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Care home not working as it should advice needed ?

Discussion in 'I care for a person with dementia' started by blackb15, Jun 14, 2015.

  1. blackb15

    blackb15 Registered User

    Jan 17, 2015
    23
    I'm caring for my mother who has vascular dementia ,three months ago I made the very difficult decision to put it into a care home. I've got much advice from this site and the alzimerers society .The home is a nursing dementia home costing 4400 per month which is top of all the inspection and reviews.
    They have been unable to get her to bathe,wash or put cream on they cannot get her to eat properly as she always just say no to everything and refuse to coperate and if pushed to far becomes aggressive so she has lost weight.
    I have of course raised these issue with the staff and manager with no success.I have to go every day to make sure she eats.
    When I can't go as I'm on holiday she just didn't eat or even drimk properly I don't want to move her and as I looked at 30 homes before I picked this one I have no other options
    Any advice please ?
    Thanks
    Paul
     
  2. cragmaid

    cragmaid Registered User

    Oct 18, 2010
    7,963
    North East England
    If this expensive and Dementia designated Home is failing to provide Mum with proper care and attention, I would be seeking advice from the Social Services as it is failing in it's duty of care. It might mean having to go back and look at some of the 30 again with different eyes....perhaps the rooms are shabbier but the residents cleaner, or the menu less exciting but the patients eat well, or simply that the staff sit and build a rapport with their residents. Does Mum need that level of care or could she manage in a CH with an EMI wing rather than the whole home being Dementia rated?

    In any case, as you point out you cannot be there 24/7 and neither should you be expected to be. If you are going just to feed Mum, then she is going to build an expectation that you will always be there to feed her.

    What feedback do you get about her behaviour when you are not there? Would she go for a bath if you were in her room to come back to?

    Talk to the staff, her GP ( perhaps her meds need tweaking) and SS, and let us know how you get on.
     
  3. Gigglemore

    Gigglemore Registered User

    Oct 18, 2013
    526
    British Isles
    #3 Gigglemore, Jun 14, 2015
    Last edited: Jun 14, 2015
    Hello Paul - what are the things that you DO like about the home? Are they doing some things well?

    Is your mother losing a lot of weight, or is the food that you are persuading her to eat keeping her stable?

    Looking at one of your old threads, I think her meds were going to be looked at. Is she still just very angry and upset that she is in a home or do you think that the staff there just don't have the skills to persuade her to eat and to wash?

    So worrying that for such a lot of money your poor mother still seems to be relying on your visits for feeding. Just wondering if the staff don't spend as much time coaxing her as they should if they know that you will be going in to feed her yourself.

    Another thought - have you tried having a meeting with the manager to discuss your concerns and to ask what strategies will be used in future to ensure that your mother's needs are met?

    (I go to feed my late stage mother 6 days a week as I know that her failure to understand that she needs to open her mouth gets a bit frustrating and it takes ages to feed her, but I only do one meal a day - she is not actively refusing food and drink, just forgets to swallow etc)

    Like Cragmaid, I think the quality of the staff is very important and it might be worth considering some of the other homes who do have good strategies for coping with your mother's issues.
     
  4. blackb15

    blackb15 Registered User

    Jan 17, 2015
    23
    I have had numerous meetings with the manager and email her all my concerns , the home has a very good standard of cleaning and the staff do try hard although there's not enough of them and agency staff are used on many occasions. The admin support is very good and the food is ok the menu is varied and other eat well.i believe the staff may not have the skills but no one can suggest how ( all the advice I recived didn't work )
    Her room is very good and the grounds and location exellent.My mother can sit and eat a meal at a pub which I still take her to.Its not a lot of weight (7 kilo) but she is small anyway
    As I said I looked at 30 other homes this seemed the best but I could re -look but didn't really want to move my mom.
    Re social service I have spent many many hours trying to get them to help and now I have gone for self funded care they do not want to know.
    Thanks very much for all your help and advice.
    Paul
     
  5. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,282
    SW London
    A good dementia care home with properly dementia-trained staff should almost always be able to get residents washed. My mother was extremely resistant to showering at home, but at the care home, which is a specialist dementia, she is always clean, with clean hair. And although she is past it now, I know she could be decidedly stroppy at times. All the other residents always look clean and tidy.

    My feeling is that there is something wrong at this home. Either they do not have enough staff to spend the time, or they do not how to manage such resistance. As for eating, it is not acceptable that you should have to go in in order to get her to eat anything. What are they being paid £4400 a month for, if not to be able to manage such basics?
     
  6. Gigglemore

    Gigglemore Registered User

    Oct 18, 2013
    526
    British Isles
    Sorry, didn't realise your mother is well enough to go out for pub meals. If she's already slight, losing a stone in 3 months seems a lot.

    Why doesn't she eat properly in the care home - does she give a reason? What do you do that succeeds - and why can't the staff do the same thing?

    I know it's scary moving someone when you think you have the best just because it looks like a posh hotel and is expensive. I moved my Mum from what I had assumed was the best local home (lovely views, nice grounds - until I realised that the staff never actually let the residents go out and enjoy the grounds) and various other issues such as showering that basically came down to staffing issues. I moved Mum to a home in which she receives a much higher standard of care, although nowhere is perfect. It was much cheaper and although that didn't influence our decision in any way, it was very satisfying to discover.

    Good luck - trying to do the best for a loved one who can no longer make such big decisions for themselves is so very difficult.
     
  7. Essie

    Essie Registered User

    Feb 11, 2015
    566
    Hi Paul, 7 kilos is just over a stone - if as you say Mum is small already that's quite a lot to lose in three months. If the positives outweigh the negatives you can persist with the home - ask them, possibly through Mum's GP for a referral to a nutritionist who should be able to offer the staff advice on feeding, best foods etc although if they are so highly rated and so expensive they really should be at the top of their game on things like that.....

    The frequent use of agency staff isn't good as they can be different people each time so there is less chance of them 'knowing' a resident as well as permanent staff could. I'm not sure what benefit the good admin support is to your Mum?

    To be honest I agree with Maureen, somewhere else might not look so great but the care, as you have now seen, is what really matters. The home my Mum was in didn't score full marks on the CQC rating but the bits it was marked down on didn't affect how anyone was cared for and the staff could not have been more loving and caring to all the residents. The paintwork was a bit shabby but the care certainly wasn't and that's the important thing.
     
  8. blackb15

    blackb15 Registered User

    Jan 17, 2015
    23
    Update re care home

    Hello
    My mom has been in the care home 6 months now it's not been a good experience despite paying huge fees,but the old manager has recently left and a number of the staff.
    A emergency trouble shooting manager has been posted in and many changes are promised.I have had a meeting with her and she is saying all the right things and it seems at this early stage to be improving.
    My mom still refuses any personnel care and not eating well so I still take her out regularly
    Just to update the post
    Thanks
    Paul
     
  9. reddollyfood

    reddollyfood Registered User

    Apr 28, 2015
    36
    Hi. This is the first time I'm posting anything so please forgive me if it doesn't go right! I know exactly what you're going through. My husband has vascular dementia and is in a nursing home - he's 69 and a lot younger than any of the other residents. He's been there since 30 December last year and I am just coming to terms with it. However I visit nearly every day - I seem to be the only one who regularly visits there - I have hardly ever seen any other residents receiving regular visits! On numerous occasions - nearly every week I have had to raise concerns to the staff about my husband's care and have formally raised it with the manager on at least 5 occasions. She's very "nice" but just agrees with me and tells me she's going to sort it but it only lasts for about a week and then things slip. Weekends seem worse - the nurse is in charge of the home then and this can be an agency nurse who has never been to the home before. Today I am visiting another nursing home as I feel I can not resolve the issues with the current one - they are similar to yours - they don't regularly bathe him and he looks unkept, he's often very wet when I arrive - I clean his nails and his face when I go in - they didn't even have any nail clippers and were using ordinary scissors on the residents which were making them cry out in pain. They don't change his bandages on his feet when they become soiled, there is no activities - the residents just stare at the TV or sleep in a circle around the lounge which smells so bad of urine that it hurts my nose sometimes. The carers are very nice but they work 12 hour shifts and a couple of them are only 17 years old and straight out of college so they're exhausted. I haven't spoken to Social Services yet as I want to find out if there are any better homes in our area but I know it will be difficult to move him. I had never even visited a nursing home before he went in and so I had no idea what to expect. I feel I am letting him down but I don't think he notices his surroundings. I haven't got any friends who are in our situation so I feel a bit isolated as none of my friends understand it.
     
  10. sistermillicent

    sistermillicent Registered User

    Jan 30, 2009
    2,951
    I missed this thread first time around. I am really glad, blackb, that the manager for your mum's home has been replaced, the fact that some staff left at the same sort of time speaks volumes. I was very alarmed when I read that there were a lot of agency staff being used, this indicates that no decent nurse would choose to work there.

    When I was looking for respite for mum I looked at loads of care homes and the one we ended up with was by no means the smartest, no en suite bathrooms, just a basin and a commode, old fashioned rooms, needing a coat of paint pretty much everywhere. But the staff were so lovely when they showed us round, they all live locally and have worked there for years. The manager is great and is always in and out of the sitting rooms, sometimes sitting himself at the piano and playing a couple of hymns or songs just because he is passing by. The younger carers can often be seen chatting and holding the hands of the residents. There is no staff shortage.

    Care is nothing to do with the building. It has everything to do with the people.
     
  11. blackb15

    blackb15 Registered User

    Jan 17, 2015
    23
    The home still not working with my mom ?

    As my previous posts they is a new manager at the home the home generally has improved but my mum still won't bath or wash, she's also having problems going to the toilet and I'm finding her in a dirty condition .
    I'm having another meeting today but they just keep seem trying to say they can't force her which I do understand and I'm not asking them to .I have spoken to the doctor as well and the Alzheimer's society and the problem seems to be that because my mother can refuse and will always refused everything as part of the dementia they can't do anything .She is now starting to smell and a feet in a dreadful state all of which I pointed out to the home . I did move her to a different unit in the home which is better but that was very stressful for her so I really don't wanna have to move her to another home.
    Any advice about how the home can get her to wash bathe have cream on her or chiropody please ?
     
  12. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,245
    Female
    England
    In my husband's nursing home the staff never stop asking. They start off with time for a shower/bath/shave and if this does not work then they wait a while and then ask if they would like one. If the answer is still no then they continue to ask, usually bringing in a bit of bribery, a piece of cake, chocolate or a trip to the shop to get a paper etc.

    The answer I think is for them not to take no as the first and final answer.
     

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