New to home, does not want to stay

[Polish daughter]

My 75 year-old mother went into a home four weeks ago but does not want to stay. Of the few friends she has left - most have deserted her and she only has one vistor. Everyone agrees that she that she should be in a home for her own safety.
She is not aware of her strange (and sometimes dangerous) behaviour. The home is fantastic and caters for Polish people (one of the problems is that she has totally forgotten all of her English and goes about everyday life speaking in Polish).
She does not want to stay at the home (where her agitated state has improved due to the care and routines). There is nowhere else for her to go.
I have Power of Attorney, but for her safety (and of others) I feel that she needs to stay - what are my options? Do I need to consider getting her sectioned (I have enough examples of here behaviour to make a strong case if necessary) or is there another option? I am getting desparate as I feel that my emotional state is getting stretched. Any advice much appreciated. Thanks

 

[jenniferpa]

Hi Polish Daughter and welcome to Talking Point

I'm going to make a global statement - I doubt that anyone who has been placed in care home has not, at some time, stated that they're not going to stay. You only have to look through the many many threads on this subject on this forum to see that. Now it can be due to a number of reasons but there are two big ones 1) They feel there is nothing wrong with them or/and 2) they express the wish to go "home". I've put "home" in inverted commas because if it's possible to question them more closely you may well find that the "home" they wish to return to is not the one they were living it but one from 40 years ago, or their childhood. This wish is also expressed by people who are still living at home. As to the former - well the thing about dementia is that it robs people of their insight and sadly, they often cease to recognise that they are ill.

Your issue seems a little different though - you are asking what steps you should be taking? Has the home indicated that they won't/can't keep her? Is she leaving the home and putting herself in danger? I suppose my question is - why do you feel you have to do anything? This question is most often asked by people who have loved ones at home but know they need a safer place but you've got her there.

4 weeks is early days when it comes to settling. Assuming that the home is quite happy to keep her, and if what you're asking is how to deal with the constant questioning, you may want to adopt the approach others have - lie. You can go home when you're better, your home is being decorated and when that's done you can go home, you're paid through the end of the month. Whatever it takes that isn't hurtful is the general consensus.

She almost certainly will not accept that she needs to be there: - if you can't remember that there's anything wrong with you, or how old you are, why would you accept that you needed to be cared for?

I think this post is long enough now, although I'm sure there was something else I was going to say

 

[Skye]

Hi, Polish Daughter, welcome to TP.

Jennifer is absolutely right, almost everyone who goes into a care home is unhappy for a while, and does not undertand why they have to be there.

But you know why she has to be there, and I'm afraid you're just going to have to ride it out.

She will settle, in time, but this stage is very hard. Unless the home is putting pressure of you to move your mum, just keep visiting, and try to change the subject every time it comes up. Constantly arguing is just going to reinforce your mums feelings.

Good luck,

 

[Polish daughter]

Thanks for your responses - some clarification

Thanks for the fast replies - to clarify, my exact concern is that she is threatening to book a taxi home (over 200 miles) and / or insist that the home releases her because she does not want to be there. My understanding from the home is that she is no obligation to stay and despite my reassurances that she is there for medical supervision to make her better, that she can actually leave.

I know that her GP from home is completely aware of her condition and some of her strange and often dangerous behaviour and will agree that she is not safe at home.

I am really concerned as I cannot visit until this Thursday (and she keeps threatening to leave before then) and am the sole relative dealing with this situation - there are other distant Polish relatives who sadly may choose to get involved if promised money by her, although I am presently invoking Power of Attorney.

I really only want what is best for her and feel tortured by these events even though I know that what I am doing is right.

Is there a legal right for her to just walk out / can she simply walk out?

How can I keep her there against her irrational will?

Thank you.

 

[jenniferpa]

I'm assuming this is a regular or nursing home not an EMI (elderly mentally infirm) home? Does your mother have a social worker? (Sorry for all the questions). It's my feeling that as she is now a resident in that home in would be up to the home to take the first steps for sectioning if that was necessary. They do have a duty not just to inform you of her planned escape, but also to keep her safe, even if that means having her moved to an assessment facility. I assume much of the stress you are feeling is because all this is being relayed to you and there is little or nothing you can do about it? I can fully relate to that having been in in situation of having such things relayed to me by my mother's friends and me being an ocean away.

I think you have to tell the home in fairly firm terms that if she attempts to leave they should bear in mind that she is a danger to herself and others and should contact emergency social services. It is true that in theory they cannot physically stop her leaving, since that might be considered false imprisonment but there are a fair number of things they can do to make it difficult for her to go. Is she capable of making that phone call for a taxi? Would she know how to pay for it? Could she get herself out of the home?

It sounds to me that the home are covering their own backs at the expense of your peace of mind. I can understand that to a certain extent but I would want to toss the ball back firmly to them and ask them how they plan to handle it. Have they tried distraction techniques?

It may be that sectioning will be necessary, but simply threatening to get a taxi is probably not enough cause for that. My understanding is that she has to be in imminent danger for sectioning to be invoked.

 

[Nebiroth]

As Jennifer says - I'm fairly sure that the home would have no powers to keep your mother against her will because that would be construed as abuse.

However, surely they have an obligation to contact Social Services if they feel that one of their residents is putting themselves or others at risk should they leave? One would hope they would be able to persuade your mother to stay until a social worker could assess the situation.

It is also worth remembering that the police have emergency powers to remove someone to "a place of safety" if they are behaving in such a way "in a public place". This is only very temporary but would again give time for a social worker to be involved.

The home is informing you, but there's not really much you can do about it, is there? Power of Attorney is irrelevent as it doesn't grant you any powers that would be helpful here. It is possible for someone's "nearest relative" to apply for a sectioning, but it is always preferred to have a qualified social worker do it.

Sectioning is the last resort and is distressing to all converned.

As has been pointed out, this problem is very common with people in care with dementia, because they believe there is nothing wrong with them, may be delusional about their situation, and arent open to rationality.

I feel a lot of your distress is coming from the fact that whilst you're being kept informed, there's not much you can actually do about the situation.

 

[Skye]

If your mum is in an ordinary nursing home, is there any possibility of having her transferred to an EMI unit? I realise language might be a problem, but at least she would be secure. These units have keypad entry, and a higher staffing level. Otherwise, the care is very similar.

 

[Margaret W]

Dear Polish daughter, give it time for your mum to settle. I was advised 6 weeks but in fact it has taken mum a year. She has been there a year, and it is only now that I feel she regards the place as her home. She now knows all the residents, has made a couple of friends, it has taken so long to get to that stage. Fingers crossed for you, it is a terrible time.

Much love

Margaret

 

[Polish daughter]

Thanks for your responses - is this a normal reaction?

Thanks again for the wise words which provide comfort when I am feeling desparate and guilty about the situation.

The weird thing is that since my Mum has been in the home, her mental state has improved. The day she went in, she wavered from being in a catatonic state to then being loud, nasty and ranting. At home, she spent a lot of time in bed, in front of the tv, not eating regularly and not having visitors, and either not taking medication or taking too much due to forgetfulness.
In the home, the routine of getting up for breakfast, going to the on-site church, having regular meals and human contact and regulated medication seems to have improved her mental outlook (in that she seems less aggrssive and calmer) and made her think that she can cope on her own and hence she wants to go home.

When she lived at home, all the Alzheimers's symptoms / tendancies were so much worse and we all really felt that she was a danger to herself.

Is this a normal reaction when an Alzheimer's sufferer goes into the safe environment of a home?

 

[jenniferpa]

I don't know whether it can be categorized as "normal" since everyone seems to respond to this disease differently. I do think, though, that regular meals, medication and a routine are extremely important for people with dementia and when that's sorted out, an improvement isn't uncommon, at least for a while. I'm reasonably certain that if I wasn't eating or sleeping properly and didn't take my meds I would be less functional (perhaps considerably less functional) than I am and I don't have dementia nor am I particularly old.

 

[terry999]

Hi Polish daughter

You seem to be further down the road than me. My mum is not English and I've found her a home that I know well which speak her native tongue but more importantly know her culture.

Everything is set up for her there, but I'm waiting for an assesment from a Social Worker after I have this I will make my move. This is so I have an assesment showing she is at risk for a second choice home which has an EMI unit.

I would recommend getting a S.Worker to review her - and find a home with an EMI unit. Just to prepare for the worst - you have a backup plan.

I hope your mum and my mum both settle in these non-EMI places - as its important to be in a place where they understand you.

 

[fearful fiona]

Hello Polish daughter,

I do sympathise with you. This is something my Mum went through last year when she and my Dad first went into a care home (interestingly run by a Polish manager and staff). She even got as far as writing a cheque (not a valid one, she had a "useless" cheque book in her bag along with a few coins, to reassure her) and asked the staff to book a taxi. They just used delaying tactics (i.e. do have supper first, there's a long wait for taxis at the moment) and it all got forgotten.

Having said that she didn't settle and is now in an EMI home. She still wants to go home, I think with some people that never stops really. Like your Mum, my Mum did to a certain extent improve which meant that she couldn't see any reason not to be in her own home.

I hope your Mum manages to settle where she can speak her own language, this is so important.

 

[Dave W]

Odd what becomes 'normal'

Hello Polish daughter (I'm sure you have a much more attractive real name!)

yes, it's very normal for your Mum's symptoms to eem reduced now's she's in a home: my own Mum was exactly the same for the first few months. The routine, the care and support, and the stimulation of company all help immensely. (I spent several weeks persuading myself she did need to be there, so suddenly 'better' did she seem. I had to remind myself what her being in her own home had been like - carnage for everyone, basically.)

The focused intention to go home is al pretty much par for the course too, although the verbal intention might not bear much relation to reality. (I've been through this stage too, as have many of us here.)

Like others here, I'd be most concerned as to how easy it might be for her to 'escape' from the home: my Mum can't get out with getting past locked doors that only staff can open, so I don't have to worry. If she could just wander off, I'd be terrified (it happened when she was in the local general hospital last year, and the hospital staff got the b*ll*cking of the century from me for 'losing' a 78 year old woman with advanced dementia), so I'd say you have to talk to the home about that. To make you feel better - I hope - my Mum's home always take the line that she doesn't *have* to stay, but they will happily spent all afternoon talking her out of leaving if she tries. They are legally responsible for her welfare and safety after all, and I hope it would be a rare home that didn't take that very seriously.

Beyond that, the advice here is pretty good. She will - eventually - settle. It could be weeks, it could be months, but it will happen. Until then (once you're happy about security) you are going to have to get used to changing the subject and telling white lies - if that doesn't come naturally to you, it will be very difficult (it was for me), but bear in mind it serves to makes sure your Mum is less distressed and can stay somewhere that she needs to be.

As others have said, this is one of the hardest stages to go through - and I wish lots of luck.

Dave

 

[Polish daughter]

Thank you to all for the support , personal experiences and wise words

Thank you so much for sharing your experiences with me. I was a total mess when i posted my message due to the worry and responsility of this situation.
Everyone says that I am doing the right thing (including her GP, psychiatric nurse, her sister and my family and friends)but like most people in this situation I feel burdened with guilt and overwhelming grief particularly due to the fact that it is just me who has been left to sort it all out.
I am going to visit my mum tomorrow to discuss her care plan with the home. I am worried about how I will handle her wish to go home and the emotional and verbal abuse I will get.
All the postings I have received have really helped to prepare me and keep myself focused on doing what is the best thing for her.
With all my thanks.