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Dad in Care Home but will they keep him if he doesn't behave??

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
My Dad, who is 81 and has Lewy Bodies Dementia, went into a Care Home last week initially for a 2 week respite period whilst my Mum, who cares for him on her own (I live in Ireland) had a week at home on her own followed by a week's holiday visiting a friend in Devon. She is at the end of her tether caring for him on her own (apart from a few hours off every week when a carer comes in to be with Dad) and was hoping that if Dad seemed to settle at the Care Home then she could leave him in there and it would become permanent. She discussed it with the Care Home before she went away and they said they would see how things went.

I rang Dad yesterday for a chat and he seemed reasonably happy but still as confused as he used to be at home so most of the conversation didn't make much sense. He told me he'd had a fall and was going to see the doctor today, so after I'd finished talking to him I rang back and spoke to one of the nurses. She said that he hadn't fallen but was very agitated sometimes and a few days ago had got so frustrated that he had torn his food chart into shreds!! This is not my Dad's normal behaviour at all, he has been a quiet and courteous gentleman all his life until now! However the nurse did say that his behaviour was probably
caused by him wanting immediate attention and not liking having to wait whilst the nurses looked after the other residents before him - he is used to having my Mum giving him one-to-one attention and always was a bit impatient!

I brought up the subject of him staying on after his 2 week respite period but she said they would have to monitor his behaviour and see how he was for the rest of his stay as they didn't want a new resident coming into the Care Home who would upset the others. This I can understand to a point but this is a specialist Dementia Care Home where Mum is paying £1000 per week for respite care (hopefully a bit less for permanent care if they take him) and if they say they can't cope with him, what is she supposed to do? We have looked at so many other homes but this seemed by far the best as the staff are trained in dementia care and we got a really good feeling from the place when we went to visit.

So I thought I'd post this to see if any other members have had a similar problem and if they could suggest a solution? I might be jumping the gun a bit as they haven't said no yet but just want to be prepared otherwise all the good of my Mum's 2 week break will have been in vain!
 

rajahh

Registered User
Aug 29, 2008
2,791
0
Hertfordshire
What status does the nurse have. Is she in a position to make those decisions. I would have thought the manager would have been the one to say those things to you.

I am sure the other residents did not just " fit in" with the others who were there at the start of their own individual stay.

It is disheartening when a home which claims to specialise in dementia care is saying they feel they cannot cope.

Jeannette
 

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
Thanks for that reply Jeannette. I think the nurse was only trying to be helpful and she did say that they would be discussing Dad's behaviour with the manager, but it was rather a surprise as I would have thought this kind of behaviour was "normal" for a person with dementia, not something unusual.

Don't know what we'll do if they kick him out - if a Care Home offering specialist dementia care can't manage him, how on earth is my 79 year old mother supposed to??
 

rajahh

Registered User
Aug 29, 2008
2,791
0
Hertfordshire
this is what staggers me. They expect one person who is probably elderly themselves to deal with aggression and difficult behaviour without a break at all.

Jeannette
 

Noorza

Registered User
Jun 8, 2012
6,542
0
this is what staggers me. They expect one person who is probably elderly themselves to deal with aggression and difficult behaviour without a break at all.

Jeannette


It's hard enough when you are younger and not even living with them, I so agree with you.
 

Katrine

Registered User
Jan 20, 2011
2,837
0
England
Don't know what we'll do if they kick him out - if a Care Home offering specialist dementia care can't manage him, how on earth is my 79 year old mother supposed to??

Exactly what I was thinking when I read your post!

I see that your Dad is self-funding and that this specialist dementia CH is quite expensive, so I wondered if your Mum and Dad have been going it alone without wanting to involve Social Services? I would recommend getting a care assessment for your Dad a.s.a.p. This can be done by a social worker while he is in respite.

Say it is very urgent because your Mum is also a vulnerable adult and cannot be expected to care for your Dad any more. With LBD, delusions, hallucinations and aggression are common, so emphasise that he has this type of dementia. It doesn't matter if your Dad has already had a care assessment; these need to be done again if the client's condition or circumstances change.

The social worker can help source other potentially suitable homes who have vacancies, or who are expecting soon to have vacancies. We found this a great help when looking for respite care for MIL because there are dozens of CHs and not all of them are very helpful over the phone to the lay person, but they will be more responsive to the SW. Social Services, at least in our county, also has some designated beds available in a number of the local CHs specifically for emergency placements.
 

fullmoon

Registered User
May 22, 2013
331
0
From my experience of looking around a few care homes when SS wanted to put mum into care I do get an impression that quite a few homes are selective about the behaviours they accept despite saying the specialise in dementia:rolleyes:. It was and still is a concern of mine that if mum does go into care in the future they could possibly move her on if she becomes too 'difficult', thereby causing more stress, upheaval and confusion.

And yes as a carer there are lots of things I wish I did not have to deal with but that's dementia! So as we have to deal with it CH should too.
 
Last edited:

Wildflower

Registered User
Apr 6, 2013
227
0
Brighton
I don't think this nurse should be jumping to conclusions by saying your dad's behaviour was probably caused by him wanting immediate attention, and what if it was, he has dementia for crying out loud. How long did they make him wait, and did they not see him becoming agitated before he resorted to tearing up the food chart? £1000 per week as well!

You think the nurse was only being helpful, but it's not helpful giving you these doubts. Is her opinion valid anyway? She is 'one' of the nurses.

The manager is the person to speak to.
 

kingmidas1962

Registered User
Jun 10, 2012
3,535
0
South Gloucs
I also think the Care Home manager is the best person to speak to. Staff may very well observe and monitor your dad but they wont be the ones making the decision, at the end of the day. They should also be able to understand that change is very, very difficult for dementia sufferers to cope with and dad would be unsettled for a while anyway, whether the care was going to be permanent, or not.

My mum was in a similar position with my dad when he went into respite - although his behaviour isn't challenging mum was unable to care for him any more. Dads care did become permanent and he is still in his care home. I'm not sure if things are different in Ireland but it sounds as if an assessment is in order, a carers assessment for your mum as well as a care assessment for dad. If their finances are assessed to be over the limit for payment then at least the assessment will have been done and they will both be on Social Services radar.

Your mum can't be forced to care for your dad - its been said many times on here that one person cannot be forced to care for another. And heaven forbid anything should have happened to your mum, then dad would have to be cared for by someone else. What you're trying to do, very sensibly, is to avoid a crisis happening.
 

bobosmum

Registered User
Oct 16, 2013
8
0
My Dad went into care over a year ago after he started to become violent towards my Mum. Like your Dad he was always a real gentleman and it was very difficult to cope with the fact that his behavior had changed so much. When he first arrived at the home he wouldn't allow anyone to give him personal care and caused a lot of problems with his behavior. The home has never given up on him and even gave him a one to one carer at the times when they knew he was most likely to be difficult. Now he is content and very rarely has bad episodes. If a home is good then they should make every effort to accommodate new residents. Ultimately dementia and alzheimers cause peoples characters to change beyond recognition, every sufferer will display some kind of challenging behavior and homes should be able to deal with this. I think you need to speak to the manager as a first stop. I really hope you manage to sort things out.
 

FifiMo

Registered User
Feb 10, 2010
4,705
0
Wiltshire
If this is not your dad's usual behaviour then I would be trying to establish what is happening. Does he have a UTI? Have they even tested him for one? Where does your dad think he is right now? Thinking he is somewhere that he needs to exert his authority can cause this type of behaviour to kick off. What are they doing to help solve the issue? If he wouldn't get agitated by being given his food first then you expect them to do that, for example. I would also keep this behaviour in context. He ripped up a food chart...my mother ate hers because she said they were starving her ! Ripping up a piece of paper is nothing on a dementia scale. I have seen violence which was uncontrollable in my mother's care home and two carers, tiny people by comparison, quietly calm the person down, remove them from the lounge to their own room for a rest. I have seen things so bad that a member of staff had to sit in the person's room 24/7 with them. So, your dad's behaviour isn't even on the scale by comparison!

The poor man is in a strange place, a new routine, is confused and has communication difficulties. What does the home expect? I know that you felt the home was ideal for your dad and perhaps it is, but I would use this as a learning experience from your point of view as sometimes we find that the person's needs have a different priority than what we first imagined. It could be, for example, that your dad might cope better in a small home where there is more time for one on one attention. If everything else is ruled out and it is considered to be a downturn, then I would ask for a meeting to review his medication as that might be all that is needed to take the edge off his anxiety/agitation.

Don't let them bully your mum back into a caring role again. If they can't handle your dad then your mum certainly can't. Just make sure that they don't approach your mum on her own in the hope she will back down. That is a favoured tactic for some!

Fiona
 

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
Exactly what I was thinking when I read your post!

I see that your Dad is self-funding and that this specialist dementia CH is quite expensive, so I wondered if your Mum and Dad have been going it alone without wanting to involve Social Services? I would recommend getting a care assessment for your Dad a.s.a.p. This can be done by a social worker while he is in respite.

Say it is very urgent because your Mum is also a vulnerable adult and cannot be expected to care for your Dad any more. With LBD, delusions, hallucinations and aggression are common, so emphasise that he has this type of dementia. It doesn't matter if your Dad has already had a care assessment; these need to be done again if the client's condition or circumstances change.

The social worker can help source other potentially suitable homes who have vacancies, or who are expecting soon to have vacancies. We found this a great help when looking for respite care for MIL because there are dozens of CHs and not all of them are very helpful over the phone to the lay person, but they will be more responsive to the SW. Social Services, at least in our county, also has some designated beds available in a number of the local CHs specifically for emergency placements.

Hi Katrine, thanks for your reply. Yes my Mum has involved Social Services and Dad has had an assessment although there hasn't been a social worker allocated to them until the last month as the previous one left and there was a big gap until someone else came along. Nothing has actually been done for Dad as my mother had this CH arranged although the SW did say he approved of it. But obviously if there are going to be problems she will need to get in touch with him and try and sort something else out asap. I appreciate your reply and will act on your advice if need be, thanks.
 

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
From my experience of looking around a few care homes when SS wanted to put mum into care I do get an impression that quite a few homes are selective about the behaviours they accept despite saying the specialise in dementia:rolleyes:. It was and still is a concern of mine that if mum does go into care in the future they could possibly move her on if she becomes too 'difficult', thereby causing more stress, upheaval and confusion.

And yes as a carer there are lots of things I wish I did not have to deal with but that's dementia! So as we have to deal with it CH should too.

Hi fullmoon, thanks for your reply. That's an interesting thought and something we hadn't considered before - we foolishly thought that a specialist dementia care home would be able to cater for typical dementia problems!!
 

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
I don't think this nurse should be jumping to conclusions by saying your dad's behaviour was probably caused by him wanting immediate attention, and what if it was, he has dementia for crying out loud. How long did they make him wait, and did they not see him becoming agitated before he resorted to tearing up the food chart? £1000 per week as well!

You think the nurse was only being helpful, but it's not helpful giving you these doubts. Is her opinion valid anyway? She is 'one' of the nurses.

The manager is the person to speak to.

Thanks for your reply Wildflower, has given me food for thought. Yes I agree, if there are still problems when the respite 2 weeks are over then Mum and I need to speak to the manager to sort things out. I only had a few vague answers to my queries and it is certainly not enough if they intend not to keep him any longer - particularly at those prices!
 

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
I also think the Care Home manager is the best person to speak to. Staff may very well observe and monitor your dad but they wont be the ones making the decision, at the end of the day. They should also be able to understand that change is very, very difficult for dementia sufferers to cope with and dad would be unsettled for a while anyway, whether the care was going to be permanent, or not.

My mum was in a similar position with my dad when he went into respite - although his behaviour isn't challenging mum was unable to care for him any more. Dads care did become permanent and he is still in his care home. I'm not sure if things are different in Ireland but it sounds as if an assessment is in order, a carers assessment for your mum as well as a care assessment for dad. If their finances are assessed to be over the limit for payment then at least the assessment will have been done and they will both be on Social Services radar.

Your mum can't be forced to care for your dad - its been said many times on here that one person cannot be forced to care for another. And heaven forbid anything should have happened to your mum, then dad would have to be cared for by someone else. What you're trying to do, very sensibly, is to avoid a crisis happening.

Hi and thanks for your reply. I live over in Ireland but my parents are in the UK so everything you say is accurate. My Dad has had an assessment and the CH came out to give him an independent assessment before agreeing to take him for respite care so they knew what they were taking on. And we chose them because they were a specialist dementia home after all so thought they would understand! You're right about my mum - if anything happened to her (and if she carries on looking after Dad on her own as she has been, then it won't be long!) then something would have to be done. And, as you quire rightly say, we are trying to avoid that!
 

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
My Dad went into care over a year ago after he started to become violent towards my Mum. Like your Dad he was always a real gentleman and it was very difficult to cope with the fact that his behavior had changed so much. When he first arrived at the home he wouldn't allow anyone to give him personal care and caused a lot of problems with his behavior. The home has never given up on him and even gave him a one to one carer at the times when they knew he was most likely to be difficult. Now he is content and very rarely has bad episodes. If a home is good then they should make every effort to accommodate new residents. Ultimately dementia and alzheimers cause peoples characters to change beyond recognition, every sufferer will display some kind of challenging behavior and homes should be able to deal with this. I think you need to speak to the manager as a first stop. I really hope you manage to sort things out.

Thanks for your reply and that makes a lot of sense. I really hope that Dad's CH turns out to be like the one your dad is in, it sounds fabulous. Maybe I'm panicking prematurely and everything will turn out okay but it's comforting to know I'm not alone in my worries!
 

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
If this is not your dad's usual behaviour then I would be trying to establish what is happening. Does he have a UTI? Have they even tested him for one? Where does your dad think he is right now? Thinking he is somewhere that he needs to exert his authority can cause this type of behaviour to kick off. What are they doing to help solve the issue? If he wouldn't get agitated by being given his food first then you expect them to do that, for example. I would also keep this behaviour in context. He ripped up a food chart...my mother ate hers because she said they were starving her ! Ripping up a piece of paper is nothing on a dementia scale. I have seen violence which was uncontrollable in my mother's care home and two carers, tiny people by comparison, quietly calm the person down, remove them from the lounge to their own room for a rest. I have seen things so bad that a member of staff had to sit in the person's room 24/7 with them. So, your dad's behaviour isn't even on the scale by comparison!

The poor man is in a strange place, a new routine, is confused and has communication difficulties. What does the home expect? I know that you felt the home was ideal for your dad and perhaps it is, but I would use this as a learning experience from your point of view as sometimes we find that the person's needs have a different priority than what we first imagined. It could be, for example, that your dad might cope better in a small home where there is more time for one on one attention. If everything else is ruled out and it is considered to be a downturn, then I would ask for a meeting to review his medication as that might be all that is needed to take the edge off his anxiety/agitation.

Don't let them bully your mum back into a caring role again. If they can't handle your dad then your mum certainly can't. Just make sure that they don't approach your mum on her own in the hope she will back down. That is a favoured tactic for some!

Fiona

Hi Fiona, thanks for your reply and your advice, that's really given me food for thought. You talk a lot of sense and I'll certainly be showing my Mum all the replies when she comes back from her break if we find that we are going to have problems keeping him there. Hopefully they are just teething problems and like a lot of people have suggested, we really do need to speak to the manager and not just the nurses who are looking after him. Your poor mum, eating her food chart! That did make me laugh :) Thanks so much for taking the trouble to post :)
 

jennyk

Registered User
Nov 24, 2011
20
0
Ireland
Hi Everyone, it doesn't look as though Dad will be staying in the CH after his two weeks respite are up, as my Mum rang me today to say she'd phoned to see how he was doing and they told her he'd got really agitated on Tuesday evening and started throwing the furniture around!! They had to get an out-of-hours doctor in to sedate him which fortunately calmed him down. So it's highly unlikely they'll want him permanently now - and there was me worrying about him just ripping up his food chart!

On the plus side, Mum already has an appointment with his SS care team the week after next so if he does have to go home then they'll only have to wait a week until they see his doctor and Mum says she's going to demand that they sort something for her. Fingers Crossed ;)
 

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