Care Homes

[Taffy]

To-day, when I visited mum I noticed the side rail was up on her bed so I inquired if there was a reason for this. I was told that she was found in the early hours of yesterday morning on the floor and it appeared that she had fallen out of bed. I only visit every second day and wouldn't of been told at all, unless I had inquired. Mum is mobile and my question is; Shouldn't the home notify me if mum has had a fall? Mum didn't appear to be injured she was conscious of her shoulder but has been ever since she injured it a few weeks back in another fall. It's so hard because mum is so baffled most of the time and today in particular she was so delusional. Regards Taffy.

 

[jenniferpa]

Hi Taffy

Well I would want to be told, yes. On the other hand, sometimes I have found, there comes into play the desire to "not worry you unnecessarily". And. I think from talking to care workers, there are at least some families who don't want to be told about such things: they can't do anything about them so they'd rather not know. I think a lot depends on how well the home knows you.

 

[Brucie]

Hi Taffy

I made a point of speaking to the manager and staff separately and saying that I wanted to be told - any time, day or night - of any 'incidents' involving my Jan.

They have done this whenever necessary, though whether they would have done so had I not asked is uncertain.

key point #1 with care homes: try and establish as close a relationship as possible with management and staff and medical staff who are retained [GP].
Sometimes that is not a possibility, but it sure oils the works if it can be managed.

 

[connie]

Hello Taffy, think Bruce and Jennifer both make the point that it depends on how well the care home knows you, and what you want to be told.

I realise it is so hard to walk into these situations. Do hope mum will be somewhat brighter next time you visit. Take care,

 

[Cate]

Hi Taffy

I have a very good relationship with all the care staff at mums home, and they know I want to hear about any incidents involving mum, however small. They are so good, they start every conversation with "Hi Cate.....nothing to worry about but......"

I always make a point of saying hello to everyone when I visit, and especially popping into the office just to enquire how mum has been, and how are they, and to say thank you for all their kindness to mum. They do a tough job, and I think they get very little thanks.

 

[Taffy]

Thank you, to all for your replies, I agree that it is healthy and in every body's interest to share a good relationship with the staff. I am on friendly terms with all the care attendants and most I find are very caring and warm. I also share many smiles and conversations with the other residents who by now are very familiar with me. To-day I went again to visit mum as yesterday I was concerned with her mental state. To-day mum was much better, some of you may be aware from my post about the care mum received after she had the fall and injured her shoulder and bruised her leg that I wasn't at all pleased with the RN and I didn't know if I should complain or not about the whole affair along with this issue I have always had a issue about mum's personal care, her needs were simply not been meet even though I had addressed this many times with the care attendants. Boy, you must be thinking I am a real complainer but honestly I have been to tolerant and actually feel that I have let mum down. To-day's events were the last straw enough was enough and I went to the welfare officer I was hampered before about doing this as my dad and sister were worried about me making a formal complaint because mum wouldn't be able to express any retribution and my gut feeling was to do it and my heart fell towards mum. So, as things stand my cards were laid on the table with the welfare officer and I will be signing a formal complaint next Monday and will then received a written explanation from the manager. On a good note the welfare officer has phoned me already and she has been in touch with the RN and she (RN) has organized a care plan for mum effective of to-day. Fingers crossed this all gets sorted out as I'm at my wits end. Regards Taffy.

 

[Cate]

Good for you Taffy, if we cannot speak out for our loved ones, who can.

Flipping hec, they are only now doing a care plan, shame on them, this should have been in place from day one.

Hope you get somewhere and quickly.

Love

Cate

 

[Brucie]

she has been in touch with the RN and she (RN) has organized a care plan for mum effective of to-day

I'd be thinking there was a care plan in place before, just that a new *improved* one has now been instituted to meet the needs now identified.

At Jan's home the care plan for her is regularly reviewed and amended as necessary.

Well done for taking such care over these critical things.

 

[Margaret W]

I'm very interested in this case, it could happen to my mum, and I'd be keen to know how to handle it.

But aren't our parents lucky to have us?

Love

Margaret

 

[Nell]

Dear Taffy,
As you can imagine, I have been following your thread with great apprehension. (For those of you who don't know, Taffy's Mum and my Mum are in the same wing of the same care home. We never knew each other till we "met" on TP!!).

I feel guilty because my Mum is not as vulnerable as your dear Mum and is receiving good care for her present needs. Your posts have made me very aware that I will have to be constantly vigilant though.

I think it is a good idea to go with a formal complant - it may resolve some of the ongoing issues if they realise you mean what you say. We (my sisters and I) met with the Manager and the Welfare Officer to complain about a lapse in Dad's treatment. We were very unhappy that he wasn't properly monitored on his Warfarin and ended up in hospital. The Home tried to blame the doctor, so we "allowed" them to do this as we felt it gave them an "out" - though one they didn't really deserve!! We did this because, like you and your family, we were concerned about any possible repercussions on our parents if we "backed them into a corner" (so to speak).

On the positive side, it did result in better care for Dad and we felt they took more notice of us in the future if we had anything to say.

Is there anyone who could accompany you if they want a formal meeting with you? I found it all quite stressful and was SO glad to have my sisters there for support.

I'm thinking of you all the time and hoping that things are going better for your dear Mum - and hence for you. How is your Dad progressing? You said previously he was making progress but it was slow - this is a curse of old age too, isn't it? Healing is such a long slow process as we get older.

Every best wish as always.

 

[Taffy]

Hi Cate Bruce and Margaret,
Thank you for the support. I'm not sure if a care plan was in place as it was never discussed with me, maybe it is only discussed with the carers. When I discussed placement for mum I was very specific about mum's personal care needs as this was a problem before placement. I was assured these needs would be meet, all I'm talking is basic care...someone to supervisor her with her showering and then to make sure she has clean underwear and clothes on. Mum is still capable with toileting, but, very confused with the pull ups she thinks they are undies and washes them and the worst part is, if she doesn't feel like washing they just go in the wardrobe and as you can imagine the SMELL! I took the pull ups away (these were requested by the home) and brought the poise pads which mum is familiar with, now I have been asked to return the pull ups (I supply them) as that's what they like to use and I have no problem with that as long as mum is supervised with them. Laundry is done at the home but mum has no understanding of this. The home has many good points the residents seem very contented the activity carers are fantastic with the residents and the carers themselves, I mostly find caring and warm towards the residents. Things have to drastically improve or I cannot see a future for mum there. Mum has identified with the place and settled very well now, she is always eager to go back if I take her out anywhere. The last thing I want is to traumatise her with another move. I entered this contract all in good faith and my expectation have never been unfair ones. Regards Taffy.

 

[Grannie G]

Dear Taffy,

I think you are handling all the anxieties you have about your mother`s care so well.

You must let the home know when you are concerned about aspects of her care, but if you do it in a non confrontational manner, you can get your message accross without raising hackles and that`s what you seem to be doing.

When I had concerns about my mother`s care and wanted to bring it to the attention of the home, I remember breaking into a cold sweat, in case I said the wrong thing. So I really admire the way you`re handling this.

Love xx

 

[Taffy]

Hi Nell,
Thank you for your reply and support. I hear what you are saying about giving management an out. If a meeting is requested I can ask hubby to come and I know I will get to emotional, especially, as they will be discussing the treatment mum received after her fall. The down side to hubby is, although he is very fair he wont take their tripe...he calls a spade a spade and not a shovel. He was present when I was assured her personal needs would be meet and the welfare officer even went as far as saying; that was mum's rights.

Having your mum in the same home I know would be of some concern, at present your mum can still manage and you and your sisters visit very regular and the home has a history there, so I am sure and hope you never have to go through this. This home has such great potential if only the establishment could see past PROFITS...no one expects them to run at a lost....this home is church run...christian founded....where is the compassion for the carers and residents.

Thanks for enquiring about dad, he had another slight heart attack and his kidneys continue to deteriorate the GP is monitoring him well and they are keeping him very comfortable with a lot of medications. He is still managing at home. Thanks for your kind thoughts. Taffy.

 

[Cate]

Hi Taffy

It might to help you to have some information on how mums care home does things, so that you have something to compare with.

When mum first went into the NH nearly a year ago now, the first care plan was completed by the senior nurse with me. We listed all mums likes and dislikes when it came to food, going to bed, getting up, in fact ever bit of her normal routine, her then very challenging behaviour and aggression. They also asked me to write out some family history, all about my dad, things she enjoyed doing, things she didnt enjoy doing, so that they could talk to her without asking her loads of questions, which they felt she might find intrusive at the time, without first 'knowing them'. They felt the further back I could go the better, as this was where mums memory is best.

They still have awful problems getting mum to change her clothes, so rather than cause her distress, which it does, this is left to me, which is fine, having said that, if they find her receptive, they do it then. With regard to her washing, again showers and baths she is terrified, so they help her to wash as and when she is in the mood, and keep a crafty check when she says she is doing it herself.

The care plan is updated with me at a formal meeting every 3 months. However it is updated also as and when things crop up, either by my instigation or the staff.

At every change over of shift, each care plan updates and days events is shared with the oncoming staff members. They see good communication between staff, residents and family as very key.

Anything that they are concerned about, or mum is worried about, or any changes at all, they are on the phone to me.

I feel they know my mum very well indeed, when I visit, or telephone to ask how mum is, they usually tell me some little bit of information which demonstrates to me they are on the ball, even little things like, "she had 3 cups of tea with her lunch today", or "Betty has been talking to me today about your dad, she was saying .....". All this makes me feel very secure, its my safety blanket that all is well, and if it isn't I know they will phone me immediately.

What confirms to be that mum is 100%, when I leave now she either dismisses me, e.g. time you went home now, or stands by the door smiling and waving. I couldnt ask for better. Initially we had to use diversion tactics, those days have gone.

Taffy I hope you get things sorted out to your satisfaction, after all the reason your mum is in a NH is to ensure her needs are met 24/7 and you can sleep at night knowing everything with mum is as it should be.

Keep us posted.

Love

Cate

 

[Grannie G]

Dear Cate,

It`s such a pleasure to read how totally secure you feel about the care your mother receives in her care home.

I remember how traumatic it was for you in the past and am so pleased it`s all worked out so well.

To leave your mother smiling and waving good bye, is what everyone would want for theirs.

Love xx

 

[jenniferpa]

I would agree: what Cate describes sounds absolutely ideal. I was thinking back about this, and although I had complete confidence that I would be informed about anything major (and I call falling major) because I was (sometimes in the middle of the night - some of the carers never seemed to work out the time difference, but that was fine) I don't think I was kept as well informed about the minutiae as I might have been, and as I would have liked. Now to be fair to all concerned, Mummy was placed in the Nursing home on a fairly emergency basis and she wasn't there that long (4 months). This lack of communication was something I was going to address the next time I was over, but it wasn't to be. There were certain people who I could contact who were more on the ball about such things, but generally I didn't think as much information was as forthcoming as might have been.

If I was doing it again, I would write out a list of my expectations and get them to sign off on it. As to the repercussion issue: I did feel that home in general was able to seperate me from my mother, but if I hadn't, I don't think I could have left her there. A lot of that is to do with the way a given home is run: in Mummy's case there were way too many people in and around the place, and too many open doors to make repercussions likely. Also, of course, Mummy needed 2 members of staff to do most things for her, and I think (I hope) that cuts down on the likelihood of such happenings.

Edited to add: Another thing that I think helps if you have to complain about things is to couch the complaint as directed towards procedures rather than individuals - even if the person in question was directly responsible for drawing up such procedures, it gives them a face-saving "out".

 

[Taffy]

Hi Sylvia,
Thank you for your support I have been trying very patiently for some one to take me seriously, hopefully things will improve. Regards Taffy.

 

[Taffy]

Dear Cate,
I appreciated the information you posted. When I placed mum I was given a questionnaire to fill out about mum's past such as hobbies siblings etc. nothing of the likes you spoke of. The RN spoke to me about mum's medication which was one anti-depressant daily taken at night, she wanted this changed to mornings which was fine by me. Then it came to the antibiotic mum was on for repeated UTI's mum would take one only a day, these were rotated with two other different antibiotics one coarse followed by another and this treatment was working very well anyway the RN said this would be stopped as the DR there would not be in favour of this, also added the UTI's were more than likely caused by poor hygiene and that would be addressed now she was been placed. I know the likelihood of UTI's is usually poor hygiene, but what a joke! The staff assure me mum is compliant with them but the RN has to put a care plan up on the computer for her to be on the shower list. After months of getting nowhere the care attendant tells me this two days ago. I think they didn't want another on the already over worked roster. So I thank you again because if the need arises to look into another home I'll be prepared. Regards Taffy.

 

[Taffy]

Dear Jennifer,
When I spoke to the Welfare Officer it was to do with hygiene matters and the fact that the stitches had not been taken out of mum's leg they were to be removed in seven days and they were still there on the eleventh day. I had already reminded them. When she brought mum's file up she mentioned the previous fall which mum needed hospital treatment for and she commented that she new nothing about that so I told her what had happened hence, a formal report now has to be lodged because I had raised the issue and it been one that could not go unreported. I didn't ask about their policy on notifying about falls as she was clearly horrified about the previous fall. I just have to see what happens from now. Regards Taffy.

 

[panda]

Hi Taffy
sorry to hear you have been having problems, our Mum's went into homes at the same time, it seems that your Mum has settled better than mine. My mum wants to know where I am taking her when I do not drive in the direction of her old house. My mums home will ring me if she has seen the dentist or things like that. They deffinatly ring me when she has jumped the fence again,(unless I find out before them!!!) I think if they have time or it is an emergency they ring. I think for myself i do not want to know every little thing it only gives me more to worry or feel guilty about. As for the washing thing I thought Mum was hiding dirty things in her wardrobe and spent every visit trying to look if she went for a cup of tea or to the loo, It was the home that in a very nice way told me it was mum that was smelly and not her room but then they explained how they intended to deal with this problem. I think they do a great job but at times they are human and get it wrong. People like you can only help these situations you are willing to speak up for your Mum,and sometimes they need to be reminded and are probably gratefull for this as it is easy to get stuck in bad habits when you work somewhere for a long time. I hope you understand what I am trying to say.