'agression' when settling in to care home

[Twin H]

We have just moved my mother, 86yr old with vascular dementia, into a care home that specialises in dementia for two weeks respite care, on the general understanding that she will stay there if she settles and we are happy with the care.

She has been at the home for just four days and the carers have told us that she is settling in well but suffering from sundowning and hitting out a bit at the carers in the early evening. The carers have told us this is normal behaviour for new residents in the first weeks. While my mum has always been a gentle soul, we half expected this as she is in a place totally unfamiliar to her and she must be confused and frightened. My sister visited her today and she looked well and seemed happy. As my sister left however, the care home manager told her that we couldn't assume that my mum would stay after the two week period "because of her aggression". We are totally shocked, as we have been told this is normal for the settling in period, and it has only been four days. Surely it is too early to make judgements like this? My assumption is that it would take a month at least to settle in.

 

[Sarasa]

Hi @TwinH, and welcome to Dementia Talking Point. You'll find this a very friendly and supportive place.
My mother was always feisty, and her first weeks weeks in a care home were bumpy to say the least. I thought the home would say they couldn't keep her there on several occasions, specially when they mentioned she might need one to one care. However they kept on working out how to manage her behaviour and eventually mum settled.
I'd give it another week and then talk to the manager again. If they really can't meet her needs it is best to know early on, though your mother's behaviour doesn't sound out of the way for someone with dementia.

 

[Twin H]

Hi @TwinH, and welcome to Dementia Talking Point. You'll find this a very friendly and supportive place.
My mother was always feisty, and her first weeks weeks in a care home were bumpy to say the least. I thought the home would say they couldn't keep her there on several occasions, specially when they mentioned she might need one to one care. However they kept on working out how to manage her behaviour and eventually mum settled.
I'd give it another week and then talk to the manager again. If they really can't meet her needs it is best to know early on, though your mother's behaviour doesn't sound out of the way for someone with dementia.

Thank you so much for the welcome. This forum has been a godsend for us over the past months. And thank you for the reassurance. We'll ask for a meeting towards the end of the two week period. I just feel it is too early for the home to make decisions when my mother hasn't had a proper chance to settle in.

 

[northumbrian_k]

Hi @Twin H , when my wife first showed some aggression after a calm initial period I was concerned that she would not be allowed to stay. A senior carer said that this would never happen because the staff in the care home had seen this many times and had strategies to deal with it. I was reassured that this was the right place for her. 2 years on she is calm, loved and happy.

If your mother's home is sounding doubtful then it is best to know this now so that you can consider finding somewhere that better suits and can meet her needs. It will be worth keeping in touch with manager. Hopefully this aggressive period will pass as your mother starts to settle. It is still very early days.

 

[Twin H]

Hi @Twin H , when my wife first showed some aggression after a calm initial period I was concerned that she would not be allowed to stay. A senior carer said that this would never happen because the staff in the care home had seen this many times and had strategies to deal with it. I was reassured that this was the right place for her. 2 years on she is calm, loved and happy.

If your mother's home is sounding doubtful then it is best to know this now so that you can consider finding somewhere that better suits and can meet her needs. It will be worth keeping in touch with manager. Hopefully this aggressive period will pass as your mother starts to settle. It is still very early days.

Thank you @northumbrian_k i hadn't thought to ask what strategies they might use in these first few days. I'm so glad your wife is in the right place and is happy. Thank you for your reassurance.

 

[Thethirdmrsc]

Hi, can I ask on this thread what did you say to your PWD to get them into the home? My OH goes into respite for 2 weeks on Saturday. I don’t know whether to tell him on the actual morning, or just take him.

 

[Twin H]

@Thethirdmrsc We told my mother that my father (who was the primary carer for my mother) has to have his hip done (this is true) and is too poorly to care for her properly, and that my sister and I had to go back to work and so the lovely people at the home would be looking after her for a bit. We told her the day that we took her in, mentioning it every now and then through the morning, being very smiley (she tends to mirror emotion). She accepted it really well. I wish you much luck with your OH, I hope it goes as well as can be.

 

[Twin H]

An update .. my mother has not settled in the care home, getting upset and cross when she has personal care and hitting out at the carers. Her mobility has deteriorated in the three weeks she has been at the home to the point that she needs a wheelchair, and she is not eating much at all.

The care home have told us today that they cannot accept my mother as a permanent resident because of her 'behaviour'. I am in shock. Various carers there over the past weeks have told us that this is fairly normal behaviour for new residents who are used to being cared for at home and suddenly find themselves in a new and bewildering environment (never mind the fact she is still recovering from having covid and a debilitating UTI). It feels very much like the care home just does not want to have to deal with my mother.

I had some doubts about this care home because they did not seem to want to talk about strategies for helping mum settle in, and talked about her 'aggression' like it wasn't a symptom of the dementia and her new situation. We have three care homes to see this weekend, and I pray one of them will be able to take my lovely mum.

 

[jennifer1967]

make sure you ask the question of what they wont accept so that you dont move your mum in then they say they cant cope. some carehomes just like the easier ones at earlier stages. see if its a home specializing in dementia and not just residential. its better to find out now then move her to one that is more suited to her where your mum can remain long term. three weeks is not long for settling

 

[Twin H]

@jennifer1967 thank you very much for your advice, yes we will be very open about how she has been over the past weeks. All three homes specialise in dementia (like the one she is in currently!) and i hope at least one has experience of new residents not settling. And yes, i didnt think three weeks was a long time.

Mum had never had personal care from someone who wasn't family, and she'd only been wearing incontinence pants during the daytime for a week before she went into the care home, so there was so much for her to have to deal with without our regular support due to visiting restrictions.

 

[Sarasa]

Sorry that home didn't work out @TwinH. Your poor mum, she wasn't well to start with so moving into the home probably totally threw her. Although it isn't what you want it's best to move her now rather than hoping things will improve. Yes do be open with the homes. I explained to the home that mum was in during the assessment process exactly how volatile she could be, but it was touch and go the first few weeks as to whether they would let her stay. Mum improved when she moved floors. Just the change of scene, different residents and different carers seemed to help her settle. Hopefully a new home will do the same for your mum.

 

[Twin H]

thank you @Sarasa that is reassuring.

 

[Fox53]

Hi everyone. My mum is 90 and has lived with me for the past 25 years and my husband and I built a granny flat on our property for her. About 10 years ago she was diagnosed with Dementia and I have looked after her ever since. As well as dementia she has really bad arthritis to the point where she could hardly walk. Over a period of around 5weeks she had 3 falls the most recent the doctor advised that she go to hospital to be checked out. After two days in hospital they told me that she needed 24 hour a day care and since that is impossible for me I looked around for a reputable care home in our area. I found a beautiful place with really nice and caring staff and booked her in for 4 weeks respite.
My mum has not taken well to this and each time I went into visit has bombarded me with "I want to go home", "why am I here", "what have I done", "don't you want me anymore", "why don't you just take me out and shoot me".... it has been a nightmare to the point where I was so stressed that I thought I would have a breakdown. Luckily for me, because it is covid, my brother is not working so he stepped up to the plate and has gone into visit my mum everyday for the first three weeks.
When she lived with me I lived my life around her, going over in the morning to give her medication, then again 11/2 hours later to give her breakfast and get her up... and so on lunch, morning tea, afternoon tea, dinner, and bedtime, medication.... so on every day. Increasingly I had no time for myself, and my mum thought she was doing everything herself even although she was doing nothing.. so to be told she would need 24 hour care was just impossible for me. I am home schooling my grandchildren and have a husband who has been absolutely amazing at the things we have had to forego to make her life happier. I was not willing to go and live with her in her unit.
Since entering the home she has constantly being asking all the staff and everyone who will listen to go home. She has told me herself that she has been a "bitch", to the staff (who are really lovely) her words, nasty to the staff and calling out for "HELP" during the day and night when she is left on her own. The home are amazing and trying all different ways to deal with her behaviour but I always knew it would be hard, and I tried my best to keep her in her own home as long as I could... but I didn't realise it would be this hard.
I don't feel guilty about her going in there as I know in my heart I done everything I could possibly do to make her life happy, but I feel very stressed and miserable to see her looking so unhappy and the fear in her eyes as she asks me "am I never going home".
Can anyone help me with how I should deal with these questions. My brother is fine, he hardly seen my mum before she entered the home so much so that she asked me if he was her brother. He has all the answers and tells me just to deflect the questions which is easy for him as she doesn't relate him to home but I have looked after her one on one more and more over the last 10 years to the point where she basically only got up to go to the toilet by herself and got help with everything else. So when she sees me she wants home and no matter what I say or try to deflect it comes back to that.


.

 

[Thethirdmrsc]

Goodness me, @Fox53 cut yourself a lot of slack. You have done an excellent job, above and beyond. My OH went into 2 weeks respite recently, and not one person said how awful I was for doing that. Everyone said that if you don’t look after yourself, then who will look after the PWD? But my goodness the guilt I had, I cried for the first week, and slept the second. I think everyone will say that it’s natural to feel that, and I think because you have been there for her and done everything, it’s like an early grieving for you.

 

[Bunpoots]

Welcome to DTP @Fox53

When my dad went into a carehome if he asked when he was going home I'd just say "soon" or "when the decorating is finished / shower mended" or whatever popped into my head at the time. It would satisfy him in the moment and eventually he stopped asking.

Others have blamed the doctor or said their PWD was there for convalescence - whatever seems most acceptable.

 

[Marler19]

Hi @Fox53 - my mum has been a bit similar; she gets on to a roll with asking about going home and has been phoning a lot, but the home say that when she’s there she is calm and says she likes it there! For me the last 4 weeks have been a rollercoaster of guilt and sadness but sometimes I have the certain knowledge we have done the right thing too! The hardest thing for the carer (me!) is to realise you have to hand the person over. My mother wasn’t at all happy at home except when my sister and I were there, said she was lonely, saw nobody, didn’t eat and was the victim of crime etc etc, but now that’s all forgotten and ‘home’ is a theoretical wonderful place. I just say ‘when the doctors say’ ‘when you’re really stronger’ etc etc. Then yesterday she told me she’d be happy to stay till February! Sometimes I think we ALL still try to make logical sense of the Alzheimer’s mind. Not worth doing!!! All the best - you’ve done the right thing!!