Care home not meeting needs

[Tiger was lovely]

Hi,
My name is Mark and my MIL is in a care home. The home has some benefits but also some shortcomings, the main one being lack of stimulation for her. The TV is on constantly and often just loops the same film (or perhaps two) repeatedly. She is not, and was not, a keen TV viewer and the volume is too loud and the screen is a distraction for all the people near her. Communication is hard anyway (understandably given the diagnoses) but this issue really precludes any spontaneous interactions betweeen residents and it even interferes with socializing when her husband, or we, visit.

We would like to look into having a suppport worker stay at the care home during the daytime hours specifically to look after her emotional and social needs. She doesn't have any nursing care needs but personal care is now managed for her. She is in a DOLS setting but is not hugely mobile.

Has anyone done this before and, if so, would you be able to let me know how you found the right kind of person? If you have any other ideas we are all ears!

We have suggested the TV be off for periods of time and also asked that regular activities are offered which could include her. Sadly, this has all been to no avail.

Thanks for any ideas,
Mark.

 

[amIinthewrong?]

So does the care home provide activities already or are you asking if she can be provided more activities? Also do you go visit at a set time or different times in order to see if you’re mother is interacting with others or is the tv on all day, also is your mil able to be taken to somewhere quieter so she can chat with the family

 

[Tiger was lovely]

Hi and thanks for your reply,
The care home seems to offer only occasional activites and my mother in law will often say 'no' if offered the opportunity to join in, it is her default. However, she is easily encouraged and enjoys engaging with others with support. The care home carers don't always manage this gentle pursuasion.

Her husband visits everyday and generally at the same time, we visit once or twice per week. The TV is on all the time. We do take her out for visits when we can and she can go to a different room within the care home but it is the rest of the time when nothing is available and we would like her to have options.

I think our question is whether others have sourced carers to be there, in the care home, for when she is ready for stimulation rather than expecting her to be available for interaction when the planned activities are to happen (when she may well be asleep).

 

[Jessbow]

Does she express/indicatethat she is unhappy with lack of stimulation?

You say the home lacks regular activities, but when offered she declines....is this something she needs/wants or something you want for her?
How old is she? With her husband visiting daily she probably gets more stimulation than most anyway- what do you want this person/carer to do for/with her?
Pease run it passed the home before you engage someone- they may object to someone being here all the time

 

[Angel55]

💗 Hi

It is a tricky one... I have never come across employing someone to provide those things but what about a befriending service maybe? A lot of charities have volunteers who they match with interests and your MIL could have a chat if she's able or maybe go out and be encouraged by the volunteer to do some other activities together. It might be more well received than another employed carer coming into the care home?

Where our loved one is there is an activity program and I have to say there is little that I would join in with myself apart from the therapy animals and gentle exercises and maybe music stuff. I notice there is a high proportion of ladies and a lot of their activities are quite orientated to ladies. I have mentioned that. My loved one though loves TV in their room and did at home so often gets grumpy if asked to join in as they are enjoying their favourite shows.

Is there no staff dedicated in the home for an activity program? 💗

 

[Tiger was lovely]

Does she express/indicatethat she is unhappy with lack of stimulation?

You say the home lacks regular activities, but when offered she declines....is this something she needs/wants or something you want for her?
How old is she? With her husband visiting daily she probably gets more stimulation than most anyway- what do you want this person/carer to do for/with her?
Pease run it passed the home before you engage someone- they may object to someone being here all the time

Hi, thanks for your answer.
She expresses unhappiness frequently but is not able to specify that this is due to lack of stimulation. It's our intuition really. When offered a choice to participate in an activity her default is always to decline. However, when she is further encouraged, she generally joins in and enjoys the interaction. She is naturally a shy and private person whose previous life was very predictable and consisted of interactions with just a few, trusted, friends. We would like a carer who can encourage and reassure her such that she does engage with activities. There are very few planned activities in the home anyway and these are often offered to residents outside the area designated for people with dementia. The care home staff are lovely but are very few in number and are often engaged in personal care/daily living tasks with residents.
We are very cognisant of how our (possible) request might be received by staff in the home and would want any arrangement to be mutually beneficial. Perhaps the carer could occupy other residents too and remove some of the workload from the staff.

 

[Tiger was lovely]

💗 Hi

It is a tricky one... I have never come across employing someone to provide those things but what about a befriending service maybe? A lot of charities have volunteers who they match with interests and your MIL could have a chat if she's able or maybe go out and be encouraged by the volunteer to do some other activities together. It might be more well received than another employed carer coming into the care home?

Where our loved one is there is an activity program and I have to say there is little that I would join in with myself apart from the therapy animals and gentle exercises and maybe music stuff. I notice there is a high proportion of ladies and a lot of their activities are quite orientated to ladies. I have mentioned that. My loved one though loves TV in their room and did at home so often gets grumpy if asked to join in as they are enjoying their favourite shows.

Is there no staff dedicated in the home for an activity program? 💗

Hi, thanks so much for your thoughts.
A befriending service is a great idea and may be better received by the home. The last thing we would want is for the home staff to feel their efforts are not appreciated because they are. It's just that she seems to be left to her own devices for long periods of time when she still has lots of potential to enjoy life. Her husband does visit each day for an hour or two but he feels the need to do some of the personal care as the staff are too busy to do it in a timely fashion or to the standards he expects. I agree with you re the attraction of many of the activities, I would decline and my MIL would too at any time. She only really needs someone to talk to. The home does have a dedicated activities manager but it seldom ventures into the area where people with dementia reside. Best wishes.

 

[Angel55]

Hi, thanks so much for your thoughts.
A befriending service is a great idea and may be better received by the home. The last thing we would want is for the home staff to feel their efforts are not appreciated because they are. It's just that she seems to be left to her own devices for long periods of time when she still has lots of potential to enjoy life. Her husband does visit each day for an hour or two but he feels the need to do some of the personal care as the staff are too busy to do it in a timely fashion or to the standards he expects. I agree with you re the attraction of many of the activities, I would decline and my MIL would too at any time. She only really needs someone to talk to. The home does have a dedicated activities manager but it seldom ventures into the area where people with dementia reside. Best wishes.

💗 You are welcome. I don't think any care home can ever be perfect and some are better than others. Our experience is okay not the best at times and yes I have given some personal care myself too. The activities manager really should be venturing into the section of the home for people experiencing dementia or how else are they going to build bonds and find out what people might like or take comfort from. xx

 

[Violet Jane]

Homes seem to vary a lot in how many activities they offer. They often promise more than they deliver. I do think that you have to take on board the fact that many residents with dementia need a lot of help and support to join in activities, particularly those which involve some active participation e.g. crafts, planting seeds. The activities coordinator can't do it all his/herself. S/he needs the other staff to join in and with homes short-staffed many will be busy just dealing with the basics of personal care. Some other staff may not feel it's their job / want a breather when there's a break in their personal care duties. Whole room activities where the residents can take part passively are easier e.g. a visiting musician singing or playing an instrument.

Two years before my mother died I took in a simple craft activity that I had just done with my toddler group. One lady made some attempt to do it but my mother couldn't engage at all and she had been quite creative (pottery, flower arranging, embroidery etc) before dementia struck.

I suppose the question is: what was your mother doing when she was still at home? I ask because the elderly lady that I used to support couldn't really engage in much at all and her dementia hadn't yet reached the advanced stage. She couldn't do any of the activities that she used to do (just running her life, going to church, reading, watching television programmes, gardening) and was, I think, bored a lot of the time even though she had a live-in carer who did her best. It was sad and difficult.

Your mother is doing well having so many visits It might be better to 'sell' the befriender to the home as someone who you have asked to visit because you can't visit as much rather than someone who is there to 'top-up' what the home is doing. Does your mother have friends who could visit (more) or are they like most friends who tend to drift away? I don't think that a single friend of my mother ever visited her in the four years that she was in her care home and my elderly friend's friends were pretty disappointing too.

 

[LadyLouise]

I’m sorry your MIL isn’t getting the quality of life you would like her to have. Please listen to your gut feelings and do what you can to enrich her life. A note of caution, if the home does allow you to pay a support worker to come in, I would be wary about suggesting that they could benefit other residents too. There are liability issues, but also a place which sounds understaffed may well exploit your good wishes. We had this situation when we paid extra to cover the wages of one of my mother’s care home staff allocated to her needs specifically for several hours per day. We found that they didn’t turn up and got sucked into being an extra pair of hands for the whole floor, instead of being one on one with mom, as agreed. We eventually brought my mum back home. If the care home can’t give good reasons for not wanting your mum to have a personal support person of her own, then I would be worried about a lack of transparency. If you haven’t already, you could escalate your requests about the blaring tv to the home manager, or further up if the care home belongs to a big chain.

 

[LadyLouise]

Also, it’s not your job to keep the care home happy. It’s their job to meet your MIL’s needs, including her need for meaningful activity.

 

[Toopie28]

I employed a "friend" to go and visit Ma. She went in between meals and and just sat for a couple of hours with her. Ma is reverting back to Italian and no one at the home speaks Italian. Ma gets frustrated as she thinks they are laughing at her whereas they are just expressing that they can't understand.

Activities, Ma will do some activities - if sherry is involved, I think.
She would love to walk in the garden but they don't let her go alone and don't have the staff to take her for a walk.

I don't think you need to ask permission unless it meddles with a routine (shower, meals and so on).
I tried recruiting though a staffing agency and there was no-one who spoke Italian.
I eventually had to recruit myself (become an employer) and it took a long time to find someone.
It's not easy - you have to set up payroll, interview, background check, then hope it's the "right" person.
You let them meet and watch the dynamics.
It may be easier in a home as there are others around.

I found someone and was present when she met Ma.
She was good and then I left the country (I care from afar) and she stopped turning up. Would send me her hours and staff would say no, she didn't come today and so on (plus sign up sheet showed who came and went) 🤷‍♀️

So I'm looking for a new one too. But I would not offer them to anyone else. Of there to help staff.

You can try the agencies. Less work than employing yourself. Try Care.com too and FB for private carers.
Be there when they meet so you can see if they "gel".
You can try this way to see if it works. It's always trial and error.

Best of luck!

Oh and to add to this, Mark.
All of this - it's for me. To make me feel better. Ma forgets who goes to see her and anything she does from one minute to the next.
So when I had someone there, she'd still be demanding and wanting just me.

But everyone is different and this may make a difference. You can but try.