Residential or nursing care home conflict

[winda]

Just to update the situation : my husband has now been five weeks in an assessment unit in hospital having his drugs monitored as he had become agitated and aggressive with me at home. The hospital now say that he is ready for discharge.
The problem is that he has become more agitated over the last three days and they are still tapering his drugs. Today he will come off Diazepam. It will obviously take time to see how he will now respond.

I attended a continuing care assessment meeting today and the nurse in charge decided he wanted to abort the meeting as it was too early to know what the situation is with my husband. I agree with this and I think that the next meeting about this will be in one or two weeks time.

I told this nurse about the care home I would like my husband to go into and all he could say was that it was expensive and that my husband might not need nursing care despite the consultant saying that he did. Our social worker thought that it would be risky for my husband to go into a residential care home as it might mean him having to be moved again when they found that they couldn't cope with him. But the independent nurse was adamant that residential homes could cope with challenging behaviour.
I feel that this is all about funding. If we aren't elligible for continuing care then we will be self-funding and I think he was objecting to my care home choice on the basis of the LA having to pick up the cost once my husband's savings reach the threshold. Also he is worried about having to pay for the nursing side of my husband's care.

I'm not sure how I stand regarding the care home. Can this still be an option? Also, when I phoned round a few residential care homes in the area and told them about my husband, they said that they wouldn't be able to take him and that he would need nursing care.

I am going to phone the social worker to try to find out how we stand and I think that it might be a good idea to ask to see the consultant again.

I would be grateful for your views and also any advice on how I can obtain the best results for my husband.

 

[fredsnail]

We had the same problem with Grandad - the consultant said one thing, nurses another and when we went round the care homes the staff said something different again.

We decided to go with a home that had residential and nursing care so that as he deteriorated and went from 1 to the other he was in familiar surroundings and staff - it worked very well as within 4 weeks of arriving he had a fall and broke his hip so was deemed to be nursing.

 

[jan.s]

I was advised by our consultant to find somewhere with a long term view, so as not to have to move R at a later date ie nursing care. I don't know how the funding works, but our SW put forward a good case for the home of my choice, due to its location and how it would meet his needs.

Jan x

 

[Butter]

I would start off by doing what you can to make sure your husband stays in hospital as long as possible. The level of nursing you seem to be encountering will not be found 'outside'. The whole business of juggling medication and blood-testing and observing and trying again - and then the patient's needs change so they have to start again - is very cumbersome once you leave hospital. Blood test results can take forever.
I am impressed that the nurse in charge managed to abort the meeting - he obviously took this view. If you are impressed by him I would take his advice as much as possible. He may know a lot about the local care homes etc. And he may know the way to get there.
The best way you can help this nurse keep your husband in hospital is by being ABSOLUTELY clear that you cannot have him home. And then by holding out for whichever home it is that you want him to go to - and not hurrying him off there.
Yes I think the business of money will be on everyone's minds. But I believe LAs do NOT always pick up the costs once your funding runs out. I know people sometimes get moved elsewhere. Similarly homes (or parts of homes) do regularly decide they cannot manage someone's behaviour. You would need to meet the CH manager, and the CH manager should visit your husband in hospital. In my experience no decent CH would take on a resident who is in hospital without visiting them and meeting the family. And then they should be able to make a serious assessment and commit them selves - or not.
It does not sound as if meeting the consultant is urgent. Once your husband is discharged to a ch he will be under the GP I would think, so you may be moving outside the consultant's remit.

 

[winda]

Thank you for your replies.
I phoned the social worker this morning to put him more in the picture regarding the situation before my husband went into hospital. On the basis of what I told him he said that he would definitely need nursing care. He also said that he would stand a good chance of getting continuing care.

We won't be meeting again for another week or so and it will give me more time to look at the care homes I have identified as providing nursing. I'm hoping the care home of my choice will have a bed available when the time comes. It is expensive but it is the only nursing home nearby and it would be good to have him near enough to be able to just 'pop' round to see him when I want to.

I feel reassured after talking to the social worker and reading your replies. Yesterday I just felt drained but I feel more energy now, ready for a battle should there be one.
Wouldn't it be nice if we didn't have to fight every step of the way?

Thank you again and I will let you know how we get on.

 

[Butter]

It is tough.
I wish I had been able to listen to the wise nurses who looked after my mother when she was last sectioned. They knew what would be best for her. But my father and my brother were so anxious to get her continuing care that they lost sight of the main issue, I believe.
I often think now of the nurse who told me how my mother would like to be in a home with a big garden so she could sit under the trees in the summer. The nurse was quite right. And my poor mother has not sat outside since that nurse took to sit in the hospital yard nearly two years ago.

 

[rosaliesal]

Do what is right for the future

From a selection of homes in your area you will find that only a certain amount can deal with someone with Alzheimers or forms of dementia. Bearing in mind that with some the mind deteriorates slowly, with others it may be quicker, then what you can be sure of is that moving is a tug on the heart strings of the famil/carer and person with Alzheimers. So it is probably better to think of the long term and chose one home that can and will be qualified to cope to avoid having to make a second move. Your local care department will be able to give you a list of those homes that are suitable. This then gives you a start to your plans. It is a fact that a residential home is not the answer because they will refuse on the basis of they are not the correct place for some one needing nursing care. A nursing home that is also residential will lock doors to avoid dementia people leaving the building and getting lost and know all there is to know about the illness and are so experienced in dealing with this illness.

Having sorted which home can help you then the money side of things needs to be assessed. Your care department will advise where you stand. Get ready for the shock. All I can say is that the problem will not go away because the illness , however small the downhill slope does not revert to climbing uphill. The sooner you have a plan the better you will feel. Even if you implement the plan at a later date, at least you will have the peace of mind of knowing where it is all leading and you will feel more in control.

It goes without saying that the person I would believe in is the consultant. He is totally trained to recognize all of the symptoms....it is his/her speciality. Care workers see and have experience but of all types of illnesses and do not specialize. Your doctor will not even be as good as the consultant but should be able to advise you. For sure the fiancial circumstances to sway the care department and I feel that doctors and consultants whilst they understand the patient they do not always know the full complicated ins and outs of the financial side of things.

You are switched on, you know you need to start getting sorted, after all you live with these problems daily so you are more of an expert than any of them. It may be a fight but in the end you will get the answers you need. It is only then you will be able to relax a little. I am so sorry for your situation and hope you find happier solutions soon. Go with your gut reaction and accept what help you can. bear in mind that the care departments always think of the money involved. wishing you well.

Just to update the situation : my husband has now been five weeks in an assessment unit in hospital having his drugs monitored as he had become agitated and aggressive with me at home. The hospital now say that he is ready for discharge.
The problem is that he has become more agitated over the last three days and they are still tapering his drugs. Today he will come off Diazepam. It will obviously take time to see how he will now respond.

I attended a continuing care assessment meeting today and the nurse in charge decided he wanted to abort the meeting as it was too early to know what the situation is with my husband. I agree with this and I think that the next meeting about this will be in one or two weeks time.

I told this nurse about the care home I would like my husband to go into and all he could say was that it was expensive and that my husband might not need nursing care despite the consultant saying that he did. Our social worker thought that it would be risky for my husband to go into a residential care home as it might mean him having to be moved again when they found that they couldn't cope with him. But the independent nurse was adamant that residential homes could cope with challenging behaviour.
I feel that this is all about funding. If we aren't elligible for continuing care then we will be self-funding and I think he was objecting to my care home choice on the basis of the LA having to pick up the cost once my husband's savings reach the threshold. Also he is worried about having to pay for the nursing side of my husband's care.

I'm not sure how I stand regarding the care home. Can this still be an option? Also, when I phoned round a few residential care homes in the area and told them about my husband, they said that they wouldn't be able to take him and that he would need nursing care.

I am going to phone the social worker to try to find out how we stand and I think that it might be a good idea to ask to see the consultant again.

I would be grateful for your views and also any advice on how I can obtain the best results for my husband.