EMI/Nursing Home - the differences and the benefits?

[kingmidas1962]

My 85 year old dad has Picks disease (frontal lobe dementia) and is in a nursing home - not a specialist EMI unit. He first went there for respite and the care home manager did say, at that point, that they didn't care for dementia patients in permanent placement. However, having had dad there for 6 weeks and seeing that he doesn't present any challenging (i.e. violent or disruptive) behaviour that they felt they could meet his care needs and would be happy to have him there on a permanent basis, which is what happened. They have three care sections on different floors - terminal/palliative care on one floor, elderly infirm with nursing care required (which is where dad is) and elderly residential (with no nursing needs)

He is settled there - he likes the staff (and they like him - he's such a gentle soul), he eats well and still has no behavioural problems although his condition is worsening (inevitably). The biggest problem is falls - he should really call a nurse to go anywhere but he can't remember to use the call button, or actually why he should use it in the first place. When the emergency call button is clipped onto his clothes he simply takes it off and goes to the bathroom anyway. They check him frequently (hourly at night) and I feel they do the best they can to care for him. I understand that he cannot be watched 24 hours a day and that with elderly patients falling is unfortunately sometimes inevitable. They always call me if he has had a fall and reassure me he hasn't hurt himself (he only did once and they called a doctor straight away)

My real question after waffling on so much is what would the difference be in a specialist EMI home/unit? Would there be any difference that would benefit him? My only experience of care homes is the one where he is. The home have not said at any point that they cannot care for him but I wondered would there be any benefit at all in him being in an EMI home, if there is not significantly different care offered there?

 

[Christin]

Hello, I'm no expert at all, but in my opinion it does sound as though your dad is in a good place.

EMI stands for Elderly Mentally Infirm, not all residents present violent or disruptive behaviour, but in my own experience there was a certain amount of confusion, and noise. If your dad is settled, and you are happy with his care, I would let him be.

Very best wishes to you both. x

 

[Bristolbelle]

My opinion...

The place your Dad in sounds AMAZING and I would move heaven and earth to keep him there. He is happy you are happy they are happy. You seem to be anticipating difficult behaviour BUT if he were moved to a place with EMI care (which he may never need) you have to be aware some other clients in the EMI unit are almost certain to have behavioural difficulties and your dad could be vulnerable to any possible aggression etc form them. The falls will be inevitable wherever he is, and honestly it really does sound like the place he is at are on top of the game far more than the vast majority of places.
The very best of wishes to you both.

 

[kingmidas1962]

Thanks so much for your reassurance! We had quite a good feeling when we first took him there - it's like a lot of homes, a little ragged round the edges and has a funny smell but most importantly the staff really do seem to care. My mum unfortunately is in a psychiatric unit at the moment following a breakdown (the aftershock of caring for dad) and every time I go to visit dad they ask me how she is.

Unless we are requested to move him for any reason I hope he can stay there

You have pretty much confirmed what I believed so thanks very much for your comments

The place your Dad in sounds AMAZING and I would move heaven and earth to keep him there. He is happy you are happy they are happy. You seem to be anticipating difficult behaviour BUT if he were moved to a place with EMI care (which he may never need) you have to be aware some other clients in the EMI unit are almost certain to have behavioural difficulties and your dad could be vulnerable to any possible aggression etc form them. The falls will be inevitable wherever he is, and honestly it really does sound like the place he is at are on top of the game far more than the vast majority of places.
The very best of wishes to you both.

 

[ggma]

How nice to read that your dad is happy in the nursing home, I agree that I can not see what difference an EMI unit would make, unless there is one to one staff there will always be a chance he will stand up, and fall.

Does he have a frame to help him walk safely, we were all amazed that after falling and breaking her hip the physio's said Mum should have a frame, we thought given the advanced state of her dementia she would never remember to use it, but she does, it had to be constantly reinforced initially, now if you try to take it away she gets really upset, so it must be something she feels safer with. It has made a real difference.

The only other thing I can think is that if your Dad usually sits in the same chair, could they put an alarm pad on it, so if he stood up it would go off automatically? He could also have one beside the bed which would alert staff if he got out of bed in the night.

 

[Sean Keys]

I work in an EMI unit in our nursing home, and to be honest, with the way you have described your father, I would personally say to let him stay where he is settled.

I'm not sure if you have been to a home with and EMI unit, or seen the variation of dementia in there, but if your father is not showing much challenging or aggressive behaviour then truly there is no need for him to go to an EMI unit, where he could also fall, but alarm mats are a great job where tags aren't working.

I reckon as he is happy there, and the home are happy to have him there, the dementia/alzheimer's progression would be slower, as he is in a home with more able bodied and for want of a better word, more "mentally stable" residents..

But then, that is not medical fact, just my opinion from working in that environment.

 

[kingmidas1962]

thanks so much everyone.

He has a wheeled zimmer, which he does use - but his mobility is quite bad and sometimes he finds it hard to manoeuvre, which in itself makes him likely to topple - when he has to turn it round / go round corners he loses his balance - but only if he's trying to walk unaided. If he has a carer (or me! ) with him he usually does manage OK.

Its funny that a couple of you mention the behaviour of other residents in an EMI home - there was a lady along the corridor from dad who was waiting to be transferred to EMI, and she used to shout and swear, and come into people's rooms - dad really didn't like her and she frightened him. Its the only time I've ever seen him look really worried the whole time he's been there, so your comments about the variability of other residents behaviour in an EMI are really very valid.

The pressure mat is a great idea, I had heard of them and will ask the home when I go in if they have them - or could provide one. If not I'd be willing to stump up for it as really that would help significantly with his safety.

 

[kingmidas1962]

...oh, and aggressive would be the very last thing I would use to describe him! It is horrible to watch him decline - BUT - he is quiet, and peaceful, and never seems really distressed so even in the awful world of dementia I can say that I know things could be much worse.