Case review after care home admission?

Insomniac

Registered User
Apr 29, 2014
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We placed mum in a care home about 10 days go. The social worker had told us there is to be a review next week as she is not settling well and is refusing to eat (apart from some toast and biscuits!). Does anyone know what I can expect at this? And what is the protocol When someone refuses food in a care home ?


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Pete R

Registered User
Jul 26, 2014
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Staffs
And what is the protocol When someone refuses food in a care home ?
Hi Insomniac, not sure if any of this has been tried already.........
My Mom is not a big eater at the best of times and struggled with food in the NH for the first month or so and I was going in most lunch times to help her eat. We tried the food she liked the most. Sometimes it was just ice cream but it was not always a success. :eek:

The dietician and then GP prescribed "Ensure" nutrition drinks along with "Pro Cal" shots which luckily she took to straight away and gave her the stuff she needed to keep her healthy.

Now she has got used to (kind of) the new routine she is eating better.

I would imagine the only protocol in any CH when someone refuses to eat is to keep trying, eventually call the GP and then hospital admission.

Hope it all works out for your Mum.:)
 

Pickles53

Registered User
Feb 25, 2014
2,474
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Radcliffe on Trent
My mum has gradually stopped eating and drinking except for a few mouthfuls now and again and is very frail. She is now being nursed in bed. We have had numerous discussions with both care home staff and GP (who prescribed Fortisip and similar supplements). The staff have tried very hard and spent a lot of time with mum but if she refuses food/drink adamantly they have to accept that and so do I. Mum doesn't eat/drink any better if I try either.

I have agreed that I do not want them to resort to any kind of tube feeding and just want her to be kept comfortable and pain-free. Also have said no hospitalisation. GP agrees. When I look back, when she was still living at home in the first half of the year and even before that, we were all worried that she wasn't eating properly and at the time thought this was because of practical problems with cooking, shopping etc. Now I'm not so sure.

However, in your situation I would hope you're a long way from where we are now. 10 days is quite a short time to come to terms with this huge change and things may gradually improve. I think it's good that they are wanting to discuss this now rather than just hoping it will get better by itself. The review is a good chance for you to check that they are dong everything they can.

I would want to know exactly how they are trying to help mum eat to make sure that no stone is left unturned. I'd want to see detailed food/fluid charts of what is eaten/drunk and when. (Mum's records show amounts by teaspoonful or ml.) Have they tried adapted cutlery so it's easier to manipulate or plates with hot water reservoirs so hot food stays hot and more palatable? Does someone always stay with her to encourage eating or do they leave her to it? Could they make different food for her based on what you know she liked? Does she eat better in a social setting in the dining room or on her own in her room?

Are they weighing her regularly? Amount and speed of weight loss is one of the main triggers for GP to refer to specialist dietician as well as prescription of Fortisip or similar supplements. They had to monitor this for at least a month before considering further action but I asked for GP to see her early on so at least he was aware of the issue.

Apart from the food issue, if she is not settling in other ways eg refusing personal care or participation in activities I think at the meeting you will want them to clearly explain their concerns, find out what they are doing to help and see what ideas you can come up with based on your knowledge of your mum.
 
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Insomniac

Registered User
Apr 29, 2014
39
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Thank-you for your replies. I know the GP is keeping a close eye on things and the home is monitoring intake closely. Feel a bit more positive now knowing the sorts of things that might come up at the meeting and gives me a chance to be better prepared. Just worrying unnecessarily they may suggest she goes back home!


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