Behavioural problems in nursing home.

[harvey]

Not sure if anyone can help with this.
My MIL had a fall in the nursing home a few weeks ago, she was taken to A&E at 6am [forgotten about and without pain relief]. After x-rays it was found to be a broken hip and we were advised she would be operated on the following day. We went to see her and although she was in pain, she had been given pain relief. One of nursing staff demanded to know who we were, what we were doing there and then told us in no uncertain terms that visiting hours were over! She then made us wait while she went to see 'what was going on' in the ward MIL was in. She then came back and snapped that we were allowed 10 minutes. The following day we were advised she would not now be operated on until the next day. When we rang the operation was scheduled for between 1 & 2pm. When we rang from 2.30pm and at 7pm [after 14 unanswered calls] we were told by the ward that she was still in surgery! When we asked why she was still in surgery after all that time her response was 'I don't know'! They also seemed annoyed that we should ask about MIL's condition. After all the hostile communications we had already had, we rang the nursing home to ask if they could try and find out how MIL was on our behalf. They were only too pleased to help us out and said they would ring as soon as they found anything out. At 10.40pm we had a call to say she was doing well. The hospital concerned does not seem to have a very good reputation and we were appalled at the treatment we received. If they treated us in that manner, how did they treat elderly patients?
The next day we went to visit MIL. I leant over her bed to say hello and she exploded with such venom, landing 4 hefty punches to my arm and screamed at me to get out. My husband then leant over and got the same treatment. We assumed that it was the effects of the morphine and turned to leave. The nurse who was caring for her said she had received the same treatment and that MIL had been throwing things at the nurses. She said that she had tried to get out of bed several times and that when she went in on one occasion MIL was on her knees on the floor in a dazed state and unresponsive. She must have climbed over the safety bars that they had attached to the bed. She had various blood/urine tests and a brain scan carried out which all came back negative.
When she returned to the nursing home they called in her own GP who was appalled at the state of her and didn't expect her to pull through. She is getting over the operation and is making progress as far as her hip is concerned.
The home rang us to say they were having problems with her as she was constantly screaming and yelling and they could not stop her. The GP attended and could find nothing physically wrong with her. This behaviour carries on night and day and is obviously disturbing the other patients.
We visited her today and the yelling was just awful, such a noise coming from such a frail 92 year old lady.
The care home staff have advised that if the behaviour does not stop, they may be forced to issue 28 days notice and we will have to find somewhere that can cope with her behaviour. This came as a huge shock, the staff are fantastic as are the facilities and MIL has been happy there.
Has anyone any idea of the process if they do issue us with notice to remove MIL?

Harvey

 

[jan.s]

I am sorry to hear what as ben happening o MIL.

The CH have the right to give notice, but are not permitted to make MIL homeless. My husband was given 14 days notice, during which time i researched other CHs in the area, but was advised that the original placement was regarded as his home, and they are not permitted to make a resident homeless.

Have you tried speaking with her mental health consultant?

 

[harvey]

Jan, we were so shell shocked that we didn't really ask anything. She has been assessed by the mental health team and they diagnosed her with Narcissism. That fits with her before dementia too. She always had to be the centre of attention and demanded everyone listen to her around the dinner table. No matter how many people were there we were never allowed to speak to whoever was seated next to us! She didn't take to any female and detested my daughter, we think because my FIL had a soft spot for her! She would create an argument and not speak to one or the other of us for years.
The team have it about right I think and even when anyone is sitting with her holding her hand she still screams 'nurse'. When they ask her why she is doing this she tells them she wants attention.
We will have to wait until after the bank holiday until we can try and obtain information. I am not sure what type of nursing home they will move her to, if they sort it or if we sort it. They say she may get over this behaviour in which case she can stay where she is. If not I am not sure what is required.

 

[ggma]

Has the nursing home asked G P about something to calm her agitation down, I am not in favour of drugs without trying other methods first but it seems to me that it might be a better option than having to move.

 

[HelenInBC]

This might seem like a simplistic response, but is she having pain? I would think a hip injury and surgery would cause significant pain. Perhaps she can't tell you?

My mom is in the moderate stages, and whenever she is ill she can't describe her symptoms. she just knows something is wrong, but can't say what it is. Even if I ask her ..do you have pain, nausea, dizziness? She just says "I don't know, but something isn't right"

 

[jan.s]

Hi there. I can understand why it came as a shock! Mine did too, but i found somewhere more suitable for my husband. I feel that dementia highlights any unfortunate traits!

My advice is to speak to the manager and seek advice on a way forward. It may possible to settle MIL with a low dose of respiridone, so it would bue worth involving the GP/consultant.

I hope things work out for you.

Jan

 

[harvey]

Hi
thanks for replies.

I am assured that MIL is not in pain, she is so frail and yet when she shouts it comes from her boots!
The GP has been again and has prescribed extra medication but I don't think it was the medication that the care home staff wanted him to give her. I think that GP's are reluctant to give these sedative drugs due to the stories in the media. Instead he has prescribed an anti depressant.
We have spoken to a mental health assessor over the weekend who also assured us that the home will not make her homeless.
For now it is just wait and see, just when you think all is going OK, we get another phone call bringing us down to earth with a bump!
Many thanks for advice and info.

H