Moving from one care home to another

[MothersCarer]

Hi to you all. I hope life is treating you at least reasonably well.

Next week I have to move mum from the intermediate care home she went into after hospital to a long-term care home. When she had her last fall at home she broke her ankle, was transferred by ambulance to hospital, a couple of weeks later, after a first week when she was in and out of delirium, she was transferred by ambulance to a physiotherapy unit. Then, after a mental capacity assessment, a Best Interest meeting determined she would not be safe to go home so she was transferred, by ambulance, to the intermediate care home where she has spent six week. After about three and half weeks, which included assessment of her care needs, another mental capacity assessment and Best Interest meeting it was determined she was still not safe to go home. She is 97, very frail but quite convinced she would be able to manage at home.

So, I am taking her in my car to the new home and the thought of moving this frail, confused and not a little angry 97 year old is terrifying me. I am beginning to think I am totally foolish to think I can do it on my own. I need to persuade her into her wheelchair, out of the wheelchair into the car and then the reverse when we arrive at the new home. I have explained the doctors and carers feel she needs a bit longer with more care and she is very cross about that. I have also explained today that this will mean going to another "unit". I cannot see her being cooperative. Does anyone know anything I can do that will make it an easier journey for both of us?

 

[Spamar]

Get someone to help. OH, by then in a wheelchair when out the house, needed two of us, in fact I couldn’t have managed on my own. And he was as helpful as he could be!

 

[Shedrech]

hi @MothersCarer
maybe use a taxi to transport your mum, there are ones specifically for transporting a wheelchair, that way you are not driving so can give your mum your full attention, and you have someone else on hand
before you set off, let the new home know so they are ready to help when you arrive
you can later move your mum's belongings in your car
and now that you have told her about the move, maybe don't mention it again so as not to raise her anxiety levels - even on the day might you say you are taking her for a treat ( no fond farewlls, unless you think that would please her), and take along her favourite cake so you have a cuppa and something nice as soon as you arrive, rather than immediately going to her new room, which will start her stay off positively

 

[MothersCarer]

Thank you both. The taxi is such a good idea Shedrech. I was going to make sure the home know and I know they will be as helpful as they can but it was the car journey that was worrying me most.

The bit about telling or not telling is so difficult but I think you are right. Really good points.

 

[Kevinl]

Our home sends a carer to do the hand over and another member of staff to drive the home's minibus which has a tail lift and wheelchairs locks and brings them to the home.
As suggested a wheelchair taxi could be arranged or you could look if the Saint Johns Ambulance Service will help, they do operate a patients transfer service in many areas, see the link below.
K

http://www.sja.org.uk/sja/what-we-do/ambulance-operations/patient-transport-service.aspx

 

[Baz22]

Hi to you all. I hope life is treating you at least reasonably well.

Next week I have to move mum from the intermediate care home she went into after hospital to a long-term care home. When she had her last fall at home she broke her ankle, was transferred by ambulance to hospital, a couple of weeks later, after a first week when she was in and out of delirium, she was transferred by ambulance to a physiotherapy unit. Then, after a mental capacity assessment, a Best Interest meeting determined she would not be safe to go home so she was transferred, by ambulance, to the intermediate care home where she has spent six week. After about three and half weeks, which included assessment of her care needs, another mental capacity assessment and Best Interest meeting it was determined she was still not safe to go home. She is 97, very frail but quite convinced she would be able to manage at home.

So, I am taking her in my car to the new home and the thought of moving this frail, confused and not a little angry 97 year old is terrifying me. I am beginning to think I am totally foolish to think I can do it on my own. I need to persuade her into her wheelchair, out of the wheelchair into the car and then the reverse when we arrive at the new home. I have explained the doctors and carers feel she needs a bit longer with more care and she is very cross about that. I have also explained today that this will mean going to another "unit". I cannot see her being cooperative. Does anyone know anything I can do that will make it an easier journey for both of us?

I may be wrong but if she is in an intermediate care home then is she not under the care of the intermediate care team in your area? In our case when my father had to be moved they arranged his transport. Failing that I do think the taxi idea is a good one. I have the transfer problem with my mother and like yourself have to use a lot of persuasion. Hope it goes well but my experience tells me it rarely does.

 

[Platinum]

Our home sends a carer to do the hand over and another member of staff to drive the home's minibus which has a tail lift and wheelchairs locks and brings them to the home.
As suggested a wheelchair taxi could be arranged or you could look if the Saint Johns Ambulance Service will help, they do operate a patients transfer service in many areas, see the link below.
K

http://www.sja.org.uk/sja/what-we-do/ambulance-operations/patient-transport-service.aspx

The residential care home which is dementia registered hinted rather strongly yesterday that they could no longer keep my OH there. I have never had any spontaneous feedback from them in the two months he has been there but have always felt anxious about his long term status to the point of ringing regularly and especially when a payment is made. A week ago the manager said they would keep him. Yesterday my OH looked a bit upset and said that he had been accused of assaulting the female staff (they are all female) and as the manager was in his office I took the opportunity to ask him about this. I was aware OH wanders about at night (he did this at home) and he will sometimes remove his night catheter bag which will result in a wet bed. I’m afraid an indwelling catheter can cause a lot of problems in a PWD as it is a constant surprise to them. He is not particularly compliant with personal care and the night wandering he denies doing because he doesn’t remember doing it. If he’s restrained he apparently lashes out. They seemed to say that they would normally leave him but they can’t leave a wet bed. I took in all his personal catheter supplies when he was admitted along with bed mats for accidents, which work well, but they have not used them. The manager said OH can be fine, charming even, but can also be quite aggressive but not with other residents. But he didn’t really say they had made a decision. I know they have to give me 28 days’ notice but what if there is no suitable place elsewhere? Does anyone have experience of this? Is the current CH obliged to wait until there is a suitable placement available? And what does dementia registered really mean?
Any advice is as usual much appreciated.

 

[canary]

I dont know the answers to a lot of your questions @Platinum because mum was never given notice, but I do know what "dementia restered" means - or rather doesnt mean.
To be dementia registered just means that they will accept people with dementia, but it doesnt stipulate how bad and the home can cherry pick what they want and what they wont accept. Many dementia registered homes will only accept early stages of dementia and once you get common symptoms like being up at night,wandering (especially into other residents rooms), resistance to personal care and any sort of aggression you will be asked to leave. I dont like the reference to restraint - it is almost guaranteed to cause lashing out and they shouldnt need to use it.

Have you found another CH? When you go and look ask them how they would deal with your dads problems and find out what they would not deal with. Dont bother looking at anywhere that has both dementia and non-dementia residents - they will not accept the more advanced symptoms and you want somewhere that will look after him to the end.

 

[MothersCarer]

I may be wrong but if she is in an intermediate care home then is she not under the care of the intermediate care team in your area? In our case when my father had to be moved they arranged his transport. Failing that I do think the taxi idea is a good one. I have the transfer problem with my mother and like yourself have to use a lot of persuasion. Hope it goes well but my experience tells me it rarely does.

Baz22, I did wonder about that but we have now arranged to go and collect her after tea tomorrow. My daughter is going to drive her over and I am going to pack up everything in the current home and follow them. We made the new room more personal this morning. My daughter is confident she will be okay and I think Mum is less likely to be difficult with her. I am now just panicking about what the local authority will pay. This should be at their rate as they will have to help until the house is sold and then there will be very little. This has been discussed but we haven't had a financial assessment yet and the home gave me a pack with forms to fill in and prices. It mentions top ups but I think/hope this refers to what they consider to be a better room. What I don't know is what might count as an extra? I have been doing mum's washing while she was in the intermediate care - my own choice although they did ask and we paid to have mum's hair done (obviously) but I am at that horrible point of anxiety where I just feel I know nothing. Sorry to dump on you all but my daughter is taking on so much I can't ring her, my son is in Australia and my brother in America. I know I will feel fine once we have her settled and I will ring the social worker on Tuesday morning to get them to do the assessment; I just need to get through the next 24 hours. So sorry.

 

[Baz22]

Baz22, I did wonder about that but we have now arranged to go and collect her after tea tomorrow. My daughter is going to drive her over and I am going to pack up everything in the current home and follow them. We made the new room more personal this morning. My daughter is confident she will be okay and I think Mum is less likely to be difficult with her. I am now just panicking about what the local authority will pay. This should be at their rate as they will have to help until the house is sold and then there will be very little. This has been discussed but we haven't had a financial assessment yet and the home gave me a pack with forms to fill in and prices. It mentions top ups but I think/hope this refers to what they consider to be a better room. What I don't know is what might count as an extra? I have been doing mum's washing while she was in the intermediate care - my own choice although they did ask and we paid to have mum's hair done (obviously) but I am at that horrible point of anxiety where I just feel I know nothing. Sorry to dump on you all but my daughter is taking on so much I can't ring her, my son is in Australia and my brother in America. I know I will feel fine once we have her settled and I will ring the social worker on Tuesday morning to get them to do the assessment; I just need to get through the next 24 hours. So sorry.

MothersCarer hope the move went off OK. I know that "just get through the next 24 hours feeling" and things don't seem to get any easier as we move from one problem to the next. I have not found people on this forum think the are being dumped on we just share experience to try and support each other. I have an assessment for my mother tomorrow so hope yours went well and hope mine goes OK.

 

[MothersCarer]

Hi Baz and thank you for your thoughts. It went very well although mum will take a while to settle I think. I was pretty anxious when I wrote the last post but better for writing it. I see your mum has had an assessment today (?) so I do hope that went well and you feel you are making progress. Just sometimes this all feels like a modern form of torture - for us and those we care for - but then you realise how caring the majority of people are, it's the system that is tortuous. Off to post another question. I do hope I can at least pass on the knowledge I have gained to others or we are all reinventing the wheel on a daily basis. Thank heavens for this forum. I will be really interested to hear how you got on.

 

[Baz22]

Hi Baz and thank you for your thoughts. It went very well although mum will take a while to settle I think. I was pretty anxious when I wrote the last post but better for writing it. I see your mum has had an assessment today (?) so I do hope that went well and you feel you are making progress. Just sometimes this all feels like a modern form of torture - for us and those we care for - but then you realise how caring the majority of people are, it's the system that is tortuous. Off to post another question. I do hope I can at least pass on the knowledge I have gained to others or we are all reinventing the wheel on a daily basis. Thank heavens for this forum. I will be really interested to hear how you got on.

Thanks and apologies for delay in response as been to a family funeral 250 miles away. Assessment could not have gone better and LA funding to start at start of January 2019. I smiled at "modern form of torture" as that just about sums it up. After a meeting with our CCG 9 weeks ago was told I would have a written reply in a couple of weeks. Still waiting despite chasing them up twice. Will probably go to NHS England with a complaint but then they only ever back themselves and you feel like you are always getting fobbed off. Mum in a sleepy, limited communication, phase at the minute but then it can change on a daily basis. I also thank heaven for this forum. Sometimes I feel better just putting my thoughts on paper. All the best and good luck.

 

[Ingrid Carley]

Hey
Your mum is too old to handle by self so you need a proper care home to take care of her. and such a person always needs assistance.

 

[MothersCarer]

Good news Baz. I do wish you good luck with the CCG; these large bodies do seem to work in a world of their own.

 

[Platinum]

I dont know the answers to a lot of your questions @Platinum because mum was never given notice, but I do know what "dementia restered" means - or rather doesnt mean.
To be dementia registered just means that they will accept people with dementia, but it doesnt stipulate how bad and the home can cherry pick what they want and what they wont accept. Many dementia registered homes will only accept early stages of dementia and once you get common symptoms like being up at night,wandering (especially into other residents rooms), resistance to personal care and any sort of aggression you will be asked to leave. I dont like the reference to restraint - it is almost guaranteed to cause lashing out and they shouldnt need to use it.

Have you found another CH? When you go and look ask them how they would deal with your dads problems and find out what they would not deal with. Dont bother looking at anywhere that has both dementia and non-dementia residents - they will not accept the more advanced symptoms and you want somewhere that will look after him to the end.

Thank you for your reply. I have now been told I have to move him before Christmas as he locked himself in someone else’s room and ‘trashed’ it. They called me and I arrived within 10 minutes and he had opened the door and there was nothing out of place. They said they had tidied the room - hardly trashing therefore. It was just more ammunition to remove him. I think this home wants to be a hospice in reality. I have found another place with a dedicated dementia unit and am awaiting the result of the assessment done yesterday. I’m finding all this very hard and depressing because deep down I think I should bring him home. Obviously one will try with the new place but if he is asked to move again or doesn’t settle I will be looking into reinstating carers at our home. It seems that care homes are quick to accept people but even quicker to eject them when they become too ‘difficult’. I think you said to me in a previous post that he was probably hosting when the current manager assessed him in hospital and I agree but he should have seen past that surely. Or is it all about the bed occupancy? Thanks for advice as always.

 

[canary]

There will be a home out there for him @Platinum and I do hope this new place will be the right one.
Even if they dont accept him, please dont bring him home. I know that there is a terrible feeling of guilt about him being in a home anyway, but please remember why he had to move to start with. It wont be any easier now - in fact it will be harder as his dementia will have progressed. If a whole team of people cant cope with him, why should you expect yourself to?