Hello again. This is only my second post here but quite a lot has happened since my first and I wondered if anyone could offer any advice. My aunt has "severe" vascular dementia. She was admitted to a secure unit (EMI) care home last February after a spell in a psychiatric hospital under section. The care home had to re-admit her to the hospital due to her violent behaviour for assessment after about 5/6 months. She was returned to the care home but sadly in January this year they admitted they couldn't cope with her and she returned, yet again, to the hospital, again under section. Two weeks ago she was considered fit for discharge as they said she was no longer showing signs of aggression and her psychosis and paranoia "had gone". She entered another care home with a secure dementia unit last Tuesday. Today I had a call from the Manageress there to say that they, also, could no longer keep her there as she is a danger to herself and others. She is punching, biting, spitting, kicking etc..... so much for "no signs of aggression". They also didn't know she had been on one to one nursing at the hospital. I am attending a meeting there tomorrow with her social worker, manageress, nurse and hopefully the CPN. By chance today I spoke to the consultant who attended to her whilst she was in the hospital and he suggested another care home which is nearby as it "has wider corridors...." "so she will feel less closed in..." . I called the care home with the wide corridors ( ? ) and was told that if two EMI units couldn't cope with her then they couldn't either. I can only now wait and see what happens tomorrow. What happens if no care home will accept her? She is only 6 stone and 5ft. During all this my mum was also diagnosed with dementia. She is now in her 6th month in a care home but is now also showing signs of aggression. She gave another lady a black eye last week. Mum is 91. I know I'm not the only person on here who is at their wit's end but can anyone suggest any questions I can ask tomorrow. Many, many thanks for reading.
Second care home to say they can't cope.
- Thread starter davesmum
- Start date
Hello & So Sorry...........................
DavesMum too read your very sad
post my sympathy too you all in such a awful & distressing situation for you all & your Aunt I have heard & read of similar problems in the past How ever I sadly do not have any experience of this situation Sorry I am not able too offer any advice but I did not want too ignore you & also wanted too push your Thread up for you & hope another TP'er can help you soon
Wishing you all lots of love & strength in the days & weeks too come
Positive Vibes for the meeting & thinking of you
Love Grove x x
DavesMum too read your very sad
post my sympathy too you all in such a awful & distressing situation for you all & your Aunt I have heard & read of similar problems in the past How ever I sadly do not have any experience of this situation Sorry I am not able too offer any advice but I did not want too ignore you & also wanted too push your Thread up for you & hope another TP'er can help you soonWishing you all lots of love & strength in the days & weeks too come
Positive Vibes for the meeting & thinking of you
Love Grove x x
Your Aunt requires a bed in a nursing home with a challenging behaviour floor.
When you have the meeting just ask them what they intend to do to sort this out. There has to be somewhere that will care for your Aunt and the ball is in their court to solve the problem as to where your Aunt goes to receive the care she needs.
There are not too many challenging behaviour homes that are for challenging behaviour caused by dementia.
When you have the meeting just ask them what they intend to do to sort this out. There has to be somewhere that will care for your Aunt and the ball is in their court to solve the problem as to where your Aunt goes to receive the care she needs.
There are not too many challenging behaviour homes that are for challenging behaviour caused by dementia.
I would also request another appointment with the consultant and a check that there is not an underlying problem like pain or Urinary tract infections. Often it seems that this can be a part of the dementia but sometimes there is an outside trigger such as pain or the carers and some care homes are very good at bottoming that out and reducing the aggression whilst others really can't manage
I assume that your aunt qualified for full funding due to her aggression, and if so, there should be funds for 1:1 care in whatever home she is in. If this is put in place there is more chance of managing to stop the aggression before it starts. I think it very bad of the hospital not to have informed the care home that she needed 1:1 care.
A properly staffed EMI unit should be able to manage dementia patients - even those with challenging behaviour.
A properly staffed EMI unit should be able to manage dementia patients - even those with challenging behaviour.
Thank you for your kind words and suggestions. It's hard to believe that after all the recent hype and press coverage to raise awareness of dementia, I, her carer, named person and power of attorney, am sitting here totally confused and worried sick about what is happening to my aunt. No-one seems to want her. She can't be cared for at home, she can't be cared for by a care home (so far) and the hospital have told me they don't take long term patients. I feel extremely let down by the NHS, especially when it comes to Mental Health. They seem to be able to talk about it a great deal, but unable to answer questions or come up with practicable solutions especially when they are asked to deal with difficult situations. I've told them my aunt is not a parcel to be passed around. Many thanks again for taking time to help and comment. This is certainly one big learning curve.
Tigerlady. My aunt is self funding. She is currently paying £800 per week less £249 per week for Personal Nursing Care. No-one has mentioned if she is qualified for full funding due to aggression. Maybe something I should ask about? We are in Scotland, maybe different rulings?
In short it's for them to find the answer not you. When the state effectively stopped treating dementia in its many forms as an illness treated by the NHS and went down the "care in the community" or using private healthcare companies the Local Government Finance Act made the LA responsible for finding her care in a place that meets her needs and if she's under a section 3 to fully fund her care.
Personally I'd take a back seat and ask them what they're going to do and if you don't like it say so.
Sorry if that all sounds like I'm a bit hard faced, I'm not by nature, however, SS and the LA rarely get their collective fingers out until you get a bit intransigent.
I've spent the last 5 months visiting my wife on an NHS secure assessment unit and although many have come and gone in that time there is a core of people I can't see anyone taking, they're simply too aggressive and need constant one to one.
If that's what you aunt needs then the LA will have to find somewhere and fund it that's part of the quid pro quo for closing all the hospitals that used to do the job.
It's their job and their legal responsibility to do this so ask what their plan is.
K
Personally I'd take a back seat and ask them what they're going to do and if you don't like it say so.
Sorry if that all sounds like I'm a bit hard faced, I'm not by nature, however, SS and the LA rarely get their collective fingers out until you get a bit intransigent.
I've spent the last 5 months visiting my wife on an NHS secure assessment unit and although many have come and gone in that time there is a core of people I can't see anyone taking, they're simply too aggressive and need constant one to one.
If that's what you aunt needs then the LA will have to find somewhere and fund it that's part of the quid pro quo for closing all the hospitals that used to do the job.
It's their job and their legal responsibility to do this so ask what their plan is.
K
I don't know much about CHC funding but I believe it is the patient's right to insist on an assessment before discharge is considered. So don't let them give you the brush-off. There is a very helpful thread on here all about Continuing Health Care which you should definitely look at. You can find by doing a search.
Oh the radio yesterday CHC funding was referred to as the NHS's best-kept secret, so make sure they know you are aware of it.
Mh
Those traits of her MH condition will vary from time to time, for the most part this is about managing the MH condition now, plus in the longer term. For me from my experience a section ward is an inappropriate place to send a dementia patient, having seen this environment when a colleague attended.The cost itself may be three times the cost of a care home, the system is so overstretched MH patients with suitable diagnosis are finding it hard to secure a place.
As suggested, it it the Authority to find her appropriate care to her specific needs in consultation with you, write down your wishes so a suitable outcome can be initiated.
Take care, this is not easy you are doing a great job.
John.
Those traits of her MH condition will vary from time to time, for the most part this is about managing the MH condition now, plus in the longer term. For me from my experience a section ward is an inappropriate place to send a dementia patient, having seen this environment when a colleague attended.The cost itself may be three times the cost of a care home, the system is so overstretched MH patients with suitable diagnosis are finding it hard to secure a place.
As suggested, it it the Authority to find her appropriate care to her specific needs in consultation with you, write down your wishes so a suitable outcome can be initiated.
Take care, this is not easy you are doing a great job.
John.
Hi
My MiL received full CHC funding because of her aggression and being a massive falls risk. She was assessed to need 24 hour 1:1 nursing and that was funded until she lost her mobility and no longer a risk to herself.
CHC is there for severe cases so ask for an assessment and read up on what you have to do. Make sure it is carried out to the letter and be prepared to fight your corner.
My MiL received full CHC funding because of her aggression and being a massive falls risk. She was assessed to need 24 hour 1:1 nursing and that was funded until she lost her mobility and no longer a risk to herself.
CHC is there for severe cases so ask for an assessment and read up on what you have to do. Make sure it is carried out to the letter and be prepared to fight your corner.
This post appears to differwith what I said.
Hospital Based Complex Clinical Care in Scotland
NHS continuing healthcare in Scotland was replaced on June 1 2015 by a scheme called Hospital Based Complex Clinical Care. This scheme is only available to people in hospital.
If you need long-term complex clinical care, your needs will be assessed based on one question asking whether your care needs can be properly met in a setting other than hospital.
If it is possible to provide care outside hospital, you will receive it in the place that’s best for you. This could be your home, a care home or supported accommodation.
If you already getting NHS continuing healthcare under the old scheme, you will continue to receive it for as long as you are eligible.
Find out more about Hospital Based Complex Clinical Care and how to get other care services in Scotland on the careinfoscotland website.
You can also read more about the changes and what to do if you don’t agree with a care assessment in the Age UK fact sheet Hospital Based Clinical Care and NHS Continuing care in Scotland.
Hospital Based Complex Clinical Care in Scotland
NHS continuing healthcare in Scotland was replaced on June 1 2015 by a scheme called Hospital Based Complex Clinical Care. This scheme is only available to people in hospital.
If you need long-term complex clinical care, your needs will be assessed based on one question asking whether your care needs can be properly met in a setting other than hospital.
If it is possible to provide care outside hospital, you will receive it in the place that’s best for you. This could be your home, a care home or supported accommodation.
If you already getting NHS continuing healthcare under the old scheme, you will continue to receive it for as long as you are eligible.
Find out more about Hospital Based Complex Clinical Care and how to get other care services in Scotland on the careinfoscotland website.
You can also read more about the changes and what to do if you don’t agree with a care assessment in the Age UK fact sheet Hospital Based Clinical Care and NHS Continuing care in Scotland.
The meeting went ok although at times I felt we were talking about something no one wanted or knew what to do with.... :-( The CH can't keep my aunt there as she is posing too much of a risk to herself and others. I can understand that they have to consider the safety of their other residents and also my aunt could be hurt if another resident reacted to her aggression. I got the impression though, that admitting her to hospital again wasn't a welcome suggestion. I had to ask twice "so what happens now?". There were a few long silences. I even asked if my aunt was to be put out onto the streets. It lasted around an hour. I just don't think they know how to deal with this situation. It was said that my aunt was an exception. It's very unusual for this to happen. I think the final decision was that the CH would officially start the ball rolling to have her removed from their care and she will likely be re-admitted to the hospital. I feel heart sorry for her. They said she is in the final stages and it's very upsetting to think of her ending her days like this. I feel she is just a problem to them. Very sad day.
My aunt is now on her way to the hospital. I only found this out in the last 30 mins. Some people have sent me very helpful private messages but apparently I cannot send a pm in reply until I have a post count of ten. Thank you very much for taking the time to send these messages, very informative, and thank you all for listening. I'll post again when I know what is happening.
