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    As a carer for a person living with dementia, the needs of the person you care for will often come before your own. You may experience a range of difficult emotions and you may not have the time to do all the things you need to do. Caring can have a big impact on both your mental and physical health, as well as your overall wellbeing.

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    You can either post questions >here< or email them to us at talkingpoint@alzheimers.org.uk and we'll answer as many as we can on the day.

How to find the right care home

Discussion in 'Middle - later stages of dementia' started by Carrie118, Feb 6, 2018.

  1. Carrie118

    Carrie118 Registered User

    Feb 6, 2018
    10
    Hi everyone

    I was hoping you might be able to give me some advice with regards to my mother's situation.

    She's 83 and was diagnosed with dementia back in 2015. My father, also age 83 is her carer. They live up north and I live down south and I try to visit every month. My mother is at the stage where she doesn't always recognise Dad as being Dad. There are multiple versions of him. I helped my dad arrange for carers to come in in the mornings and evenings to get her dressed, clean and ready for bed. He also pays for 3 hours one afternoon, and receives 1hr 50mins for free on another afternoon each week. My mother now wakes up every 2 or 3 hours during the night, and my dad's exhausted. But he says that he doesn't see the point of getting someone in to look after mum at night when she starts packing to move out at 3am, as he says that he would be awake anyway. I go there once a month to give my dad a break and am exhausted just after a weekend and I'm half the age of my dad.

    My mother had been going to a day care centre once a week, which seemed to be going OK and gave my dad almost a full day off. After an episode with her getting away from the house, going missing for 3 hours, and then being brought back by the police I had said to dad that things couldn't carry on the way that they are, and that we either needed to pay for more care or that we consider moving mum into a home. We're both really reluctant to do this (I am dreading it!!!!), but otherwise I know that things will come to a head and one of them will get hurt, or something bad happen.

    My dad's just told me that the care home where she had been going for day care has expelled my mother, due to her behaviour. She's a bit deaf, won't wear her hearing aid and gets frustrated when she can't follow conversations. I also think that my dad losing patience with her because he's so tired, and raising his voice or telling her off is not having a good impact on her behaviour and is making her unhappy.

    I've been looking at care homes but there are so many of them that all seem to be rated "good" with many of them saying that they can care for people with dementia, but I get the feeling that they may not specialise in this, or only take on the easier to care for. How can I find out if they can cope with my mother if she has an episode of bad behaviour? Or will they just expel her as the day care centre did? Will they just dose her up on drugs to control her behaviour? SS have offered a re-assessment of mum's needs and I am looking to get them to assess my dad's needs too as a carer. I don't know how to find a home that will give my mother some stimulation, look after her with care and will also be able to cope if she becomes angry or frustrated. Has anyone been through the process of finding a care home when their loved one can become aggressive?

    Thanks for any help you can provide
     
  2. Amethyst59

    Amethyst59 Registered User

    Jul 3, 2017
    5,738
    Female
    Kent
    I have just noticed your post has received no reply. I will check tomorrow to see that it has been noticed, as you raise some important concerns on which members here will be able to advise you.
     
  3. margherita

    margherita Registered User

    May 30, 2017
    2,409
    Female
    Italy, Milan and Acqui Terme
    Hi @Carrie118 ,
    I have no direct experience of care homes.
    My husband is in the early stages of Alzheimer's and quite independent.
    Your mum doesn't seem so aggressive as not to be accepted in a care home.
    Maybe the main problem to manage is her wandering, but care homes are well organized to prevent PWDs from going out and being in danger.
    Re the use of medication to keep PWDs quiet, I think they are often necessary, not only to let carers survive, but also because PWDs suffer when they are anxious and restless.
     
  4. Louise7

    Louise7 Registered User

    Mar 25, 2016
    1,073
    Has your Mum's medication been reviewed recently? If not it would be a good idea to arrange this. As dementia progresses medication does sometimes need to be changed, not to 'dose them up' but to help with changing symptoms/behaviours, for example anxiety and lack of sleep. I think it would be worth waiting for the outcome of the social services assessment into your Mum and Dad's care needs and having a medication review before you make any decisions as there could be things put in place to help, although how your Dad feels about the situation is important as he will be the one who will be impacted most by your Mum's behaviour. What behaviour was it that got your Mum expelled from the day centre? It's not unusual for those with dementia to get angry/frustrated with others so if the day centre couldn't cope with that then perhaps it isn't the best one for your Mum. Other day centres may be better equipped to deal with the behaviour. If considering a care home you need to be honest with them about the behaviour but they will always carry out an assessment first prior to agreeing to take someone. Best thing to do is to ask what behaviour they wouldn't be able to tolerate/cope with, and you can ask social services at the assessment if they can provide a list of homes which would be suitable for your Mum.
     
  5. love.dad.but..

    love.dad.but.. Registered User

    Jan 16, 2014
    4,380
    Kent
    In terms of looking at care homes be very frank about describing her challenges and ask what strategies they would use to handle those and also ask what behaviour they could not handle. Continual Physical aggression apart where even some very good experienced dementia homes would have to assess the safety of other residents and staff...a good true dementia home should be able to deal with most things having seen it all before. Often though from my experience of looking at a lot of so called dementia care and nursing homes they tell you they take dementia but actually only want early stage where there are fewer demands on staff. 2 I looked at having described exactly dad's pacing wandering trying door handles and was told that was fine for them to deal with etc after a day assessment at
    each they refused dad because of his challenging behaviour! Another more specialist day care setting may be more experienced with your mum's behaviour. Are you able to share what the main problem is that the day centre found difficult?
     
  6. Risa

    Risa Registered User

    Apr 13, 2015
    483
    Essex
    Is your Mum going to be self-funding for the care home? If not, then don't assume your LA will be agreeing straight away to this option. Certainly where my Mum lives, there is the expectation that Mum will need to be at the stage of having four carer visits a day and Dad still not being able to cope before our LA will entertain the idea of Mum moving into a care home that they will have to fund.

    Does your Dad actively want your Mum to go to a care home or does he just need more help? If he needs more help then when SS do the reassessment see if there are other options such as a sitting service so your Dad can get a break from caring for your Mum. My LA funds this via direct payments and it allows my Dad to have 5 hours a week away from Mum.

    With daycare, have you looked at centres that are situated within a care home? These might have better security and won't be so easy for your Mum to escape from. We tried my Mum in two regular daycare centres and neither could cope with her. However looking back, we think the other attendees weren't as far along with their dementia journey or else didn't have dementia and were there more for company. As my Mum has advanced dementia, we will be looking specifically for ones set in a dementia care home as we think the staff will be able to deal with her better.

    If your Mum is a wanderer then look at getting a tracker so you can locate her easily. We also took Mum's bus pass and money from her so she couldn't escape very far by public transport.

    Hope you and your Dad can get some more help from SS.
     
  7. Lou16

    Lou16 New member

    Jan 24, 2018
    81
    Female
    This story really has touch my heart. Not that long ago me and my family had to make the awful decision to put my grandma in a care Home. Unfortunately we chose the wrong care Home where she was badly treated, all I can say to choosing a care Home is to not be fooled by there over niceness like we were. When u go to just visit the place just turn up. Don’t tell them your going as if u can them of guard and they r good then you’ll know. Also listen to how the residents are spoken to, wether they r clean and tidy. And smell the place too, see if there’s cleaners up and down all the time. If residents look happy enough etc.

    Although I know u don’t want to and neither does your dad (I’m not saying he isn’t caring for her) but she does deserve the best care there is, I’ve learnt so much about dementia sufferers not just my grandma but many others in care homes that I’ve become fond of. They really are inspirational I take my hat off to each and every one of them. Your mum really does need 24 hr care from “professionals”. Ask how many staff they have on? To how many residents they have. Also if the staff are welcoming and don’t just ignore you that’s also a good sign. They’ll treat u like family like they did in the second care Home my grandma was in. I know quite a bit about how care homes and how they work and also dementia (I’m 16 and want to go into the dementia sector)

    Anything else I can help with just reply to this thread
    Lou x
     
  8. Carrie118

    Carrie118 Registered User

    Feb 6, 2018
    10

    Thanks Margherita. I felt very let down by the day care centre. As Louise7 has said below, I think maybe we had a lucky escape that we found out that that particular care home doesn't really want to look after people with dementia



     
  9. Carrie118

    Carrie118 Registered User

    Feb 6, 2018
    10

    Hi Louise7 thanks ever so much for your advice. My mum apparently was throwing tea at other residents, and then when they moved her upstairs to a quieter area she started going into people's rooms and lying down (normal behaviour for someone with dementia I would have thought). My dad has said that he doesn't want to put Mum into a home yet, and they have since found another day care centre where my mum seems to be happy. I did ask him about whether he has tried giving my mum some of the pills her GP gave him to help her sleep through the night, but apparently they knocked my mum out for a day and a half. As you say, it might be worth another try with some milder medication.
     
  10. Carrie118

    Carrie118 Registered User

    Feb 6, 2018
    10
    Hi love.dad throwing tea at other residents and getting into other people's beds was what the care home couldn't cope with. I think you're right in that maybe some care homes give the impression that they specialise in looking after people with dementia, but the reality is that maybe they don't. She has been once to another day care centre since and came back quite happy, my dad said, so hopefully this is a better choice
     
  11. love.dad.but..

    love.dad.but.. Registered User

    Jan 16, 2014
    4,380
    Kent
    The throwing tea at other residents may be frustration and a reaction to something that he is misunderstanding and that would need to be handled correctly. At dad's NH there were 2 residents that until staff intervened quickly used to throw their juice at each other when they confronted each other. Getting into other residents beds can be a common thing for some pwd...dad used to do it...he was elderly tired and thought ...I see a bed...he wasn't aware that it wasn't his as he had lost his orientating skills by then...dementia homes should be able to deal with that. I hope this day centre is more suited to your mum
     
  12. Carrie118

    Carrie118 Registered User

    Feb 6, 2018
    10
    Hi Risa, thank you ever so much for your advice. My mum will be funding her own care. I worry that things will come to a head because my dad isn't sleeping because my mum is up every couple of hours. My dad has said that he doesn't want mum to go into a care home yet, but there's a part of him that does want this I think, and it's almost like he wants me to make the decision (I have power of attorney). I think I might encourage my dad to explore some milder pills that might keep mum in bed at night but not knock her out for the following day as well. With the trackers that you mentioned, are they electronic? My dad was saying something about the fire brigade providing something but then it turned out that this was just a name and address tag, which wouldn't really help if my mother was roaming around in the fields with the dog with evening approaching. It would be good if we could put something in her anorak so if she did get away from my dad, we could tracker her down easily rather than calling the police and hoping that someone will find her.
     
  13. Carrie118

    Carrie118 Registered User

    Feb 6, 2018
    10
    Thanks love.dad.
     
  14. Carrie118

    Carrie118 Registered User

    Feb 6, 2018
    10
    Thanks Lou. My dad was saying the same thing about just turning up at a care home and having a look round rather than booking an appointment, so it's really helpful to hear this from someone else who's gone through finding a care home for a loved one. Do you know if care homes do give people who wander at night a pill to keep them in their beds, or do they just intercept them? I've talked with my dad about this and that if she'll end up being given something in a care home at night to keep her in bed, we could maybe speak again to her GP about giving her something very mild, if it means that my dad can sleep and so is better able to cope and isn't permanently exhausted.
     
  15. love.dad.but..

    love.dad.but.. Registered User

    Jan 16, 2014
    4,380
    Kent
    #15 love.dad.but.., Feb 16, 2018
    Last edited: Feb 16, 2018
    My dad used to pace and wander at night at home then continued this in his NH. A sleeping tablet such as zopliclone can be given but many Drs are reluctant as it can increase risk of falls in those with dementia. Dad was tried on a course at the home but it made no difference he was still up and about. The night staff just let him walk made him a cup of tea and biscuits he usually settled in the lounge although sometimes he could be persuaded back to his room...he wasn't the only night time walker in his NH...again can be common amongst some pwd but make sure you describe all the behaviour to any prospective care home. I looked at 16...some weren't suitable for dad...some dad didn't suit them...he had moderate stage by then..those only wanted early stage...2 refused him after assessment. Always go unannounced but avoid lunchtime...I never minded being kept waiting...you can pick up quite a lot about a home and staff by watching and listening. I looked after dad 24/7 and he was a night time pacer doing a circuit of the house all night getting dressed etc...it is exhausting and sleep deprivation for your dad is one of the hardest things to cope with...definately speak to the GP. In dad's case because he was finding his way determinedly up and down stairs his GP didn't want to prescribe anything in case it affected his mobility and caused a fall...there were no stairs at his NH so slightly different environment to try
     
  16. Carrie118

    Carrie118 Registered User

    Feb 6, 2018
    10
    I hadn't thought about the whole issue of falling whilst under the influence of sleeping pills. My mum does go up and downstairs to the loo during the night, so maybe it's not such a good idea.
     
  17. Risa

    Risa Registered User

    Apr 13, 2015
    483
    Essex
    Hi Carrie118

    The tracker we got for Mum was on a keyfob design (see link below) as when Mum went wandering, she was obsessed with carrying her handbag with her at all times so it was easy to slip it in there. We could then get a signal to our mobile phones and get a map reference. However there are other types of trackers available and if your Mum was likely to keep a watch on, that might be a good alternative.

    https://www.personalgpstrackers.co.uk/gpstrackershop
     
  18. Lou16

    Lou16 New member

    Jan 24, 2018
    81
    Female
    My grandma was on some liquid medication to just calm her but tbh it never worked. She hardly ever slept. I personally don't believe in just giving them medication however if they are at high risk at harming themselves then maybe something to relax them. They shouldn't giver her something unless GP maybe contacts you. I hate it when they give them the medication that comatose's them if they r aggressive. Like I said I think you can get round situations without medication been involved. Its a hard thing to do, trust me I know. But it could be the best thing for your loved one. Your dad also needs to take care of himself.

    lou xx
     

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