Care home problems?

miggie

Registered User
Jun 27, 2012
26
0
Midlands
Mum was moved into a care home from hospital 10 days ago after we were advised that she had reached the point where she needed 24 hour care.
She is in a specialist dementia home which we were very happy with when we went to view it.
We were advised to let her settle in for a week or two before seeing her so our first visit was yesterday.

What we found was quite upsetting but I'm not sure, having no previous experience of this, whether it's what we should have expected or if we should have concerns. We haven't yet spoken to the staff and manager about this.

She was sitting in her room and was visibly distressed and upset. She claimed that the staff, when she saw them, were not very nice and were ill treating her but that she was being left on her own most of the time. Her underwear was damp (she was not wearing incontinence pants), she was quite "smelly" and did not look very clean. Her room also looked as if it had not been recently cleaned.

We have called the home almost every day since she went in and we were told that, after being upset on her first day, she was settling in quite well, although preferred to spend her time in her room, she was accepting help with washing and dressing etc.

Over the weekend we were told that she was complaining of back pain, refusing to get out of bed and eating very little so she was referred for a doctor's visit on Monday. He has prescribed antibiotics (in case of a UTI) and painkillers.

I must add that my mother can be very stubborn and awkward and she can be verbally aggressive.

I suppose what I would like advice on is:

Should we be concerned about her claims of ill treatment or is this something that other forum members relatives have said when they have first gone into a home?

Should the carers be making more effort with her with her personal hygiene and incontinence issues - are they only allowed to use persuasion if my mother refuses their help?

Our first reaction on seeing her was that we had made a mistake in moving her into a home and that we should have tried a care at home "package" but I realise that this could be a heart over head thing.

Any advice and comments would be much appreciated.
 

Lucy Lastic

Registered User
Nov 30, 2009
135
0
Dorset
Miggie,

Personally I would be concerned. Your Mother should not be damp or smelly (though it could have just happened I suppose?) and her room should certainly be clean. I would say these are basic requirements. Did her clothes look clean/well kept?

Although she may prefer to spend time in her room, I would hope that she is encouraged to mix with the other residents and to join in activities.

I think you need to speak to the care home manager and voice your concerns. Ask to see your Mother's care plan and discuss her day to day routine.

I would also visit as often as possible so that you can get a feel for the way things are run and get to know some of the staff.

I hope it all turns out OK, this is a very stressful time for all concerned.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
81,447
0
Kent
Hello miggie

I can understand how distressing it was for you finding your mother so upset. The only way to find out why, and make sure there is no repeat, is to speak to the manager.

Does your mother prefer to be in her room? Do you think she`d be happier in the sitting room among others?

When my husband was at home with me, he spent his days in our living room and his nights in the bedroom.

When he went into the home I wanted his life to be as similar as possible to the life he knew at home. I asked that he should be taken to the sitting room during the day and only use his bedroom for sleeping.
The thought of him being alone in his room all day was upsetting to me and I knew the isolation would be upsetting to him.

You know your mother best and know what she would like. The staff at her home need to know that too.
Please make an appointment to see the manager. I know it is early days but it`s best to nip concerns in the bud before they get worse.
 

ggma

Registered User
Feb 18, 2012
1,126
0
North Staffordshire
What you describe is not right, but there could be any number of explanations, and yes as others say to start with you need to see the Manager or supervisor on duty.

If it was me I would have immediately gone to find the duty supervisor and asked her to see what you had found, she could have put it right and made sure it does not happen again.

I think it is important to visit regularly, and I would monitor very carefully what you find over the next couple of weeks. Also try and talk to other residents and see what they are saying, and get to know who the member of staff is who is your mothers named carer and talk about your Mum's preferences.

We walked in on my Mother in a state of bad confusion one day when she had mistaken where the toilet was, it was a mess, we called the staff who were distressed and cleared it immediately and sorted out Mum, it was a genuine one off, it has not happened again.

Hope you can get some anwers and reassurance.
 

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
I would certainly make noises to whoever you can, both with carers and the manager. If they are aware that you are vigilant and not afraid to say when you are unhappy with something, then they might be more careful. I know it isn't easy to keep on mentioning things. I find it very difficult to do so and when my husband went into the nursing home, everytime I asked a simple question of the nurse, she took it as a complaint which it wasn't! So I became very wary of saying anything.

However, the staff moved around and the nurses now are far more approachable. Nevertheless, there is a sense of defensiveness there which I think is perfectly understandable and I try to be careful in how I approach matters- though probably don't always succeed!

If you go in to visit as often as you can, especially in the early days, staff will get to know you and it will become easier to discuss your concerns with them. They will also get to know and understand your mother better. The early weeks are very hard and it can be a massive reality hit. I was devastated when my husband went into a nursing home and if it had been physically possible, I would have got him into the car and taken him home immediately. However, as he needs to be hoisted everywhere it was a non-starter! It has become easier though and although not perfect, I am now accepting of the status quo. I hope you will find things improve too.

Best of luck with this. Your mother is the priority here and her health, well-being and contentment is important. X
 

jaymor

Registered User
Jul 14, 2006
15,604
0
South Staffordshire
When my husband went into his nursing home from the assessment unit our son, daughter and myself were already there to greet him when he came. The nursing home suggested that we do it this way. We were supplied with tea and cake During the time we were there a carer came to ask us about my husband's food preferences and drinks and wrote it all down in his records.They even asked bout his favourite biscuits and any treats he enjoyed. A male nurse came in regularily as he was to be my huband's one to one carer until the change of shift next day. When we left he was there to take my husband off for a cup of tea and another piece of cake. They knew him already!! He has been there for just over three weeks and we have been every day but only stay for hour or hour and a half. He is happy, he smiles, he talks a load of rubbish, but who cares. We have visited at all different times so we have a good idea of what goes on throughout the day and the staff now know us and we are happy for them to use our christian names. Even on a day when he is not recognising us he hears familiar names.

Maybe for you the advice was wrong in asking you to give her time to settle in.Having familiar faces around when the enviroment is not familiar would maybe have been a comfort. If you had been there you could have given them some idea of how Mum's life has been and her likes and dislikes. When you have a word with them maybe suggest things might have been made easier for you and your mum if you had settled her in when she arrived. I don't say your Mum might have felt abandoned, everyone is different but it might have helped her in her thoughts, how ever muddled, that it was not such a nice place. It is so difficult to understand how someone with dementia is thinking. There was one patient at the assessment unit my husband was in who was not happy unless on his own. He paced the corridores all day and if anyone walked towards him, he turned and walked the other way. He ate his meals in his own room and never entered the sitting room, dining room or OT room. I hate to think how he will manage when he goes into a care home.

The care we can never know about until in residence and receiving it. If we are unhappy then we must say and hen they know we are on the ball and watching. Somethings although not good can't be helped like being damp. If she had been damp for a while then that is unforgiveable but not if it had just happened. Your Mum should not have been smelly, they should have been aware of that and sorted it. As for saying they are ill treating her maybe it is because she is she is resisting them when trying to help with personal care. The SRN I spoke to in my husband's nursing home said the aggressive behaviour did come out at this time but she said how would you feel if two people came towards you and started taking your clothes off and you did not understand? If it was me she said I'd give them a good kick where it would hurt. It may take a while for your mum to settle and trust the staff and i think I would be happier for them to keep trying to persuade than have them force after one rejection.

My husband is in a wonderful nursing home and sometimes when I go I think I could cope at home now but in reality it is only because of the level of care he is getting now that he is as he now is, not tormented, seeing lots of people and above all having quality time with his family with me not being dead on my feet from lack of sleep. No one nags him to sit down for a bit, he paces around with someone who has the time to pace with him and chat to him and if he wants to pace all night, as he does, no one is uptight and they are happy to make tea and eat cake all night with him. Maybe if my husband became lucid and understanding for a day he would if given a choice, choose to stay where he is rather than come home. We all really need to know when we have done all we can and hand over some of the care. Now I care by making sure everything is as it should be and I am ready to fight his corner at any time should I need to. I do hope your Mum settles soon and you can then relax a bit. It is yet another difficult time in our journey with dementia.

Jay
 
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Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
Maybe for you the advice was wrong in asking you to give her time to settle in.Having familiar faces around when the enviroment is not familiar would maybe have been a comfort. If you had been there you could have given them some idea of how Mum's life has been and her likes and dislikes. When you have a word with them maybe suggest things might have been made easier for you and your mum if you had settled her in when she arrived

Judging by the posts on TP, this does seem to the advice generally given, though I didn't receive it and visited every day. I don't think that helped my husband's confusion though and can see why the advice is given. It means that the person adapts to their surroundings without being reminded of outside or past experiences.

However, I would think that it helps or hinders according to the actual person concerned and also the extent of the dementia sp that there is no right or wrong way to manage the early days.
 

stanleypj

Registered User
Dec 8, 2011
10,712
0
North West
Absolutely agree with Saffie - no right or wrong way. It depends. The least they could do wold be to ask carers what they, knowing their loved one very well as opposed to the home who know her/him not at all, feel would be best.

This isn't person-centred care or anything like it.

Personally I think the approach described by jaymor would suit many, probably most, people.

A woman whom we had got to know quite well suddenly disappeared from various activities we attend. It turned out that she had gone into a care home and the family had been told that she should stay there without visits or trips out for three weeks. I had seen her in several different situations and though it was clear that she could become a bit confused she was very aware and articulate. After a few weeks in the home, I wonder if she still is?

It's not very difficult to institutionalise somebody. And almost impossible I guess to do the opposite.

I would be desolate to be apart from my wife for two/three weeks. I think she would feel the same.

I think your concerns are understandable, Miggie. I hope you'll let us know how things go.

Good luck.
 

jackamo

Registered User
Sep 13, 2012
1
0
Research

Mum was moved into a care home from hospital 10 days ago after we were advised that she had reached the point where she needed 24 hour care.
She is in a specialist dementia home which we were very happy with when we went to view it.
We were advised to let her settle in for a week or two before seeing her so our first visit was yesterday.

What we found was quite upsetting but I'm not sure, having no previous experience of this, whether it's what we should have expected or if we should have concerns. We haven't yet spoken to the staff and manager about this.

She was sitting in her room and was visibly distressed and upset. She claimed that the staff, when she saw them, were not very nice and were ill treating her but that she was being left on her own most of the time. Her underwear was damp (she was not wearing incontinence pants), she was quite "smelly" and did not look very clean. Her room also looked as if it had not been recently cleaned.

We have called the home almost every day since she went in and we were told that, after being upset on her first day, she was settling in quite well, although preferred to spend her time in her room, she was accepting help with washing and dressing etc.

Over the weekend we were told that she was complaining of back pain, refusing to get out of bed and eating very little so she was referred for a doctor's visit on Monday. He has prescribed antibiotics (in case of a UTI) and painkillers.

I must add that my mother can be very stubborn and awkward and she can be verbally aggressive.

I suppose what I would like advice on is:

Should we be concerned about her claims of ill treatment or is this something that other forum members relatives have said when they have first gone into a home?

Should the carers be making more effort with her with her personal hygiene and incontinence issues - are they only allowed to use persuasion if my mother refuses their help?

Our first reaction on seeing her was that we had made a mistake in moving her into a home and that we should have tried a care at home "package" but I realise that this could be a heart over head thing.

Any advice and comments would be much appreciated.

You can go onto the CQC Site--Care Quality Commission and read the homes report,if you have concerns- stay at the home for a few hours and watch the staffs performance when dealing with your mum.
Sometimes the care goes out of caring and it becomes a job.
Your mum should have two key workers who she learns to trust.I wouldnt dischard any different behaviour your mum exhibits,insist on seeing a specialist,try not to encourage the use of to much medication as this can shut her down not allowing her to express herself.and ask to see the homes care plan as this should describe how they see to her needs,and how she eats,drinks and spends her days.
It seems to me she needs a friend and she is being isolated.It is sad and hard and in the perfect world we wouldnt have to deal with this,but you must ensure your mum is treated as an individual and not a nuisance,they should see the person first and take time to make her life more bearable.xx
 

miggie

Registered User
Jun 27, 2012
26
0
Midlands
Visited Mum again yesterday and things were much better as regards cleanliness etc. Mum looked very clean and tidy and there were no unpleasant smells. Her room and ensuite were also spotless.

However, after going into the lounge and dining room during her first couple of days there Mum is now absolutely refusing to leave her room despite continually complaining about being stuck in one room day and night! Nothing we did or said yesterday could persuade her to go out. The reasons she gave yesterday were:

The "landlady" will not allow her to leave her room. When we explained that she could go wherever she wanted she said there was no point because "there are no other guests in the boarding house anyway"!

We then told her that there were plenty of other people in the lounge her reply was that she was not interested in being with anyone else.

When we tried to persuade her to go for a walk to the lounge with us so we could all sit in there she decided that she wasn't fit enough to walk.

All the time we were there she complained about the "landlady of the boarding house" and how she keeps her shut in, takes all her money, hides her clothes and doesn't feed her. She also demanded to be taken home over and over again because, she said, she might as well sit in her own house rather than sit where she is all day.

I did note that when a carer brought her a cup of coffee Mum was very unpleasant towards her.

So now I have visions of Mum just sitting in her room on her own all day doing nothing and being thoroughly miserable but I also realise that she is being her own worst enemy.

I hope she starts to settle soon but, at the minute, I can't see it happening.
 

Chemmy

Registered User
Nov 7, 2011
7,589
0
Yorkshire
It's very early days. Glad to see that she was clean and tidy today - that should give you confidence in the standard of care. It will take time for her to get to trust the care staff - it took them six months to persuade my mum to have a bath. if your mum is being aggressive towards the staff, then it is probably best for them not to insist she changes her clothes etc, which could explain the state she was in the first time you saw her.

If you were to visit little and often over the next couple of weeks at different times of day, you should be able to build up a proper picture of what's going on and you will also get a feel of how the place operates and will get to know the staff. But, be prepared, it could take weeks before she will be at ease with the new faces and they get to know her idiosyncracies too.

What was she like before she went into hospital? Was she sociable? Was she making up stories to explain her view of the world then too?
 

jaymor

Registered User
Jul 14, 2006
15,604
0
South Staffordshire
The problems never stop do they and life does not get any easier. Hopefully it is something like when children first go to nursery. Clinging on for dear life, crying and not wanting to stay. What happens when you leave?, they calm down, take hold of a carers hand and off they go to enjoy the day. I watched my son do this through a window.

My husband is happy in his nursing home, was from day one but he has no idea it is a nursing home. I don't really know where he thinks he is and I don't want to rock the boat by asking. The carers all use his name and he smiles at them and thanks them for his drinks, snacks etc and have a little joke with them and when they have gone he will ask who they are and what are they doing here so maybe he thinks it is home. I just say wasn't it kind of him/her to bring us all a drink.

Hope your Mum settles a bit better, have you asked the staff if she has a little wander around when you are not there. My husband has never been a mixer and lots of people have always made him uncomfortable so choosing a nursing home was difficult because it needed to be small. The one he is in is 26 bedded with just nine on his self contained floor. He is sitting in the lounge in the day but he is on one to one care as are most of them so plenty of carers around. Maybe they can slowly persuade your Mum to go into the lounge or just to take a walk. It really must be difficult to settle and mix with new people when you have dementia, they always seem to be suspicious of people.

Jay
 
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ggma

Registered User
Feb 18, 2012
1,126
0
North Staffordshire
Glad surroundings seemed better to you when you visited again.

My Mother alternates between thinking that she lives in a hotel, or school! Initially Mum did spent time when she was not walking around in her room, but gradually as she settled she started to sit with others.

Hopefully the staff will keep trying to encourage your Mum to sit out of her room, and as her confidence increases in her surroundings she may be more willing to give it a try.

Would you Mum listen to the radio if you put one in her room, or are there anythings which she might like that she could do herself in her room, unless she needs help to do everything, in which case it is more difficult.

hope she settles in time, it is early days still