Help - Carers not feeding mum!

[Plum1108]

Hi

We have carers going in 4 evenings a week to give mum an evening meal (the 3 days a week she goes out). However, they very rarely give her a meal. They ask if she wants anything and she either says she is not hungry or that she as already eaten. When I go over there, I find biscuits, cakes, chocolate bars in all sorts of places! No wonder she is not losing weight!

We have spoken to the Dom Care Company several times, as well as Social Services and have now written to them (that was 2 weeks ago and no one has replied yet ) but they are still not cooking her a meal. We have asked them to say they are there to cook a meal rather than ask mum if she wants anything and to give her limited choices about what to have but this seems beyond them - sometimes they don't even give her a drink!

Mum is a long way from needing to go into a home but if the carers can't get something as simple as this right, how will we be able to trust them in the future????

Advice please....

Plumx

 

[Christin]

Hello Plum, I am sorry to read about your mum. I don't really have any experience to share with you on carers cooking meals, but I think in your case I would continue to contact the agency and SS. Is there a care plan where it clearly states that they should be cooking a meal? If so, then I assume that is what they should do. Of course, they can't force your mum to eat it, but it could be left for her to have later on, or with some encouragement she might be tempted to try it. My first thought is how much time do the carers have? This is not an excuse, but in my own experience, they are often rushed.

I do recognise the eating of biscuits etc, so much tastier and easier! Also, any food left in the fridge was not eaten here because FIL told me one day that he couldn't remember where the fridge was.

I hope you get some answers very soon. Best wishes. x

 

[Goingitalone]

Hi Plum,

Is there a possivbility that you could access direct payments and employ someone you know to cook her a meal?

Just a thought.

 

[Pacucho]

Hi Plum

Sorry to read of the problems you are having with your mum's carers.

The only advice I can offer is keep contacting the agency. You have to keep reminding them to tell the carers to cook your mum a meal automatically, rather than ask her. You may have to resort to telling the agency you need to go elsewhere if this does not improve, and if they do not improve actually do it.
Keep strong

Paco

 

[Amy]

Hiya Plum,

I think my plan of attack would be to ensure that the Care Company had clear written instructions that a meal had to be cooked on each visit (are they preprepared meals) and a drink given. Instructions should be given that a meal was to be prepared, even if mum says she has already eaten, or wasnt hungry.

I would leave the same instructions in mum's home....taped up somewhere so that they were clearly visible. I know when my mum had carers they had to sign each visit and say what they had done...and if they hadnt adhered to the care plan, then why not.

I would check up on them for a week or two to see if there was an improvement, and if not get onto the company again. If there was an improvement I would also get onto the company and tell them you are pleased....cos praise can do a lot of good.

Amy

 

[kazza73]

If the carers are given a certain job to do they should be doing it. They shouldn't be asking if she wants them to cook they should just say 'I'm here to make your lunch/tea' and make it.
I'd certainly be chasing this up with the agency or SS. They aren't fullfilling the purpose of their visit.

 

[Amy]

I suppose it could be an issue of consent and personal choice...if mum says she doesnt want them to cook a meal, the carers may not feel that they have a right to go against it. The situation may need to be clarified.
Amy

 

[simonmonty]

Hello Plum
Is it written in the care plan that they must cook a meal even if your mum says no? Care plans have to be very specific as carers have to follow the wishes and choices of the person receiving care even if it seems totally illogical given the nature of your mothers illness.

Carers must follow the instructions in the care plan if they don't it is neglect of care as they have a duty of care to follow it!

If they cooked a meal would your mother eat it even with prompting from the carers? and would the carers have enough time to spend cooking the meal and then prompting your mother to eat it?

How much time do they have to spend with your mother? Some care calls are only half hour calls not much time to do anything apart from making a sandwich or microwave meal and a drink.

Have you thought about meals on wheels? or pre-cooking a meal so all they have to do is reheat it?

I know its hard and frustrating trying to get the care your mother deserves unfortunately that's the care industry for you as it very often fails it's duty of care

 

[beena]

Hello Plum
We had exactly the same thing for Mum: paying for visits, care book saying "all o.k on leaving" (standard phrase) but then found unappetising food left where Mum couldn't reach it: I was always throwing food away.
It seems, unfortunately, that unless you have the good fortune to meet a really humane carer (which we did, but then she left so back to square one), it really is a case of constantly getting on the case with those providing the service. Consistency of person and them getting to know your loved one appears to be the key, but this is, as I am sure you're aware, so difficult.
We watched our Mum lose weight and become more and more frail (whilst spending nearly £300 per month on the service). I know this is not what you want to hear-really all I am saying is that being persistent is the only key.

 

[sussexsue]

another small thought is that I notice you said the carers go in the evenings. I now find it difficult to get mum to eat in the evenings (usually because she has been grazing on biscuits all day), she will say she isnt hungry or feels sick. I now provide a cooked meal at lunchtime (12:30) every day. She always eats it and I worry less if she doesnt have anthing healthy in the evenings.

just a thought.

 

[Tinkerbell26]

Hi plum

This is totally unacceptable, I have been in a similar situation with dad (Carers started in feb) I've found leaving a list for dad which tells him someone will be coming to cook dinner has helped as well as buying microwave meals which can be cooked in the limited time they have, it might not be ideal but if you can find things your mum likes this may help, chicken korma works for dad. I also left strict instructions for the carer to serve a meal even I'd he refuses, more often than not he will eat it. Dont be scared to escalate to someone senior at the care provider, unfortunately we had to when sleeping tablets were given in the morning (apparently by mistake) I also find dad eats biscuits and things, I think because it's easy and they get a sense of doing something for themselves, so along with treats I make sure there are lots of grapes, bananas, oranges yougurts etc that he can snack on too.

I've also left a list of tips for Carers of dads fav/foods likes/dislikes and how I coax him to do things.

Also is it worth getting your mum's teeth checked at dentist? I found dad had a wobbly one once which was causing his refusal of food.

So difficult and hard, I try to think out of the box for all the possibilities that could cause refusal.

Keep persavering and good luck

 

[Plum1108]

Hi All

Sorry for the delay - been having trouble with the internet!

Anyway, thank you for your replies - it makes me realise that we are doing pretty much everything we can, which is a small comfort!

I have just checked mum's care plan and it says "carers are to heat up a meal & serve as if asked" and " Mrs B will say that she has already eaten when in fact she has not"

I don't think it could be any clearer than that!

We have thought about meals on wheels but as mum goes out for lunch twice a week and also likes to go for a walk in the day, we got the carers to come in the evenings so that she will be in. The meals we buy are microwaveable or ones that we have cooked and left in the fridge to be heated up so time shouldn't be an issue. Usually, though they sit in the fridge for several days then get binned which is such a waste.

We still have not had a reply from social services or the care provider - it's been 2 1/2 weeks now! I really don't think that is acceptable, so I think they will both be getting calls by the end of the week!

I like the idea of a sign - may get the kids to make one to put up on the fridge.

Thanks for advice, it helps just to vent sometimes!

Plum x

 

[simonmonty]

Hello plum
A reason as to why they are not preparing a meal for your mum by what is written in the care plan is:
They are following the right of "CHOICE" code of practice. Every carer is told that everyone has a right of choice and they cannot force or go against some ones wishes if they say no to something like having a meal, even preparing one and even if its written in the care plan. All they can do is report it and make a note of refusal in the care plan. It is obviously right that everyone has a right of choice but when someone has a form of dementia it can be a very tricky situation a catch 22 situation , It can be classed as abuse if they do go against some ones wishes. I would suggest you have the word "PROMPT" added to the care plan it may make no difference because it depends if the carer is prepared to spend time trying to persuade your mum to have a meal even being involved in helping to prepare the meal. You have to realise that some or most carers have no training or real knowledge of dealing with dementia sadly

I know how you feel I had exactly the same problem with my mum I just had to leave out snacks and drinks for my mum and make a meal for my mum my self later but even then my mum would sometimes refuse to eat it even with prompting from me

 

[Plum1108]

Hi Simon

Thanks for your reply. It's funny but I had the same conversation with a woman at work today (she is the care industry) and says it comes down to capacity.

At what point does giving someone a choice (who does not have capacity) come down to a form of abuse in itself? Surely, if my mum were to become ill from lack of food (unlikely, I know) due to refusing to let the carers prepare a meal for her, does it come down to neglect on their's or anybody else's part? I mean, if my kids said they didn't want anything to eat day after day it would be abuse if I respected their choice, gave them nothing and let them become ill - why isn't it the same with my mum????

The frustrating thing is, when food is prepare, she will quite happily eat it (never known to refuse food, as my brother says!). However, when the carers prepare a meal it is usually only a sandwich which she usually has for lunch and I really don't think that is good enough although it is better than the nothing she usually gets

And still no reply from Social Services / Care Provider about our letter.

If what you say is true (and I find it wholly believeable) then we may as well stop the carers going in!

Thanks again.

Plum

 

[Sue J]

it comes down to capacity.

At what point does giving someone a choice (who does not have capacity) come down to a form of abuse in itself? Surely, if my mum were to become ill from lack of food (unlikely, I know) due to refusing to let the carers prepare a meal for her, does it come down to neglect on their's or anybody else's part? I mean, if my kids said they didn't want anything to eat day after day it would be abuse if I respected their choice, gave them nothing and let them become ill - why isn't it the same with my mum????

The frustrating thing is, when food is prepare, she will quite happily eat it (never known to refuse food, as my brother says!). However, when the carers prepare a meal it is usually only a sandwich which she usually has for lunch and I really don't think that is good enough although it is better than the nothing she usually gets

And still no reply from Social Services / Care Provider about our letter.

If what you say is true (and I find it wholly believeable) then we may as well stop the carers going in!

Thanks again.

Plum

I totally agree with you Plum - in some ways we train people 'not to care' instead of teaching them 'how to care' . Your Mum is unable to know what her needs are because of her condition - that is the nature of it and that should be part of a proper assessment of needs. I think the problem isn't helped when carers get little supervision in the community. Keep going - they should make her a meal.

Best wishes
Sue

 

[LesleyA]

Hello Plum
How worrying for you that the care provider won't reply to your letter. We had similar problem with both parents telling the carer they were not hungry, or had eaten earlier. Both were losing weight and living on biscuits! We also had a problem when I discovered the bed hadn't been changed for over 7 weeks despite it being clearly stated on Mum's care plan. We solved the food issue by asking the local pub if they would provide a meal, my Dad felt more in control if he could choose his own and they very kindly delivered each day. Gradually we reduced the number of meals from the pub and in the end they both accepted the situation and just have a meal delivered from the pub occasionally as a treat. The bed situation turned out to be that on one occasion the bed had been changed mid-week due to a spillage and Dad had said it wasn't necessary to change it on the Friday when it was marked down to happen. The carer took this to be a permanent situation so the bed was not changed at all, apparently they cannot go against the client's wishes, even though it doesn't make sense. I think you just have to keep on even if you feel you are making a nuisance of yourself! I hope you get on top of the problem soon. LesleyA

 

[simonmonty]

Hello plum I totally agree with you! I've just gone through training to be a carer and from what I have learnt the training is just "NOT" geared up to helping someone with dementia like Alzheimers. The training is more for someone who has capacity and understands what your trying to do for them. I found it very frustrating as I knew what they were teaching me would just not work for someone with dementia like Alzheimers
I think if your caring for someone who has Alzheimers it should be more specialized and certain regulations regarding choice should be more relaxed as normal caring procedures will just not work and you will just end up in reality abusing them anyway not being more persuasive or just following common sense. I think the entire care industry needs changing as when I was caring for my mother I felt like I was just banging my head on the brick wall were common sense with caring was just not being applied. When I did my training we were constantly being told about duty of care and right of choice repeating it like a mantra! and if we did not follow it we could end up in court possibly being charged with abuse or being sued I felt like I was being trained in what I could NOT do rather then what I should do. It was a real eye opener

I like you use to constantly complain to my mums care company and social services and get absolutely no were everyone is frightened of being sued or prosecuted or just can't be bothered That's why I want to be a professional carer and try to change things from the inside though what I face scares me to death regarding stupid regulations that only work in an ideal world The entire stupid system has taken away the caring part out of caring

 

[FifiMo]

I think there are a number of issues here. The carers are in a damned if they do and damned if they don't scenario here. If your mum says no food I've already eaten then how is she going to react if they ignore that and go off and start making a meal anyway. I know my mother used to take great pride in having some measure of control over these carers and often showed that by saying she'd already eaten, was going out for a meal, wan't hungry etc. She too would then snack on anything she could find once the carers left - almost like she was having some kind of celebration that she had won this time round. At the end of the day the carers are given guidance as to what they should do and you will probably find that all they are permitted to do is to prompt the person to eat. Same goes with medication too - nothing more than a prompt. The latter having potential serious consequences if the person continuously refuses to comply and take the meds. All they are then able to do is to report back to the supervisor that there is a potential problem that needs to be addressed.

Maybe some thought needs to be given therefore about what they could do as an alternative at the times when a cooked meal is refused. Could they prepare some finger food perhaps, or a nice fruit salad - that kind of thing. I know you said that they sometimes leave a sandwich - there can be a lot of nutrition in a sandwhich. For example a cheese and tomato sandwhich can be very nutrionally balanced as an alternative to a meal. What about a toasted sandwich - would that be an alternative perhaps - with a bit of salad on the side?

From my experience the challenge is almost to beat the individual at their own "game" and find alternative approaches that lets them still feel in control whilst ensuring they get proper nutrition on a daily basis. It is difficult to achieve and at times we just had to concede that it was better that my mother had a couple of biscuits with a cup of tea than going for hours without anything at all.

Not easy at all, and I wish you luck at getting it all sorted out.

Fiona

 

[scottmcfc]

hi plum

Hi

We have carers going in 4 evenings a week to give mum an evening meal (the 3 days a week she goes out). However, they very rarely give her a meal. They ask if she wants anything and she either says she is not hungry or that she as already eaten. When I go over there, I find biscuits, cakes, chocolate bars in all sorts of places! No wonder she is not losing weight!

We have spoken to the Dom Care Company several times, as well as Social Services and have now written to them (that was 2 weeks ago and no one has replied yet ) but they are still not cooking her a meal. We have asked them to say they are there to cook a meal rather than ask mum if she wants anything and to give her limited choices about what to have but this seems beyond them - sometimes they don't even give her a drink!

Mum is a long way from needing to go into a home but if the carers can't get something as simple as this right, how will we be able to trust them in the future????

Advice please....

Plumx

Hi plum, as a nurse I advise you to get an urgent referral to the dietician at your local NHS trust. They do home visits and will write out a care plan for your mum - in my experience carers will respond much better to something that is written in black and white - leave a space in the dietary plan that each carer can sign each day (ie: make them responsible) - your mum has a much better chance of getting what she needs this way. good luck. regards Scott

 

[Plum1108]

Thanks Scott - I will look into that.

Well, last week the carers gave mum a jam sandwich one evening & a mug of soup (no roll or sandwich) another evening. She didn't have anything the other two evenings they go in!

I got on the phone to social services (again) on Friday and they called me back today to say that they have arranged for a new care provider to start next week. I hope they are better than the current ones!

Will let you know I get on with Scott's advice.....