Move from Residential into EMI Wing

[davide]

My dad has been in a care home for the past 15 months, where he has generally been settled and content. When he went in he had already been diagnosed with AZ, but was "not too bad", and the staff and his psychiatrist agreed that he could go into the residential wing.

Recently his condition seems to have got a bit worse, he is more difficult for the staff to deal with, is refusing help with personal care, and has been snappy with some of the other residents. The care manager has said it is now more appropriate that he move into the EMI unit, and that they can no longer give him the care he needs in the general wing.

I knew the EMI unit was there and might be needed one day, which was one of my reasons for choosing the home. I visited it at the time and met the manager, and it seemed very nice, well laid out and with a calm atmosphere and good staff.

So I think it is probably the right thing, but it still comes as a shock. I feel so sorry he had to move, he has a lovely room and has made a good friend in the residential wing, from whom he'll be separated. I'm worried he'll find the move disorienting, or be angry at why he is being manipulated. The saving grace is that his memory is so bad that, after a couple of days, he may be unaware he's moved. This was the case when he moved into the home originally.

I suppose I also feel I should uphold my father's dignity on his behalf, and that he is "not bad enough" to need the EMI unit - though probably this is just denial.

Anyone been through a similar transition and have any advance?

 

[Vonny]

The care manager has said it is now more appropriate that he move into the EMI unit, and that they can no longer give him the care he needs in the general wing.

I think the important thing here is whether the care manager has come to this conclusion to make the staff's lives easier, or whether your dad genuinely needs more support than the residential side can provide.

It is very sad when deterioration makes such a move necessary but if it will keep your dad safer then it is really the only option. I believe there is a higher ratio of carers to patients in EMI units and staff there should be experienced in the more complex presentations of dementia.

However, you probably still know your dad best. I think you need to take an objective look at your dad which is very hard. When the time does come to move him, whether now or at a later date, it would help your dad more if you were positive about the move.

Sorry I have no personal experience of this because my dad simply refused to let mum go into a home, which of course presented its own problems!

Good luck

 

[monkeysusie]

moving to a different home or wing

Hi David,we were forced into a similar situation with my mum. She was in an ordinary care home before she was showing any signs of Alzheimer's,this was her choice and she was happy for a very short time before the onset of this horrible illness. Once she was diagnosed,we were given a months notice to find her a new home. However we were very lucky and found a really nice one with lovely staff.We expected mum to be a bit worse for a while. We are so much happier with the care that she is recieving,but I have to say that mum is not happy. We have come to the conclusion though that she wouldn't be happy anywhere now and as someone said to me on the site they seem to loose the ability to be content. We try to content ourselves with the fact that we know we have found the best place possible for her,and she gets the best care she could have.I hope your dads move goes ok,and try to assure yourself that it is in his best interest,even if he can't see that. Take care of yourself, luv monkeysusie

 

[Pescita]

Hi

My mum is in the residential part of a care home which also has an EMI unit for more advanced/challenging dementia sufferers. Mum is doing well where she is & hopefully will do so for a long time yet, but I am aware that the day may come when she will have to move. However, I take comfort from the fact that she would at least not have to be uprooted & moved to a completely new home. It's one reason we chose this particular home.

It was made clear to us when we first looked round the home that they sometimes have to move people to the EMI unit because their behaviour is causing distress to other residents, which is understandable really. One lady has recently been moved to the EMI unit, & it had been clear for quite a while that her behaviour was becoming difficult to manage (the staff were very good with her but she was needing more one-to-one attention than was sustainable with the staff resources in the residential section)& was also causing stress to other residents.

I think in your shoes I would want to feel reasonably happy that your Dad's deterioration wasn't just a temporary thing, perhaps because there is something making him feel more stressed & anxious than usual. Do you think that's a possibility?

One more thing - in Mum's home, a couple of the EMI residents are still brought to the main dining room for meals, with support from staff, so they are not necessarily completely cut off from other residents. If this was possible in your Dad's home it might enable him to maintain the friendship he has made.

 

[DIL]

We have been through this, and although at first some of the family were unsure whether my Mother in law was "bad enough" for the nursing unit, it has proved to be the right move. I think initially, as there are many patients in there who have deteriorated much futher, it can seem daunting and not quite right for the new residents.

And of course, there may be a slight decline initially simply due to a change. Hopefully as the new unit is in the same care home, it will look and feel similar to the existing unit and this will be minimised.

But the advantages we have found include a much higher staff to resident ratio which is essential in order to deal with the increased needs of someone with challenging and often unco-operative behaviour. They are much better at ensuring meds are taken too.

The unit she is in is not solely for bed ridden or completely immobile residents, they are free to wander if they choose and the lounge is well used. Communication & friendships between residents is less common though, we feel MIL has to rely on our visits and the staff for conversation and stimulation, but they are very good at giving her their time for this.

This is the only aspect of your Father's care that I would perhaps draw attention to with the new section manager, the fact that he has formed a relationship in his current unit that he will lose. Perhaps they can arrange for him to have tea with his friend some days, or at least point out that as he will be losing this company and stimulation you expect them to compensate for it?

Try not to worry, and trust that the staff are doing their best to care for your Father in the best way. But don't be afraid to highlight any concerns to them & hopefully they will work to reassure you.

I hope the transition goes smoothly.

 

[Margaret W]

Hi David

Although your dad is staying in the same building, to him it will probably seem to be a different home - different layout of rooms and corridors, different bedroom - so that might cause some problems for him. Will any of the staff be the same as those from the general unit? That would help. And I would certainly broach the possibility of his friend visiting him for tea, or him visiting the friend, or both. Perhaps he could move to the EMI unit but continue to join people in the lounge of the general unit say in a morning, or whenever he is at his best, and gradually reduce the visits there.

Well, that is me as a amateur, saying what I would think, perhaps it is better to make a clean break.

I hope it works out for you and dad.

Love

Margaret

 

[Lynne]

Hi David

I knew the EMI unit was there and might be needed one day, which was one of my reasons for choosing the home. I visited it at the time and met the manager, and it seemed very nice, well laid out and with a calm atmosphere and good staff.

I think this is the crux of the matter isn't it, and yes, I do think that you are in (understandable) denial that this change is necessary.
Nothing with dementia is easy, but these landmark decisions & changes are very hard to come to terms with, especially the decisions you have to make for your own parent.
It seems "all wrong" that it should be so.

Is the care home manager reasonably sure that they will continue to be able to meet your Dad's needs (once in the EMI unit)?
It would be doubly difficult to have to uproot him again for a different location altogether.

 

[Mameeskye]

Hi

My Mum was one of those who had to make this transition. She was admitted to the Nursing Care side of her NH but as her condition physically improved, but mentally deteriorated she was moved the EMI unit.

Like you I was worried about it confusing her, but the staff had been taking her to the EMI unit for activities, she had made friends there and they would also come to the nursing unit in the afternoon for activities. This action had been taking place over time as it was known Mum would need EMI care eventually.

When she was deemed to need to transfer, she was already spending much of her day in the EMI unit, had made friends there and was eating at least one meal a day there. She made the move easily enough. Staff from the nursing care unit popped in to see her and she still went upstairs for afternoon activities with the Activities Co-ordinators.

It was so smooth in comparison to moves between hospital wards and the move to the home.

She was content and made good relationships with the staff and residents at a similar stage in those early days. The staff managed the move very well as it was something that they were used to doing.

Hope it goes as well for your Dad.

Love

Mameeskye

 

[Lynne]

Like you I was worried about it confusing her, but the staff had been taking her to the EMI unit for activities, she had made friends there and they would also come to the nursing unit in the afternoon for activities. This action had been taking place over time as it was known Mum would need EMI care eventually.

When she was deemed to need to transfer, she was already spending much of her day in the EMI unit, had made friends there and was eating at least one meal a day there. She made the move easily enough. Staff from the nursing care unit popped in to see her and she still went upstairs for afternoon activities with the Activities Co-ordinators.

It was so smooth in comparison to moves between hospital wards and the move to the home.

That was excellent 'management'; perhaps David could discuss something of the sort with his Dad's c.h. manager.

 

[Margaret W]

That was my idea, I perhaps didn't express it well. Some transitional period where time is spent in both units, so neither seems strange.

Some continuity.

Love

Margaret

 

[davide]

The staff seem to think that it would be better to have a clean break and move permanently into the new unit, rather than having a transitional period of coming and going, as they think that would confuse him more.

I'm inclined to agree - my dad will dislike the change, and will probably protest a lot initially, but I think a one off change might be less distressing than lots of toing-and-froing. After the initial move from "home" into the care home, he did adjust to it very quickly, so hopefully the same may happen again.

But I'm visiting tomorrow to discuss with the managers of both units to hear what the issues are and try to decide whether the move is right, and how to handle it. I feel incredibly anxious, I wish I didn't have to make the decision - but I suppose this is how it is for most of us.

 

[DIL]

I'm sure the staff know what they are doing as they will have handled this many times before.

Hope it goes smoothly, all the best.