Who's looking after mum's mental wellbeing whilst in EMI hospital?

[keep smiling]

I wonder if anyone might be able to provide some advice.

My mum has vascular dementia and my dad is her carer. For the last 2 years he has done absolutely everything for mum and hidden the extent of her dementia from most people. Recently mum was taken into an emi NHS hospital unit and I am worried.
The nurses are lovely lovely lovely people and handled my mum's admission with real compassion and skill. My mum was extremely distressed at being left and having never been more than an inch away from my father for the last couple of years even more distressed at him leaving her behind.

We are now 12 days into her 28 day restraint order and I am worried. Today my mum seemed very 'drugged and dazed' when I visited. The nurses were busy and none of the dementia patients seemed to have anyone looking after their mental welfare. One very nice nurse told me that mum had been fine all morning and that she had been following the staff around all morning. I understand that that means that she was with someone the whole time and that this might have lessened her anxiety a little. But does that really constitute looking after my mum's mental welfare, which surely is part and parcel of dementia care (social interaction is referred to as important in Alzheimer society's information.)

I hope I am making sense. Seeing my mum registering so little around her today was really upsetting and I worry about who is interacting with her in any meaningful way when we, her family, aren't around. We visit every day,have taken up cd player and music and dvd's and photograph albums. When we are at the hospital we take her into the garden, listen to music with her, browse through magazines with her and generally try to keep her active and involved.

But when we are not there, none of this seems to happen. This is not a criticism of the nurses, who I know are very busy, but there seems to be no consideration of her 'mental' wellbeing/social wellbeing other than getting her medication right.

Thankyou for listening.

 

[kazza73]

This has crossed my mind before too. The nurses in the unit are fantastic with mum but when I had been in mum seemed to either be wandering around alone or sitting in the lounge with other patients (many of whom have no communication). I wondered if this was what mum did all day every day. However, one day when I visited I arrived to find mum going round with a carer with the tea trolley- at first I found this a bit odd but then I heard the carer talking to mum whilst doing it, she was asking mum 'what do I do next?', 'can you pass me a cup?', how many sugars do I put in for Annie?'. It dawned on me that the interaction with the carer was actually quite challenging for mum and also allowed the carer to informally assess mum's abilities.
Another time when my dad visited mum and another patient were playing dominoes with 2 nurses, again I think it was an informal assessment, but mum was at least interacting with others.
Having spoken to several members of staff who asked me about my kids etc I am now aware that they have obviously spent time looking at mum's photo album and 'life story' notes with her.
The senior charge nurse asked me the other day if there were any particular hobbies or interests mum has so she could pass the info on to the activities coordinator- they had tried to involve her in a craft activity one day but mum had shown unwilling. I was glad to be asked as I felt reassured that they were trying to cater for mum as an individual and to offer her stimulation.
Although we dont always see things when we visit there is obviously a lot happening when we are not there.

 

[keep smiling]

Thankyou for your reply - this is really helpful to me. I tend to visit in the afternoons and haven't really seen mum interacting with anyone. Some of the patients are quite immobile. One is quite aggressive when she sees my mum - which frightens her and the others are really quite unresponsive so it all seems quite depressing.

But I see what you mean about helping with the tea trolley etc and how helpful that could be. I hadn't thought about it in those terms.

FYI my parents are also perthshire. I'm in fife.

 

[bunnies]

I think your concerns are quite valid. I experience the same thing with my relative. Particularly at first, when the person moves into the nursing home, everyone is very friendly and attentive to you as a relative, and you see all the good things about the move, which is reassuring....but you have pinpointed the weakness I think. There will always be 'good' and 'not so good' nurses and carers, but in general it takes a very motivated member of staff to engage with a resident in a home unless there is a need. I know there are the exceptional staff who may do this, but it is the exception in my experience. To make sure your relative is kept active, you will have to keep active in reminding them that you want this to happen. In my relative's nursing home, I see many residents there who do nothing all day, when I believe they would respond to some thing given the chance. My experience of activity coordinators is that they cater for the more able residents, and provide single event activities, which are good to have but do not meet the need for something to keep residents active on a day to day basis.

In my relative's case, I think the nursing home is relatively good, but I have to introduce activities that are suitable for her, and then try and make these known to the staff so that they can keep it going when I am not there. Also, I repeat the need for this to the manager every month or so, to keep them aware that I think it is important. This can be quite a lot of work, since my relative's needs change according to her illness, so at one time she could knit, but then not. Most times she needs very simple things - a collection of pictures or photos to arrange repeatedly, or some small items to move in and out of a box - but if I did not insist these are brought out every day I think she would just be sitting there asleep like everyone else.

 

[kazza73]

I do totally understand your concerns though. I find it especially hard as the other patients in with mum are all much older and many in quite advanced stages. Mum is only 63 and I think the staff are very aware of that and that is why they are trying to spend time with her as other than dementia she has very little in common with the other patients. Long term I do worry about where we will find a suitable placement for mum, it looks like she will need nursing rather than residential care which immediately limits our options then on top of that many homes dont take people under 65 and those that do tend to be full of people who are much much older.

I'm near the border with fife although mum and dad live an hour further north! Mum is currently in MR in Perth.
K x

 

[keep smiling]

mum's well being

Thanks for this. We seem to be in a quite similar situation - I find it all very distressing and more so for my dad who I think feels like he is swimming in treacle a little. He is about to go down the guardianship route and mum will probably stay in longer than the enforced 28 days and this seems to suggest for any period up to 6 months. So I worry from her perspective that she will have enough to keep her alert and interested. It's a holistic approach to her wellbeing that I think that I am looking for but feel that I need to be treading softly with the medical care staff who I can see are very stretched at the moment.