My mother has been in the same residential home for 10 years. She is declining rapidly since a hospital admission of April 2016 following a fall, chest infection & eye infection. This year she has had 3 falls - one of which I wasn’t told about straight away. In June this year I was shocked to see that mum could barely walk and by the beginning of September she needed hoisting out of armchair and wheelchair for getting around. Although the ambulance was called out for one of her falls I cannot see a record of anything being down after her last fall. I was told that the Dr would be called out the next morning. I was worried that she had a cut to the back of her head and no one was called out that evening. The staff checked her over and said she was ok . Bearing in mind my mum cannot speak - how could they be sure she was ok! They are not nurses only caters. Should they have got the ambulance out again as it was the second fall in 4 days!.? Anyone experienced this?
Ambulance call out?
- Thread starter ZuluFoxtrot
- Start date
Hello ZuluFoxtrot and welcome to Talking Point.
It sounds like you have been happy with your mum's care up to this point. Would you be able to talk to the staff about your concerns? I would talk to them about your expectations should another fall occur, so that you know what the procedure would be. Let them know that you would like to be informed if she has any injuries/falls.
In my experience it wasn't in my mum's best interests to be taken to hospital - A&E is not a good place for people with dementia if there's no-one there to advocate for them. The last time my mum was taken to hospital she was left in a wet pad - the carers felt she was left overnight - they didn't do anything for her and just sent her back to the care home the next day.
The care home manager and I then discussed and agreed that she would only go to hospital if she was in unmanageable pain or had broken a bone. She had a few seizures after that which were managed at the home.
It may be that your mum's care home have had similar experiences and felt that a hospital visit may not be helpful.
It sounds like you have been happy with your mum's care up to this point. Would you be able to talk to the staff about your concerns? I would talk to them about your expectations should another fall occur, so that you know what the procedure would be. Let them know that you would like to be informed if she has any injuries/falls.
In my experience it wasn't in my mum's best interests to be taken to hospital - A&E is not a good place for people with dementia if there's no-one there to advocate for them. The last time my mum was taken to hospital she was left in a wet pad - the carers felt she was left overnight - they didn't do anything for her and just sent her back to the care home the next day.
The care home manager and I then discussed and agreed that she would only go to hospital if she was in unmanageable pain or had broken a bone. She had a few seizures after that which were managed at the home.
It may be that your mum's care home have had similar experiences and felt that a hospital visit may not be helpful.
I am inclined to agree with Soobee. Generally, hospitals are to be avoided if at all costs for people with dementia, as the upheaval of ambulance, paramedics, transfers, waiting for hours, staff who are often not trained in dealing with people with dementia, all of this takes a huge toll on the person, particularly if a family member isn't available to stay with them.
Dad had quite a few falls during his last year of life in his nursing home. Nothing ever broken fortunately but as he didn't break his fall with his hands, his face or head always bore the brunt. Dad was very medical frightened so a and e was only if absolutely necessary ie stitches...there was no joy in holding my dad down even after sedation so necessary treatment could be given, upsetting obviously for him and me. I was lucky in that as he was in a NH, nurses did his obs and if he didn't have an injury that required ambulance they monitored him, applied dressings which he wouldn't keep on, kept an eye on any bumps then the Dr was asked to come and see him in the morning. I was always phoned whether he was injured or not as standard policy for all residents. He had 4 necessary ambulance trips but generally I trusted the nurses to make the correct assessment. Some of the carers must be first aid trained, I would chat with manager to agree the way forward to put your mind at ease, a and e for dementia sufferer and carer or family is not pleasant and to be avoided if at all possible if patching up and monitoring can be done at the home but I would certainly expect to be told asap and if there are concerns with a head injury the GP to assess.
Another one agreeing that any visits to hospital can be counter-productive for PWD unless absolutely necessary. My mother has several hospital visits in her first couple of years in the Nh and then emergency call-outs, when we decided that hospital visits weren't necessary. On one occasion the ambulance crew said they were happy to leave her at the Home and come out again if her condition deteriorated in some way. they were we'll aware that waiting times even at A & E were long and not necessarily the best place. In each case though we had the discussion and for the past 3 years Dr and I and the Home agreed that hospital was only a last resort, in the case of a broken bone for example, otherwise the Nursing Home could cope and she had her 'just-in-case' meds prescribed for use in an emergency.
Thank you for replying. I was happier up til about 2 years ago when she had a few falls and ended up in hospital. I agree not nice for her to be taken in but as this is not a nursing home and only a residential home,I would be happier if the paramedics came out to check her over. Also 2falls in four days with knocks to head is my concern as she cannot speak.
I have spoken to the manager but I feel she down plays it and they are not putting some things into place which could make her more comfortable when sitting in armchair or at the table.
HelloZuluFoxtrot, I agree with SooBee my Mum was just taken into hospital from a CH where they performed an angioplasty which did not work. I believe her foot (which has staph infection) is worse than before. She is much worse now than before and I feel her dementia has really taken hold now. Upsetting for all of us, she was fairly chatty before and even making sense but she is less chatty now. And full of painkillers which may always have been the case for anyone who has had a fall or injury . Of course the painkillers have an effect and it's sad to imagine your loved one being given a lot of drugs. Like you, I feel pretty devastated - it's just tough all round. I wish these things would stop happening but i suppose they are all part of the disease and how dementia eventually .... it makes me sad. 
Mum has been taken to A&E several times following falls, each occasion was an awful experience for mum and us. No active treatment was offered and she was eventually returned to her care home. On one of her visits following a fall where she had hit her head the Dr said that they wouldn't do a CT scan because if there was injury to her brain they wouldn't do anything about it anyway. Personally I would, and have, do anything to keep her home where she is most comfortable.
Hi Quizbunny, okay this is interesting - I must pass this on to my Dad and make sure she doesn't go to hospital again, I've no idea why they decided to go ahead and do a procedure on Mum last week, perhaps inexperience ? I can understand why the nurse at the home thought of sending her to hospital but we need to try and stop that from happening another time. Thanks
It is difficult with care homes as they have their policy's and guidelines to follow and usually have to call for an ambulance. We do usually manage to speak to the paramedic over the phone and at least try to reinforce the benefits of keeping her away from hospital if at all possible. My mums falls have,thus far, not resulted in fractures or anything else beyond bruises, obviously if she did break something that would be different.
Basically I suppose every incident needs to be looked at and the risks assessed, but overall I would want mum home if at all possible.
Hi, Agree with the not going to hospital unless necessary. My wife had symptoms of another stroke which turned out to be aTIA when admitted to hospital .Apart from normal tests for BP etc there was'nt anything done & left her confused as she has Vascula Dementia.She is in a hospital bed at home.It is the stuck on a trolley in the corridor for hours in hospital that is so frustrating.
