Nursing homes need to be really careful when their residents have any sort of accident, no matter how small, due to the possibility of their being accused of abuse. So they tend to be over cautious when a resident falls.
I have left standing instructions that I want to be telephoned at the slightest injury for Jan. If they do that - which they do - then I can discuss what is the appropriate action.
Sometimes they have taken her to Casualty - which is in the hospital on the same site, so it is not far. On such occasions I always drive there and join them as the enormous waiting times are so difficult for someone in Jan's condition, and if I can't help her in the waiting, at least I feel I am sharing her trials..
More often than not, she is treated at the home, which works out very well.
Hospitalizations can be very tough on the elderly, especially folks with dementia who cannot understand where they are or what is going on. That is a very valid consideration to weigh against the small possibility that going to the hospital might be the best thing to do in some circumstance.
My dad is in a nursing home (not for dementia; it's my mother that has dementia) and my agreement with them is like Brucie has -- they would call us before sending Dad to the hospital. If they cannot reach us (e.g., when we were on holiday out of the country) they should use their best judgement.
It seems like only if your dad were in serious pain (if for example he should have a fracture) would there be a real reason to rush him to the hospital.
I think your idea of a letter saying the default should be to *not* send him to the hospital is a good one.
Blue Sea - I think you have made the right decision for your father and the others right in that perhaps it should be agreed that they contact you first if your father has another fall so you can discuss the situation. It is so distressing to see someone who is disorientated in a busy medical ward where no one has the time to spend that they need with them and when you know that he will be better off in the home where he can recognise some "normality". Dont feel bad - its a good and brave decision you have made which will make his life better in the long run and save him distress.
Hi Blue Sea
one o fthe problems is not only does the patient not understand what is happening in a general hospital situation,the staff do not understand Dementia.
Time back my wife had a TIA and was admitted into a general ward,I left her tablets and warned the staff on duty that she has Alzheimer's disease.
They obviously did not pass on the message ,by early morning they where asking me to fetch her out as she had been dresed 5 times during the night and wanted to go home.
I think you would be right in asking for notification if Father suffered any accident or injury
Iv'e found all your thoughts very helpful - thanks a lot. I'm going to make an appointment with dad's GP to discuss it then will take a final decision. I'll let you know how it goes. Have also been told now that dad has an MRSA infection in some wounds on his legs. I just feel so desperately sorry for him all the time. I wish I could have him home but know we couldn't cope with his agitaton and wandering. To be honest I don't think I could cope with the incontinence issues either as he won't use either the pads or the toilet at the moment. That feels cowardly to say but it's true. Do people sometimes bring their loved one home as they reach the last stages? Is that an unrealistic idea?
I don't know anyone who has brought a loved one home for the last stage. I think it is unrealistic but I understand why you would want to do so. I suppose if funds are not a problem and you can afford lots of nursing care then you could bring your dad home. But I understand the end can be very unpleasant - not that anything is pleasant about this disease - and nursing care would be required. Think of the bedsore potential, the cleaning & bathing, the choking when eating. With all the will in the world, I don't think I could do it on my own. I would absolutely require lots of nursing help & we can't afford that. So mum is in a nursing home (very good one) and we just plod along.
And I just try and deal with the guilt as I go. I KNOW I shouldn't feel guilty but my heart is not listening to my brain. My heart sometimes says I've been selfish & should be doing a lot more. Those are my crying days.
Hi Blue sea
some never go into a home.
Some are nursed at home to the end.
It's all down to what resources are available,finance and practical help.
Every case is different and the decision is a personal one.
Dear 'blue sea', we all have our crying days. You will do whatever you can. Some situations are more possible than others.
Some days I try to work out what I could cope with, other days I just want to run away and hide.
Just don't take on more than is possible. As Norman says, some of our loved ones never go into homes..........that is just one senario.
Thinking of you, Connie
Just read your thoughts about hospital I think you should get the home to phone you first about your dad when he falls and then make the decision with them. One of the things that I have found hard is that sometimes I have felt that decisions have been made for us and then you go home and think have we done the right thing. What struck a real cord with me is what you said about dignity. That is the one thing that I think all of us want to maintain for our loved ones for as long as possible.