Struggling with dad's move to new care home

[looviloo]

I need to write this down... my emotions are overwhelming me right now and although my OH is supportive I feel that no-one really understands what I'm going through.

Dad (90) moved care homes yesterday, which I've posted about on a different thread. It's been a difficult few months. I picked what I felt was the best dementia home for him, visiting it several times beforehand. My problem possibly stems from how different dementia homes in general are from the residential home he's lived in for past 3.5 years. I know it's very early days, but I feel bereft. And guilty. And angry at the whole horrible situation.

My concerns, having spent a few hours with dad on his arrival at the new home:
- one of the orderlies (referred to as such by the carer in charge) tried to offer dad a jelly baby. Dad's a choking risk and on a soft food diet. Of course I intervened.
- there seemed to be fewer staff than I'd been led to believe. Another visitor told me his mum has been there two years and they are always short of staff (he mentioned this without prompting).
- dad has very limited mobility, but can just about shuffle around with a frame, which he relies on. He is a falls risk. Unlike his previous home, the policy of the new one is to remove frames once the person is seated. Is this usual? I only saw two frames (tucked away) and no obvious hoists, but at least a dozen residents sat in the main lounge.
- dad cannot speak. He became agitated (no frame in front of him, possibly needed the toilet or just reassurance) and wanted to get up. I watched, because the carer sat next to him ignored him completely and stared into space. Didn't say a word to dad, or any of the other residents needing help. I couldn't bare it any longer, and it turned out dad just wanted to move seats (he was happy after that).
- only one carer interacted with dad or showed any care towards him. But he was also quite physical in his treatment of dad, something I'm not used to. Maybe it's needed? For instance, dad is capable of sitting on a chair but needs a lot of guidance and support. Instead, the carer positioned dad, plus frame, in about the place he wanted him and brought the arm chair up behind him for dad to sit down. Then dragged the armchair to where it should be. He did this twice, dad's feet dragging on the floor.
- dad was asked once if he'd like to sit at the table for lunch, and he shook his head. I think dad misunderstood. But it meant a low-ish side table was dragged in front of him and he ate his lunch off that.

I spoke to the deputy manager before I left and as calmly as I could tried to express some of the above. She was very reassuring. But my mind has been turning it over. Maybe I just need time to readjust? The home needs time to get to know dad? I didn't sleep well last night

 

[Sirena]

I'm sorry you are so upset about the move, but I'm glad the manager was reassuring. Re being short-staffed, what does the latest CQC report say?

Possibly the new CH just need to adjust to your dad's needs. My mother's speech is very muddled and she's likely to say yes when she means no, and it took the CH a few weeks to fully understand her needs. You'll be able to tell more when you've visited a few times.

Do you think the carer thought that as you were there you'd want to take care of what your dad wanted, which is why he didn't help him? Re the other carer, I have never seen that method of seating a resident used, doesn't sound right to me. My mother's carers guide the resident to the chair then patiently give whatever assistance they need to sit.

I'm not sure what the policy is re walking frames. There is often one at the end of the row of chairs but I'm never clear if it's for the neighbouring resident or if it's for whoever needs it next. My mother refuses to use one so not an issue for her. The hoist isn't always in the lounge unless it's just been used for someone.

I hope your next visit is a better one and leaves you feeling a bit happier.

 

[looviloo]

I'm sorry you are so upset about the move, but I'm glad the manager was reassuring. Re being short-staffed, what does the latest CQC report say?

Possibly the new CH just need to adjust to your dad's needs. My mother's speech is very muddled and she's likely to say yes when she means no, and it took the CH a few weeks to fully understand her needs. You'll be able to tell more when you've visited a few times.

Do you think the carer thought that as you were there you'd want to take care of what your dad wanted, which is why he didn't help him? Re the other carer, I have never seen that method of seating a resident used, doesn't sound right to me. My mother's carers guide the resident to the chair then patiently give whatever assistance they need to sit.

I'm not sure what the policy is re walking frames. There is often one at the end of the row of chairs but I'm never clear if it's for the neighbouring resident or if it's for whoever needs it next. My mother refuses to use one so not an issue for her. The hoist isn't always in the lounge unless it's just been used for someone.

I hope your next visit is a better one and leaves you feeling a bit happier.

Thank you Sirena, I wish my post was more cheerful. Writing it all down has helped a bit .

The latest CQC report was published last month - overall good, with 'requires improvement' in the 'effective' category. There's a concern around administration of covert medicine. Since all previous reports have been good in all areas, plus the general low standard of homes in our region, I've tried not to worry about it. As for staff, the report says staffing levels during the inspection 'were adequate'. It also says that someone felt there were not enough staff at night - I asked about that, and was told there are two carers plus a nurse at night for 20 dementia residents, but I now think that the nurse is in the nursing unit but can be called on.

Yesterday, I saw 3 male carers (one of them just seemed to be sitting in the lounge), plus a female carer in charge who was less hands-on.

I'd like to think the carer ignoring dad was just deferring to me, but he was ignoring the other residents too, which made me uneasy. The fact that he just sat there for a long time worries me. He was still on the same seat when my OH visited the care home later in the day.

Something I forgot to mention, I asked the deputy manager about activities and she said they were concentrating on the Royal Wedding yesterday. Hmm. There were no decorations, nothing to indicate a celebration. Most of the residents were in the large lounge and there's a tiny TV and it wasn't turned on. The carer from dad's old home asked for someone to put it on, to inject a bit of life into the place, so that everyone could watch the wedding. This was done a bit begrudgingly (maybe because it was a carer from a different home?), and I noticed that the screen has black spots on it, obscuring the picture. I don't think it's used very often.

I honestly wonder if this is less 'dementia care' and more a 'dementia management' facility i.e. keep the residents quiet, provide food and medication, toilet when needed. Sorry, I'm feeling quite down about it today. I will leave it a couple of days before visiting again and hope that I get a different impression next time.

 

[looviloo]

I just reread my last posts - I was SO stressed and frustrated. Thankfully the situation is settling down, and dad is doing well, I think.... my OH has been visiting so that I can have a break. So my first visit was yesterday late-morning, but dad was still in bed! They were just dressing him as I left. I'll go back this afternoon. I chatted with the deputy manager again and feel much calmer about it now. As I mentioned above, the change has been enormous, probably more for me than dad! But we're getting there...

 

[Sirena]

I'm pleased you are feeling happier about the move. It must be difficult when he was in such a good CH before as you have high expectations, I'm sure I would feel the same if I had to move my mother to a new CH. It will take a while for things to settle down but hopefully it will all work out.

 

[love.dad.but..]

It takes a while for both your dad and you to adjust to different ways of doing things and no 2 homes work in exactly the same way even 2 in a chain. No one home answers everything for everybody and you will gradually adjust to feeling what needs your intervention and what can be let go. Still keep a vigilant eye and don't hesitate to seek clarification or reassurance from the staff and management if necessary but hopefully all will continue to settle for you both.

 

[looviloo]

Thank you both, I've appreciated all your support. It's been a difficult time.

When I walked into the new home's lounge this afternoon, I was greeted by a big smile and a wave from dad! I can't tell you how good that made me feel! He seems very relaxed, and even asked if we are all missing him... because he has it in his head that he's on holiday . I hope we can keep this little delusion going, because it seems to be working wonders.

There was music playing today, and more carers moving around than last time. Overall it's quiet though, but maybe that's just what he needs...

 

[Sirena]

Oh how lovely to have that greeting. And as you say, maybe quiet is what he needs now.