Is this normal for care homes re incontinence and a couple of other things!

[ragdoll]

Mum in care home for nearly 3 weeks and seems to be wetting the bed most nights and her room stinks of wee. I think mostly dry during the day but I always suggest she try for a wee when I am there as does my sister so haven't seen her wet, just evidence of it. I have spoken to various carers about her incontinence and seem to get vague answers. Is it normal that after this amount of time they still would not be putting in place any form of in continence care and just let her wet herself and then change the bedding clothes etc. Seems odd to me that they would rather do that than just put pads in place but I have no previous knowledge of care and don't want to feel I am pushing for something that isn't the norm.
They did talk about taking a wee sample in case she has a uti, that was two weeks ago and it hasn't been done, On Saturday I asked for a pan to go in her toilet but she didn't go, the pan was still in her bathroom yesterday so did get a sample and left it in the pan with the lid on under her sink and let someone know just hope it isn't still there today.

They also seem to let Mum get herself dressed so sometimes we go and she will have a cardigan on but no top underneath just a bra or underslip or no pants, I just assumed as she can't do these things that they would supervise her dressing.
She also seems to not be brushing her teeth as toothbrush dry, I know if you ask her she will say she has but we have pointed this out and it still seems to not be checked.

Lastly should they be expected to check on mum in the night as she can't use a call bell, after 2 months in hospital/rehab ward she doesn't know what one is and despite one going off somewhere in the ward/home she still asks what is that buzzing noise and when you explain and that she has one is very surprised. Just worried that if she fell in the night they wouldn't know until the morning. They did have a pressure mat next to her bed for a couple of days but she soiled it and it hasn't come back.

Being in a home does mean she is now safe from wondering and getting lost but I assumed they would do more in terms of personal care, she is in a dementia unit.

She doesn't seem to have any record book so we don't really have any idea of what is done.

What do people expect a care home to do for residents I don't want to make a fuss as they are very nice and it might be the norm.

 

[Beate]

Well if it's the norm, it really shouldn't be! Make a fuss! Nice but incompetent staff isn't what you need. They should be making an appointment for her with the continence clinic, and they should wash and dress her properly. Is she compliant or would she resist help in dressing or brushing teeth? Even though, good staff would know how to overcome this and not just say "we can't force her" or something. Usually checking on someone at night every two hours is standard. I'd be very worried this isn't done and there seems to be no record book or care plan in place detailing things.

 

[LadyA]

Absolutely, make a fuss. At least make an appointment to talk to the manager, and discuss her care plan, and how they see it panning out as her illness progresses. Make a list of what you have described here - that your mum appears unable to dress herself independently anymore, so now needs assistance dressing, that she is not brushing her teeth, so needs help with personal care, that she is regularly wetting at night - so needs incontinence care etc. and that you are seeing no evidence at all of this care being put in place, in spite of your bringing these things to the staff's attention.

 

[Leeds]

Absolutely agree, with all the comments. We had similar issues with showering and clean clothes. A new manager arrives and asked us to be involved with the reviews of the careplan every month now. We also comment in the record book that is kept in his room. Go for it Leeds X

 

[jaymor]

It certainly is not the norm. Nor should it be the norm.

It's good that they are not taking over and they are allowing your Mum to continue to do what she can but they need to give her a quick once over to make sure she is clothed properly. They may be doing this of course but your Mum is refusing the help. They cannot force your Mum to do anything but they can encourage. The same goes for cleaning teeth, they can encourage but not force.

The smell of wee is not necessary or acceptable and easy to avoid. If it was the occasional accident then great that they are not putting pads or pants on her but if she has reached the stage of continual accidents then she needs them for her own comfort and dignity.

There will be a care plan for your Mum, it will detail her medical care and her daily care. If it is not freely available ask to take a look at it. I looked at my husband's folder daily and was able to pick things up very quickly especially towards the end when hydration was important and turning was important.

Make a list of your concerns and with a smile on your face and a quiet voice put them to the senior Carer. They are far more receptive to a smile and a chat than a scowl and a rant. If you are not satisfied then ask for an appointment with the Manager. An appointment will give you their undivided attention, just dropping in they will only be half listening whilst they dealing with other things.

They should have your Mums best interests at heart just as you do. Please keep in mind though that your Mum is your only concern, for them they have many more. I felt I could accept less because there were only 9 men with at least 7 of them having 1:1 care, had there been less staff and more residents I would have let some things go as long as they did not compromise his comfort or dignity. I once said to one one Carer that this is what I want for my husband, if it was your husband I would still want the same.

Going luck and make sure all your concerns are heard and you get answers.

 

[love.dad.but..]

Not the norm for a well led care home. Unacceptable on all your points and I would have thought CQC would and hopefully should be very concerned about this home's standards.. Sometimes as in my dads case as he veers into incontinence,this maybe what is happening to your mum, it takes time once assessed and approved for pull up pants for the slow system of assessment and first supply to kick start but the home should have an interim strategy to help her nights until this happened.

 

[Lets_Stop_Time]

When the incontinence started they put mother in law in incontinence pants, she didn't like it and would pull at them as obviously wasn't used to them.

 

[ragdoll]

Thanks everyone, my sister went this afternoon and has had a meeting and asked certain things be put in place by Friday. They said she was wet again overnight so by Friday what to know what they have implemented or refer to incontience nurse. The wee sample was still under her sink this afternoon, which I am so disappointed about. Will have to see what Friday brings.

 

[Wigan]

Thanks everyone, my sister went this afternoon and has had a meeting and asked certain things be put in place by Friday. They said she was wet again overnight so by Friday what to know what they have implemented or refer to incontience nurse. The wee sample was still under her sink this afternoon, which I am so disappointed about. Will have to see what Friday brings.

Definitely insist they send a fresh urine sample off to be tested. They can actually dip it at the home as most have dipsticks in stock. It is always best though to have one sent to the lab for proper testing. That sample needs to be flushed down the toilet now as can't be used. If a sample isn't going on the same day, it needs to be kept in the fridge overnight, they must know that so why they left it under the sink is beyond me unless of course they forgot about it. In any case their excuse isn't acceptable. You need to insist on this being sent asap as if it comes back clear, then you need to request the continence team come out to see your mum. In the meantime, the home should be putting pads on your mum as it's not pleasant for her to lie in a wet bed until they discover she has had an accident.

The care sounds poor to me so I hope you get something sorted out.

 

[Kevinl]

I do sometimes wish people wouldn't say "care home", when the type of care is in question (sorry I don't want to sound ranty). If this is a residential home then maybe they're not geared up for this situation, if on the other hand it's EMI or EMI nursing then it's a different matter.
My wife's in EMI nursing and I've heard relatives complain about the use of inco pads before they think it's necessary not ask for them and not get them.
Likewise on the issue of night care, there's a book in my wife's room where they record her hourly, most nights she sleeps fine but some nights she gets up and they record taking her to the dining room for a cup of hot chocolate and a biscuit at 2am and back to bed at 2.30.
Like everyone else there she has a pressure mat by her bed and it's recorded every time she sets it off even if they get her back to bed.
If she's in a residential home then I would ask if that's now the right place for her, if it's EMI then I would say they're incompetent.
K