Moving Dad from hospital to nursing home when he wants to go home?

Discussion in 'Middle - later stages of dementia' started by Meanmum, Apr 15, 2017.

  1. Meanmum

    Meanmum Registered User

    Apr 14, 2017
    19
    I'm new to this forum, found it very helpful over last few weeks!
    Dad is in around stage 6, was living at home with Mum caring for him 24/7. They are both 80. He became ill (UTI, delerium) & was admitted to hospital 2 weeks ago. He lost all mobility, & has been hoist only & 2 staff in hospital. Some of his cognition is coming back - he knows where he is, & who we are & can express some thoughts - but is very variable. He keeps indicating he wants to go home, but can't possibly do that in his current condition. His mobility is still poor, but he's showing some signs of voluntary movement. He has a NHS funded rehabilitation place for 4 weeks in the nursing home that would be our long term choice - realistically, we are not expecting him to improve enough to go back home. This was made as a best interests decision as he was judged not to have capacity (& his preferred option of home is impossible just now).
    Now the difficulty is how we tell him this next stage. He won't be able to process the idea that it's short term, and there is no point preparing him in advance, as this will just add to his extreme anxiety. The plan is to tell him on the day - but we are worried he'll get very upset and resist. He'll be transported by hospital minibus in a wheelchair, we hope with a family member, just a couple of miles. Does anyone have any tips?
     
  2. LadyA

    LadyA Registered User

    Oct 19, 2009
    13,552
    Ireland
    I'd go with telling him that it's "Doctor's orders". For convalescence "until you are completely well, and strong enough". It's never an easy time, and I'm sure he will take time to settle.
     
  3. HillyBilly

    HillyBilly Registered User

    Dec 21, 2015
    1,947
    Ireland
    Hi there. Sorry you're having to deal with all this but welcome to TP.
    Most people, myself included, have taken the approach of deceit!
    Which is -
    Don't talk about it, don't forewarn, nothing.
    In the moment, if necessary, tell your Dad it's for convalescence, until he's well enough to go home. The doctor says...etc.
    Other tactics include saying there's essential work being done at home - no heating, floors, no water, that sort of thing.
    Maybe consider letting the health team accomplish the move, without the presence of a family member.
    Honesty, in the strictest sense of the word, can cause distress.
     
  4. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,617
    Female
    England
    Hi Meanmum and welcome to Talking Point.

    Your Dad is of an age when, if he still has long term memory, will remember convalescence. He may accept that after a hospital stay he needs to convalesce to regain his health and strength. This would hopefully get him into the care home without too much resistance.

    He may well return home after his stay but if it does become a permanent move and he has not settled then it will be the doctors insisting he stays until he is fit.:) It will take a lot of pressure off of you and your Mum because you won't be the evil ones keeping him there.

    My husband spent 9 weeks in an assessment unit and he wanted out from day one. This lasted about 5/6 weeks but he settled and transferred to a nursing home without any problems.

    Edit. Sorry Lady A types quicker than me, sorry to repeat.
     
  5. ElizabethAnn

    ElizabethAnn Registered User

    Jan 4, 2014
    189
    North Hampshire
    Such a sad time :(

    I agree completely with all the advice so far... my only contribution would be to think about having someone your Dad knows well (his wife - if she's well enough and up to it, or another family member he definitely recognises and loves) already at the home, so that the first face he sees is familiar and loving? as well as having someone travelling with him if possible.

    I wish you all the best - it's a very emotional time :(

    rgds, Elizabeth
     
  6. LadyA

    LadyA Registered User

    Oct 19, 2009
    13,552
    Ireland
    :d:d:d
     
  7. ellejay

    ellejay Registered User

    Jan 28, 2011
    4,018
    Essex
    Hi there, We had the same with mum.

    What worked for us was the hospital did the move, as in "We're moving you to another ward Ethel, you'll go for a drive first"

    We went to the CH just after she arrived. We treated it as "convalescence" even though she never returned home again. Mum moved to her permanent care home after 3 weeks and we did have issues, but permanent care was the only way to keep her safe.

    Good luck, it is hard, but it's the right thing for dad & your mum :)

    Lin x
     
  8. Meanmum

    Meanmum Registered User

    Apr 14, 2017
    19
    Thanks everyone, all sounds like good advice! I've asked the ward today if a family member can be in the ambulance with him, and then I will arrange for Mum to be waiting in his room on arrival. The home will be far more used to dealing with this than we are.....
    I'm well beyond telling him the whole truth - if he's happier with an untruth, then I'll lie until my nose drops off ;)
     
  9. canary

    canary Registered User

    Feb 25, 2014
    11,103
    Female
    South coast
    If there is family with him when he goes into the care home make sure that they understand the importance of putting on a good face. People with dementia are incredibly good at picking up on body language and if they pick up that the family is upset about them going there then it will make them afraid and they wont want to stay (why are they upset about me going here? What is going to happen to me? Im not staying here!). So adopt a bright and breezy isnt-this-nice attitude (oh this convalescence hospital is so much nicer than where you were before), dont stay long so that he is tired out and dont do long goodbyes. When mum first went into her CH I used to time it so that when dinner arrived I would just excuse myself without actually saying that I was leaving - just said "I'll be back soon". Alternatively you could get one of the carers to distract him and leave then. Doing this is much less upsetting for everyone.

    I hope it all goes well. xx
     
  10. Meanmum

    Meanmum Registered User

    Apr 14, 2017
    19
    Excellent advice Canary. It's actually a really lovely nursing home (arranged in small "households" within a retirement "village") and we are largely happy to see him taking the next step from hospital. And we can we truthful in saying it's for a period of convalescence......although it will almost certainly become permanent.
     
  11. LadyA

    LadyA Registered User

    Oct 19, 2009
    13,552
    Ireland
    Actually when I visited my husband in his nursing home, I never took my coat or bag in with me - just went in in indoor clothes. That way, there was no unspoken clues that I was leaving, by picking up coat and bag! I just said I would be back shortly, and slipped off. He thought I lived and worked in the nursing home too, and was just busy doing stuff when I wasn't with him.
     
  12. Snowdog

    Snowdog Registered User

    Apr 15, 2017
    10
    Not staying too long after he has been moved is very important. It's hard to leave, but it's a lot like kids who fuss on the first day of school. They don't start to settle in until the parents have departed. This is just winding down at the other end of the age spectrum as someone else said. Just make sure your mother understands that it's just a short visit ... If she gets upset and wants to stay until he's calmer, that could make things worse.

    I have a dear friend in a Memory Care Unit, and I have to leave if she starts to cry. It seems uncaring but once started, she can carry on indefinitely. If I go, she stops. They take wonderful care of her and know what they're doing.
     
  13. Jessbow

    Jessbow Registered User

    I just talked about it as a 'far nicer place to get better than that hospital ward''

    Staying until you are better- which never happened ( we knew it wouldn't)
     
  14. Meanmum

    Meanmum Registered User

    Apr 14, 2017
    19
    More excellent advice - from Lady A especially around wearing normal indoor clothes, I'd never have thought of that but makes complete sense!
     

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