Assessment bed in care home

[Hellebore88]

hello everyone, looking some advice please. My mum was admitted to hospital 3 weeks ago due to a bang on her head and strange behaviour a few days after - hallucinations, confusion, refusal to sleep etc. has wandered a little in the past. previously she had been referred to memory clinic. Ct scan at hospital revealed what looks like dementia. They now think she has lewey body dementia and we are awaiting a datscan and formal diagnosis. On the day of admission lots of questions were asked and social worker sat me down like it was an intervention and they told me she should be in full time care.

Sorry this is long.

So week 1 in hospital she was extremely confused. People could talk about dementia in front of her and she didnt notice. Week 2 she started getting much better and i requested we look into a care package at home (she lives in an annex not connected to my house). We had got a care package confirmed ( 3 carers and blister pack for medication as she had been double dosing heart meds) etc then she the day or 2 she was going to be discharged she decided to try to escape the hospital and had to be sedated. Told me a very wild story about what had happened. Social worker etc took it very seriously for a day or so. I explained i was obviously rethinking her coming home. They did a capacity test and she failed. They did it a few times til she passed then said cause she passed she can come home if she wants to which she does.

she still seemed extremely confused and unable to retain any info and the social worker continued to push for her to come home. Told me i can sedate her next time she gets agitated (i said no multiple times) social worker asked can i work from home more, can my partner work from home more etc. can we make sure she is supervised as much as possible etc. the months before she went to hospital has been hell. Constant phone calls, constant fights, not recognising me etc. hallucinations, its been v bad. So i put my foot down and said she can come home but it is your responsibility not mine. I cannot be a carer. I work full time and am out of the house 11 hours a day. So they now say she has fluctuating capacity.


Still very long. So they proceed to find a assessment bed in a care home. Had to be an emi bed as she occasionally wanders. It is only day 2 but it is awful. I was on the phone with her and all you can hear is screaming and doors slamming. One woman got agressive with her, screamed in her face and went to strike her (according to my mum, which i believe) my mum is having her better sets of days at the mo in terms on confusion. So she is fully aware of the other patients. The way the care home was described to me was that she would have so much company. There would be activities and we could spend quality time together as all the mundane tasks would be taken care off. This is more like a jail. It is a highly secure site with advanced stage dementia patients. I spoke with the staff and they said she doesnt fit in and will probably be quite lonely.

Does any one have any advice?

If this is where she is going to be cause she wanders i would rather she took her chances at home, it is like a horror institution. How long do these assessments take? Does it sound like she needs care?

Many thanks for reading

 

[amIinthewrong?]

Well here is what I get from what you have put they had to assess your mother multiple times in order for her to pass it which does not sound good, she is wandering you are not going to be able to keep an eye on her 24/7 from what I have read your job will be taking a hit if you bring her to your home, the social workers say she needs full time care, if she lives with you I can guarantee you will be driven mad in a few weeks because you will be stuck at home all day and you will feel trapped, let her get settled into where she is at, heres something from my experience my mum is in hospital from a stroke another patient is in there too I visted and that other patient was screaming help for more hours than I can count the nurses help her and she was still screaming and also agruing with patients telling them to shut up when they weren't saying a word why I mention that is because that is what can happen when people have this condition,You said you work 11 hours a day do you really think in you're heart of hearts that you will have the energy to keep up with your mother's care when social services have said she needs to be in full time care, I know you want the best for her and that is to let her get accustomed to where she is now, you need to think how it would affect you if you keep her at home with you I personally don't think it would end well. I'm sorry this is happening to you and that this is difficult decision to make💐💐

 

[Sonya1]

...if she is in an assessment bed, which is the norm after a hospital stay, then this is highly unlikely to be where she would remain should she go into full time care - it is usually for a maximum period of 6 weeks, or as long as is needed for a full assessment of her needs to be carried out. Normalyy there are multiple agencies involved - physios, speech & language, mental health assessors and so on. I would maybe, after another week or so, request an update on their thoughts as to the type of care your Mum may need. Then perhaps start looking around yourselves at potentially suitable placements. When my Dad was in an assessment bed - after 5 weeks, in his case, they popped him onto a database where he was effectively looked at by (in his case) nursing homes, who then have the opportunity to respond and say whether they can meet the needs, whether they have space, etc - and to quote their costs. We were able to have a say in the final choice and were very glad at this point that we had looked at a few in advance of this. It is a difficult position to be in - but if a SW is involved, they should be guiding you through this process. Hugs to you

 

[DeeCee7]

Hello @Hellebore88 . I am sorry to read of your gruelling experience with your Mum. She clearly needs specialist care, but in the right place. And that’s not with you, for multiple reasons, as you have written.
In my experience, SS were totally focused on sending our PWD home, suggesting all sorts of ways we could spend our lives doing this. The process went on for weeks, probably due to their overstretched department, and he was in his assessment bed at the care home for 12 weeks, until our meeting where I read a 8 page statement of why we were withdrawing our care support and what they would have to put in place to cover 24 hour care at home. Eventually they agreed, and he remains in care. The care home he was sent to, is in fact a lovely home. We researched many, and visited 6, and couldn’t find anything better for him. He was also by now settled, so although it’s very expensive as a self-funder, it was in his best interest to stay there.
Unfortunately it sounds like your Mum isn’t in the right care home at the moment, but there will be one out there. Whilst she’s in her temporary placement, start the search now so you can locate her next move. Good luck with it all.

 

[Hellebore88]

Hello, thank you so much for the replies. It just seems to be getting worse. Another patient was in her room today pulling her clothes out of her drawers and went to hit her. Last night the same patient went into her room my mum told her to leave and she got slapped across the face.

Staff have told me to speak to the manager in the morning as there isnt one during the weekend. Staff have also told me they dont know why she is here as it is not an assessment centre and they have no staff on site to assess.
My mum has high bp and a very small
Woman so i am extremely worried. Phoned an emergency social worker and they said to phone another department when they open tomorrow. Also said i could just take her home. I am worried about that as there is no care package in place etc. bringing her home i feel will make it so much more difficult to get her assessed anywhere

Ugh no idea what to do. Feel like she has been totally failed by the hospital social worker

 

[DeeCee7]

Oh dear, sorry to hear that things are getting even worse. You are right to be concerned about bringing your Mum home, firstly you cannot look after her as you are working long hours and she needs specialist care anyway, and secondly that neatly means you remove their responsibility, and she’s basically “out of sight, out of mind”. . And everything is always worse at weekends! Tomorrow you will be able to find out why she’s been placed there, and who will be assessing her. It sounds like you will have to be firm and advocate on behalf of your mum in the strongest terms. Stay strong.

 

[Hellebore88]

Oh dear, sorry to hear that things are getting even worse. You are right to be concerned about bringing your Mum home, firstly you cannot look after her as you are working long hours and she needs specialist care anyway, and secondly that neatly means you remove their responsibility, and she’s basically “out of sight, out of mind”. . And everything is always worse at weekends! Tomorrow you will be able to find out why she’s been placed there, and who will be assessing her. It sounds like you will have to be firm and advocate on behalf of your mum in the strongest terms. Stay strong.

Hello thank you for the reply. Yes i think they want her out of sight out of mind. She now has a new social worker who thinks we should try her at home. They have suggested a carer 4 times per day. The current care home manager also thinks she should go home with a care package. She said they can also assess at home. However a vacancy has came up at a care home that sounds like they will take her. All the professionals are keen to send her home. Friends and family think it is a bad idea. What if following assessment that care home thinks she should go home too?

The downside of this care home is the top up fees are steep which isn’t sustainable long term
Thanks

 

[DeeCee7]

I had to fight the battle of getting my PWD into his care home, as I didn’t have a LPA for health, even with him being a self-funder. SS seemed hell bent on sending him home with carers 4x daily. That seems to be the line they are told to take. However, like you, we were already doing the caring role, but unofficially. I even had a working SW tell me, they are told to lean very heavily on friends and family. This all started because they were reluctant to agree a DoLS , which I wrote about extensively on the forum. As your mum wanders, apart from anything else you have chronicled, she needs 24 hour care.
I would go for the care home you have found for initial assessment. I really don’t think, from what you have written, they will think her able to live at home.
I can’t advise about top up fees as I haven’t any experience of this, all I know is about the £23,000 odd limit.
You have much to think about, and decide. I hope others pop onto this thread to offer advice too! You are doing the best you can for your mum, it’s the living example of being between a rock and a hard place. Deep breaths and carry on!

 

[amIinthewrong?]

Sorry I must have read it wrong because my brain said you were working at home for 11 hours a day and what was actually put was that you are at work outside of the house 11 hours a day, I think that if you find a care home that will take her and then when the self funding runs out the government has to provide the funds afterwards but I can't guarantee that she might not have to be moved to a different care home for it to fit with the funds that would be provided, I don't know why they think you would be able to look after her at home when you literally are not home for about 77 hours a week working when do they expect you to have a rest? I'm sorry that this happening💐💐

 

[DeeCee7]

Also, have you thought of phoning the helpline on here for advice?

 

[helpingpeggy]

@Hellebore88 just a thought: your mum has been moved into an EMI home which is where people with more advanced dementia and challenging behaviour tend to be placed. It sounds very much as though her needs could be met in a “care home”..the wandering that you mention is normal for people with dementia and most care homes can manage with that. I think your priority should be to find a care home able to meet her needs (not an EMI home). You could do this privately or get the social worker involved. I’d stress to the social worker that your mum is at risk of harm from other residents at the emi home. Hope that helps.

 

[canary]

It sounds very much as though her needs could be met in a “care home”..the wandering that you mention is normal for people with dementia and most care homes can manage with that.

You are right that wandering is normal for people with dementia, but non-secure care homes do not usually accept people who wander and if they start the care home will usually give notice.

My mum started wandering and had to move to a secure care home. It was an EMI home, but it wasnt like the one that @Hellebore88 s mum is in. That EMI home does not sound well run and seems to me to be short staffed. The one mum was in had people with advanced dementia and people with challenging behaviour, but the staff knew how to deal with it and would intervene before the behaviour escalated. Mum was happy there and I have good memories from that time.

Care homes - even EMI homes - are not all the same and I would recommend looking around at other homes, but not discounting EMI homes. I would also suggest visiting at different times during the day as they can seem very different at different times: - mornings are usually bright and busy with activities and the residents are often at their best, afternoons are when many of the residents are having naps so it seems very quiet and evenings are when most of the dementia residents are sundowning and it can be a bit chaotic.