Can eat, but now needs food held to mouth on spoon, what help can care home give?

Discussion in 'I care for a person with dementia' started by sueorbell, Dec 27, 2015.

  1. sueorbell

    sueorbell Registered User

    Mar 15, 2010
    92
    California, USA
    I have been a member since 2010, joined because Mum entered EMI Nursing at that time.

    yself and my sister are joint carers, however we live in France and the USA, and only get to see Mum every 2 to 3 months. We also call 3/4 times weekly so she hears a voice that loves her.

    Latest issue for us is weight loss. In November last year we noticed it, home also confirmed it was happening, said they would put "eating plan" in place. They told us the entertainment coordinator (who has a good relationship with Mum) would be helping her eat.

    My sister is home with Mum now, and feels she is still loosing weight. Asked for her chart, and no weight recorded since November. When my sister sits with Mum for 20 minutes and presents spoon Mum will eat a reasonable amount. However is it reasonable to expect the home to provide this level of service to one resident? Everyone seems so busy, and they have to feed bed bound, those who cannot sit straight etc.

    Any thoughts will be much appreciated. My sister has a meeting with nurse in charge of Mum's ward tomorrow.

    What are reasonable expectations for us to have of the home with regard to helping her eat.

    Sue
     
  2. Spamar

    Spamar Registered User

    Oct 5, 2013
    6,992
    Suffolk
    Hi, all I can say is that OH was helped to eat, on a one to one basis for a couple of months before he died. If I was there, I would do it, but otherwise a nurse or care assistant would help him. So it is possible.
     
  3. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    Reasonable expectations are that the Home provides whatever support is necessary to ensure the well being of the person they are caring for. It is not acceptable that they are not feeding her and that she is losing weight because she is not able to feed herself for whatever reason. Your Mum must be hungry. It is not acceptable standards at all.
    It is also not acceptable that they have not recorded her weight since November. The Care Quality Commission would be horrified - there is an obligation for CHs so keep careful and accurate records
    The adult social care team would also consider this to be a safeguarding issue
    You can report to both and this would alert the authorities to the fact that the home is failing in its duty to residents. I can post details later if you want them.
     
  4. nitram

    nitram Registered User

    Apr 6, 2011
    19,262
    Male
    North Manchester
    I agree that anybody who requires assistance in feeding should be given that assistance, I also think that 20 minutes is a relatively short time to feed a person, my wife took at least an hour.

    I agree that weight should be monitored and recorded.
     
  5. sueorbell

    sueorbell Registered User

    Mar 15, 2010
    92
    California, USA
    Help with eating...

    Thanks for your replies. I am in the USA, but Mum is in a Care Home in Chester UK. Would you raise this sort of issue with Unit Nurse, or go the the Care Home Manager?

    Also I feel that we should have documented efforts to address the matter with the care home before going to outside regulatory agencies.

    What do you think?

    Sue
     
  6. canary

    canary Registered User

    Feb 25, 2014
    10,786
    Female
    South coast
    I would raise this with the CH Manager. It sounds like her care plan should be updated.
     
  7. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    I would go directly to the care home manager with a list of questions in writing including
    why is her weight not documented on a weekly basis at the very least

    I think this is quite worrying but I'm guessing that you find other standards in the home good?
     
  8. southlucia

    southlucia Registered User

    Dec 19, 2011
    166
    Annoyingly, I had a bit of a fight on my hands when I noticed that my dad was struggling to eat by himself. He no longer understood what he had to do, so would get quite agitated. This meant he wasn't eating very much. They claimed that feeding him would remove his independence (?) He had been losing weight quite rapidly. This was six or so months ago, and although he's since fed by a carer at each meal, his weight is still declining, although not as fast. They put him on a high calorie diet. Full fat everything...
    Sadly, weight loss is a part of this awful disease. That said, it's so important that your mum is given the help and encouragement to eat what she is able to.
    They should be taking a note of your mum's weight at least monthly. This should be an essential part of her care plan.
    Do ask them what this 'eating plan' entails. The home must provide a carer to sit with and feed your mum.
     
  9. sueorbell

    sueorbell Registered User

    Mar 15, 2010
    92
    California, USA
    Thanks for the replies

    The home seems to take good care of Mum's personal hygiene, she looks clean and tidy, and smells OK when we visit. We do worry about the constant staff turnover. It's hard to build a relationship with anyone on staff. We, as Mum's carer's, live abroad so only get to see her every three months or so. This makes it difficult to keep an eye on quality of care, day to day.

    We dream of being able to hire a case manager, maybe ex nurse, who could keep an eye on Mum for us with a weekly visit and feedback to us. Not sure such a service is available, but if anyone knows of one please PM me.

    Seems incredible that Mum is paying over $5,000 for her monthly care, and we still feel we need someone to monitor standards.

    Crazy, crazy.

    Sue
     
  10. Gill C

    Gill C Registered User

    May 22, 2015
    3
    This is somewhat off topic but I believe more attention could be paid to the etiquette of spoon-feeding in homes. When volunteering in a home I befriended a lady in middle-stage Alzheimers. On several occasions we were sitting together at the lunch table and when she paused while eating her meal a staff member came up and put the spoon in her mouth. She told me she hated it when they did that. I now work with someone in late Alzheimers who went from needing no feeding help at all one day to not being able to raise a fork the next. She is a fiercely independent person and it was obvious she initially disliked being fed and ate little. I now keep up constant conversation during the meal to divert attention and use a teaspoon with a long handle. I also keep asking if she's had enough so she feels she's in control. She eats very well and doesn't seem to mind being fed.
     
  11. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    I so agree Gill. The number of times I have seen them shovelling food into residents mouths - I often say something but often they do it whilst they are talking to someone else or even doing something else at the same time. It is rude and unacceptable and an extremely unpleasant experience for the resident involved. I often can't believe we think we live in a civilised and caring society. Rant over - apologies people!!
     
  12. sueorbell

    sueorbell Registered User

    Mar 15, 2010
    92
    California, USA
    Dear Gill:

    The lady you befriend is a lucky lady to have someone so empathetic alongside her. I hadn't even thought about how people are fed yet. That will be the second step. Sue
     
  13. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    sent you a message sue xx
     

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