. She took her back to the bedroom and put her back into bed. Then it says she rang her office to inform them. Then she left. I'm I wrong I thinking I should have been informed and an ambulance should have been called? Mum has two carers from a different company during the night and on looking at their records the last one called at 5.30am and mum was fast asleep in bed then. So she obviously hasn't been on the floor all night. I have done quite a lot of complaining to her daytime cares office since they started so just wondered what anyone thinks about this.

 

[Izzy]

I would have thought that she should have been checked for concussion.

 

[Shedrech]

Dad's carers have called me, in the past on several occasions, to say he's refusing meds and such just so I know - and I'm grateful for the information because then I can choose what happens next.
So I'm sure they would call me if dad had been found in your mum's situation - I would be more than disappointed if they didn't.
At the least make it clear to your service provider that you expect to be called immediately in future in any circumstances which are out of the ordinary. It should be up to you to decide how any situation should be dealt with, not the visiting carer. Surely she and the provider would not want to be held responsible should anything happen to your mum as a result of being left in such a position.
I'd be fuming too and seriously considering a change of agency and a report to the SW etc.

 

[Emily M]

I have just this minute posted a new thread titled: Carers with poor English - External agencies. I was concerned that when I spoke to my Mum's Carer today that she couldn't understand English very well.

In your mother's case I would have thought that if she had a fall she should have been checked for injuries. You have to wonder about the training of the Carers that are provided by these agencies.

 

[lexy]

deleted

 

[opaline]

I don't think the carer should have called you but she did alert her office and they should have certainly alerted you immediately! My mum has a fall alert buzzer on her wrist (neck ones are also available) which goes off automatically if she falls and alerts MECS and they come to assist then decide if an ambulance is required. These alarms are available through your local social services/council. Hope this helps, x

 

[1953barney]

Hi thank you for all your replies I will be ringing the carers office first thing in the morning. Mum has had quite a lot of falls since last September and the Independent living carers she had in the beginning always called an ambulance and never attempted to get her up off the floor. It is true that there are many carers now who struggle to speak English as mum has had a few from this Agency. I shall also be ringing mum's Keyworker at Social Services again on Monday, I have spoken to her before about some other problems we have had with these carers.

 

[FozzyC]

My default position is call paramedics, my mom falls regularly, in the last two years she has broken her pelvis, leg and rib in separate falls. Dad used to get her up, or cover her and leave her where she was because she would shout at him if he said he should call someone (he has dementia, not mom), this would put him in a difficult position. If she had fallen downstairs and he wanted eventually to go to bed he would then ring us. This resulted in many late night call outs. I call 999 before even leaving the house and they are usually there before we are.

Dad is very upset by these falls and by the responsibility of dealing with the situation, Social Services have now put a carer in place to see mom to bed each night as that is mostly the time she falls, this was prompted by a fall in which mom only received bruising but a couple of days later it turned out dad had damaged his thumb because he had fallen trying to catch her. The phrase 'two vulnerable adults' seemed to get things moving, the nurse who saw dad in A and E got the ball rolling and the SW was very good to be honest, apart from being a bit slow on the paperwork side of things probably due to workload I've found her very sensible and supportive. People tend to regard involving the various services as a last resort but we have been dealing with a situation we just couldn't have carried on with alone.

The carer visits have reduced the falls dramatically, but not totally. When they found mom on the floor before Christmas they called the paramedic, then their office, the office called me later to say she had fallen, had been checked by paramedic who had seen mom into bed and that she was fine now, not to worry. I'm sure if the paramedic was concerned we would have been asked if we wanted to attend immediately.

They just don't 'bounce' too well as they get older, mom is worried that if they call for help she will go to hospital and then not be allowed home after. As a result she puts pressure on dad to get her up, or hide the fall from anyone. Dad gets so upset trying to do the right thing but he is now calling for help far sooner bless him. Mom has a pendant and a falls alarm, but having it and wearing it are two different things! It went off once in the night and dad was frightened by the box 'talking' to ask if they were ok so now mom says she doesn't want to wear it. The Physio has persuaded her that she wear the wrist strap in the day when she gets up until bedtime, and the pendant now hangs off her walker so if she makes a trip to the loo in the night the pendant should be hanging off the walker at a height she can reach from the floor. It's a compromise, but better than them both being thrown on the bedside table.

I'd ask the Agency what their protocol is for dealing with falls.

I'm desperately trying to persuade them that a move to extra care housing is needed, because I need the reassurance that there is someone there 24/7 to support dad if he's put in the position of responsibility for mom after a fall, he can raise the alarm (cord in every room) to the team on site and they can then take the decisions out of his hands about what to do next. I also hope the smaller floor plan and single floor layout will help, otherwise I can see mom going into hospital then a home and dad being left alone until his dementia puts him in a home too. It's inevitable I guess that they will be separated but I'm trying to keep this at bay as long as I can.

 

[1953barney]

My default position is call paramedics, my mom falls regularly, in the last two years she has broken her pelvis, leg and rib in separate falls. Dad used to get her up, or cover her and leave her where she was because she would shout at him if he said he should call someone (he has dementia, not mom), this would put him in a difficult position. If she had fallen downstairs and he wanted eventually to go to bed he would then ring us. This resulted in many late night call outs. I call 999 before even leaving the house and they are usually there before we are.

Dad is very upset by these falls and by the responsibility of dealing with the situation, Social Services have now put a carer in place to see mom to bed each night as that is mostly the time she falls, this was prompted by a fall in which mom only received bruising but a couple of days later it turned out dad had damaged his thumb because he had fallen trying to catch her. The phrase 'two vulnerable adults' seemed to get things moving, the nurse who saw dad in A and E got the ball rolling and the SW was very good to be honest, apart from being a bit slow on the paperwork side of things probably due to workload I've found her very sensible and supportive. People tend to regard involving the various services as a last resort but we have been dealing with a situation we just couldn't have carried on with alone.

The carer visits have reduced the falls dramatically, but not totally. When they found mom on the floor before Christmas they called the paramedic, then their office, the office called me later to say she had fallen, had been checked by paramedic who had seen mom into bed and that she was fine now, not to worry. I'm sure if the paramedic was concerned we would have been asked if we wanted to attend immediately.

They just don't 'bounce' too well as they get older, mom is worried that if they call for help she will go to hospital and then not be allowed home after. As a result she puts pressure on dad to get her up, or hide the fall from anyone. Dad gets so upset trying to do the right thing but he is now calling for help far sooner bless him. Mom has a pendant and a falls alarm, but having it and wearing it are two different things! It went off once in the night and dad was frightened by the box 'talking' to ask if they were ok so now mom says she doesn't want to wear it. The Physio has persuaded her that she wear the wrist strap in the day when she gets up until bedtime, and the pendant now hangs off her walker so if she makes a trip to the loo in the night the pendant should be hanging off the walker at a height she can reach from the floor. It's a compromise, but better than them both being thrown on the bedside table.

I'd ask the Agency what their protocol is for dealing with falls.

I'm desperately trying to persuade them that a move to extra care housing is needed, because I need the reassurance that there is someone there 24/7 to support dad if he's put in the position of responsibility for mom after a fall, he can raise the alarm (cord in every room) to the team on site and they can then take the decisions out of his hands about what to do next. I also hope the smaller floor plan and single floor layout will help, otherwise I can see mom going into hospital then a home and dad being left alone until his dementia puts him in a home too. It's inevitable I guess that they will be separated but I'm trying to keep this at bay as long as I can.

Hi FozzyC. Mum had quite a lot of falls during September-November last year. Mum was in hospital overnight at the beginning of September as she wasn't drinking/eating properly and she had to be put on two drip and also be given medication for another UTI, caused obviously by her not drinking. When she came out the next day to my relief (I had been looking after mum morning to night every day, whilst trying to make GP etc understand that her memory was getting drastically worse) she had carers from the Independent Living Team who come in and help for usually six weeks when they come out of to try and get people back on their feet again. There problem was that they weren't aware just how bad mums memory was. They were ticking things off a chart when she had done them (but they didn't realise that she probably wouldn't do them the next day). They only came morning and lunch time but it gave me back a little time before I had to be at mums usually around 1pm. Mum did most of her falling during the evening when I had left or during the night when she needed the toilet. She was found on the floor by the morning carer twice and each time the carer rang the ambulance and also rang me and said mum was on the floor and an ambulance has been called. Fortunately mum only sustained bruising and scratches and never needed transporting to hospital. The other falls were during the evening as she was trying to turn of tv etc and one she had at 4am, she had pressed her buzzer and I was rung by the call centre, the emergency warden had been sent to mums and also an ambulance called. When I got there everyone else had arrived and mum was being attended to, still in the floor, the warden said he had already been out and helped mum off the floor once that night. I went through to the bedroom to get the bed ready for them to out her back in, only to find the bed had not been slept in at all! Mum didn't kniwnwhy she hadn't been to bed and that does remain a mystery to this day!

The carers she has now attend morning to help her to get out of bed, washed, dressed, medication prompting and ensuring she takes them and then breakfast. Lunchtime carer does her lunch and then I am there from 1pm to 6/7pm everyday. A carer comes around 8pm to help her undress, give medication and put into bed, turn all lights, heating and tv off (as mum doesn't know how to do any of that anymore) then they leave. She has two carers from a different agency who come in during the night one around 12.30am and another ariund 5.30am. The recent fall is the first one she has had for quite a long time, but I was so surprised and very angry to find she had been in the floor, picked up by the carer and asked if she wanted an ambulance, mum would never have an ambulance as she fears going back into hospital. I have arranged to speak with someone tomorrow from the carers office and I am also contacting mum's Keyworker who arranged these carers. I have had quite a few issues with them over the time they have been looking after mum, plus another one today as when I arrived at mums at 1pm it was freezing cold as no central heating had been put on by the carer who came at 9am this morning, nor had the carer at lunch time checked to see if it was on!! Nothing seems to run smoothly and I will continue my note writing until I feel they are looking after my mum correctly x

 

[FozzyC]

Hi 1953barney, I do hope you make some progress with the carer agency. I understand that Carers are often told they need to listen to the person they care for, but safeguarding overrides that, and I'd expect them to call for an ambulance rather than ask your mum what she wants tbh? It's hard enough work dealing with our situations and caring for our loved ones, it's a shame it has to be made more of a battle by those who are there to help.

Is it in the care plan to check heating, you would think it would be something they do instinctively however, I think it used to be called Common Sense? There's no excuse but I guess they might say if they are rushing in and out they might not notice how chilly it is, but for your mum sitting there she's going to get cold really quickly. Maybe you could adjust the timer or thermostat so the temperature doesn't fall below a set level. When our boiler was changed recently we had a timer/stat you control from a phone app, so I can see what temperature is now and adjust remotely. It's quite handy especially if we have a cold snap and I want to make sure the house is warm when we get in. My mom and dad's is always like the tropics, honestly it's a wonder any of us can get anything physical done there without stripping off first! Mom and dad don't really understand their new stat but they've told me what times they want it to be on, which is basically all the time except a few hours overnight and when it's too chilly to turn it up. The heating bill there is scary!

If the Carers don't seem to be working out is there a different agency you can move to? It shouldn't be necessary, but if despite your bringing things to their attention it still seems that problems occur then it could be down to the quality of their recruitment, staff training, policies and procedures?

These regular falls are worrying and hard to avoid, we've had referrals to all sorts of specialists to find out what's going on with moms health. I suspect biggest culprit is not eating and drinking properly however. In moms case it seems that tests show she has minimal sensation in her feet and lower legs so her brain doesn't know where her feet are on the floor (if that makes sense) so she can easily trip or topple. I can only imagine it must feel a bit like walking on a bouncy castle? We see the neurologist in February so we will see what he concludes.

Hope you get some results when you speak to the care company! Xx