What to do when CH say they can't meet needs any more?

[Bugsbunny4]

Hello everyone,
It's been a while since I posted anything but I do read the comments posted.
I did post a comment about 5/6 weeks ago saying my husband had been the centre of a safeguarding issue. There were more concerns largely around him going into other people's rooms at night. I think he is searching for me.
As the weeks have past there have been reports of increasingly aggressive behaviour but the CPN having looked at all the documentation has concluded that most issues stem from incidents on the night shift when the staff have approached him insensitively and he has reacted. Sometimes the mood he has been left in has impacted on the day staff. Now the situation is such that some staff say they can cope and others can't. The management have suggested a move to another home which has nursing needs.
The CPN will have to go through the process of assessment but is sure he won't trigger a full assessment.
I have asked my husband if he would like to try a different place to stay ( he can still understand that) and he says not because he knows people there.
My sons are saying that we don't want Dad in a place where he isn't wanted but some of the staff love him to bits.
There is going to be a meeting involving people from all sides to discuss the best way forward.
My husband has been on a new medication to help with the behaviour but this is making him very drowsy and his appetite is poor.
The CPN has said that the behaviour problems my husband has are nothing compared to what happens in some care homes.
I really don't want to move him but will be happy to hear what other people think.

 

[Kjn]

What sort of care home is he in ? Is it a dementia emi or residential ?

My dad is like that in the evening where he is (hospital awaiting a place in a residential emi) , he sundowns , doesn't know where he is going , gets cross, shouts, wanders in others rooms. The staff all now know how to handle him, just to take his hand calmly and lead him back to his room. These staff arnt trained but have learnt with dad and family.
Dad needs emi due to these evenings, we have met with managers and explained fully dads position , SS also have an assessment for their information also.
Some of the homes did accept dementia but always want to know about any aggression and wandering as not all are as secure (emi).

I hope you can get something sorted soon X

 

[canary]

If the staff are already having trouble looking after him it is only going to get worse.
I know it is horrible to have to contemplate a move and, lets face it, your husband is unlikely to understand why it might be necessary. If it has got as far as a safeguarding issue, then I think that really you need to start looking for another residential home.

When you go round and look at places it is always worth asking what sort of behaviour they would not be able to deal with. Mum is in a dedicated dementia home and wandering at night, going into other peoples rooms, some aggression (mum even hit one of the staff once ) are all tolerated.

 

[love.dad.but..]

Although the phase is lessening as his illness progresses Dad goes into people's rooms and sometimes can be very difficult to budge daytime and during the night as he is a walker! There are other residents who also do this it is common with dementia. The staff know him well and use strategies that usually work well or back off for 5 minutes if he resists and is verbal then approach again or divert him before he gets into a room if seen...he doesn't see a room as someone else's just an empty bed in 'his home' to lay down on or a toilet to use if he gets the signal which is lessening. The staff have expertise in specialist dementia home but it sounds as though that isn't the case at your husbands home unfortunately. I think the cpn has probably hit the nail on the head and their handling of your husband during nights atm or if his reactions become worse are unlikely to improve so whilst you don't want to do this a move may be in your OH best long term interests in helping him.

 

[tigerlady]

I think if some staff love your husband and can manage him, and others can't, then the ones that can't should have more training. There are strategies to deal with dementia sufferers without upsetting them. Maybe a nursing home is being suggested as there are more staff there, and usually better trained in coping with dementia sufferers, but if your husband is settled there and in general you are happy with the home, it might be unsettling to move him.

I think more homes should be like the one my husband is in as wandering into other peoples rooms is something that a lot of people with dementia do. His home have locks on the bedroom doors which automatically lock when they are closed, but the people inside the room can open the door - it just can't be opened from the outside without a key. It does restrict the person from just going into their room when they want, but staff are always available to let them in, and it is no problem for relatives to get a key from staff while they are visiting but for security they have to return it when finished with it. When I visit, if I am going to be in and out of his room a lot, there is a little catch that I can put up so I can get in without a key. I think in the future, if there is the technology, bedroom doors should be accessible without a key by the resident with eye identification or fingerprint as it would give them more independence to go in and out of their rooms.

His home has quite a few wanderers, but they soon learn that they cant get into the other bedrooms, and stop trying the doors eventually

Apart from that the home is very open to wanderers the corridors go round in a block linking the bedroom areas, dining room and lounges, and there is free access to the courtyard gardens.

 

[love.dad.but..]

Good points Tigerlady but in dads emi nursing home probably more than half the residents on dads floor are bed ridden so their doors are open so staff when passing can see them and importantly they can see people and activity going past during the day otherwise I would imagine for some in bed but with some awareness it could be very isolating with the door shut. Dad if he can't open a door will still carry on wiggling the handle for some time before moving onto another door and handle! I don't think he has capability to learn he can't get in just that he gives up on that one and tries another.At night doors are closed but regular checks made. Even in a good emi home it is probably from time to time the case that some staff handle some residents more effectively than others experienced staff leave new staff have to get used to each resident and learn to apply different strategies. A home is very lucky if they can honestly day all their staff have the same high level of expertise and understanding all the time. I looked at many 'dementia' homes where it was clear they saw dads common dementia wandering and resistance to personal care as challenging behaviour which was disappointing as he isn't aggressive but in hindsight I am pleased that he was turned down in 2 cases. It is obvious to me now they would not have had the experience to deal with his stages over the last 2 years in care. Perhaps more that as he wasn't passive he would need more attention from staff than they were willing or able to provide.

 

[Bugsbunny4]

What sort of care home is he in ? Is it a dementia emi or residential ?

My dad is like that in the evening where he is (hospital awaiting a place in a residential emi) , he sundowns , doesn't know where he is going , gets cross, shouts, wanders in others rooms. The staff all now know how to handle him, just to take his hand calmly and lead him back to his room. These staff arnt trained but have learnt with dad and family.
Dad needs emi due to these evenings, we have met with managers and explained fully dads position , SS also have an assessment for their information also.
Some of the homes did accept dementia but always want to know about any aggression and wandering as not all are as secure (emi).

I hope you can get something sorted soon X

My husband is in a residential dementia unit where he was assessed by the manager and accepted. His behaviour on arrival there in November last year was like a baptism of fire for them, you name it he did it, but then settled down and is very happy there. He just wants me there with him all the time.
The safeguarding issue wasn't upheld as a matter of fact.
I will go to see other care homes but I really believe he is ok there for the present time.

X

 

[Bugsbunny4]

I think if some staff love your husband and can manage him, and others can't, then the ones that can't should have more training. There are strategies to deal with dementia sufferers without upsetting them. Maybe a nursing home is being suggested as there are more staff there, and usually better trained in coping with dementia sufferers, but if your husband is settled there and in general you are happy with the home, it might be unsettling to move him.

I think more homes should be like the one my husband is in as wandering into other peoples rooms is something that a lot of people with dementia do. His home have locks on the bedroom doors which automatically lock when they are closed, but the people inside the room can open the door - it just can't be opened from the outside without a key. It does restrict the person from just going into their room when they want, but staff are always available to let them in, and it is no problem for relatives to get a key from staff while they are visiting but for security they have to return it when finished with it. When I visit, if I am going to be in and out of his room a lot, there is a little catch that I can put up so I can get in without a key. I think in the future, if there is the technology, bedroom doors should be accessible without a key by the resident with eye identification or fingerprint as it would give them more independence to go in and out of their rooms.

His home has quite a few wanderers, but they soon learn that they cant get into the other bedrooms, and stop trying the doors eventually

Apart from that the home is very open to wanderers the corridors go round in a block linking the bedroom areas, dining room and lounges, and there is free access to the courtyard gardens.

Hi
I think the door locking system you describe is really good. They have actually started to lock doors during the day but this doesn't stop wandering at night of course. They put an infrared device in his room so they know when he is up and about but don't seem to have the forethought to place this under his chair when he falls asleep in the lounge.
I think training in dementia is key to how successful units are and I know what gat although some are specialist trained some are not.
I also think the number of staff on at night is too low. There are only two on a dementia unit of 21 residents and one senior who moves from floor to floor.
X

 

[jan.s]

Hi Bugs

I was in the same situation a couple of years ago. I had taken care when choosing a care home for my husband, but after a few months the placement fell apart; the manager blamed Roger for everything, which made him aggressive. The manager had assessed him and knew he was funded because of his aggression. I know the manager lied about situations to make him look worse than he was. So ultimately he moved to another place, a nursing dementia unit. To be honest, it was the best move I ever made for him.

He settled down within a few days and looked less stressed. The new care home knew how to work with him and because he became more settled, he became less agitated. He was happy there and the staff loved him to bits because he was so gentle and polite. That was him, not the monster in the first care home.

I know how hard it is to accept that things aren't right, but if your husband's needs aren't being met, then he deserves to be somewhere that can manage him well, and keep him calm.

Roger wanted me with him all of the time at the first care home because he felt unsafe, and I used to spend most of my time there with him. After the move he was happy to stay on his own.

 

[Bugsbunny4]

Hi Bugs

I was in the same situation a couple of years ago. I had taken care when choosing a care home for my husband, but after a few months the placement fell apart; the manager blamed Roger for everything, which made him aggressive. The manager had assessed him and knew he was funded because of his aggression. I know the manager lied about situations to make him look worse than he was. So ultimately he moved to another place, a nursing dementia unit. To be honest, it was the best move I ever made for him.

He settled down within a few days and looked less stressed. The new care home knew how to work with him and because he became more settled, he became less agitated. He was happy there and the staff loved him to bits because he was so gentle and polite. That was him, not the monster in the first care home.

I know how hard it is to accept that things aren't right, but if your husband's needs aren't being met, then he deserves to be somewhere that can manage him well, and keep him calm.

Roger wanted me with him all of the time at the first care home because he felt unsafe, and I used to spend most of my time there with him. After the move he was happy to stay on his own.

Thanks for your reply,
I don't think my husband will trigger any of the criteria for nursing care but I will have to wait and see. I don't know of any good nursing homes around here so would have to look further away which isn't helpful really. I do agree with the points you have made though.
Thanks again x

 

[jan.s]

I'm glad my experience was helpful.

I admit, the first care home was just around the corner from here, but I moved him over 20 miles away. I did visit most days, but am so glad I did, otherwise now would be full of regrets.

I hope things work out well for you. x