Next stage - what should I watch out for?

[Feezee]

Hello
My dad has deteriorated a lot since going into care 8 months ago. I haven't seen him get out of his chair for weeks, he seems almost completely withdrawn from the rest of the world, he doesn't necessarily react to people speaking to him and he doesn't seem to talk much. He's on the less advanced ward of a dementia home and he seems so much worse now than all the rest (whereas when he went in he was one of the more lucid ones).

He's also now unable to feed himself and incontinent (not sure if he is doubly incontinent or not). He is got up and dressed every day and generally looks OK although he's lost an awful lot of weight (he's on building up milkshake medicine).

The care home look after him OK although there have been quite a few changes in key personnel recently and they've just changed care home manager, and sometimes it's a bit erratic on the small things (like hearing aids being clean and working, nose and ear hairs getting a bit wild, the odd day when I notice nails could be cleaner). All in all, I'm a little nervous about the changes at the home and what they may bring, and I could do with some help in spotting what signs I should be looking out for now that he is no longer able to express any concerns/discomfort himself.
Can anyone help?

If he's sitting most of the day in a hard chair, should I be asking them to make sure he gets up now and again?

What about his medicines - should I be asking for a complete review of his drugs? He was on anti depressants and anti psychotics and he still is and I'm just wondering if they may be making it more difficult for him to "resurface" since his decline. One of the nurses (who has now left) cut the dose of his anti psychotic drugs in half while he was fighting an infection and this made him much more "with it" but he seems to have lost this.

Is there anything else I should be asking/doing? Should I be asking for a complete review by the doctor or even a consultant?

Many thanks
Feezee

 

[sue38]

Hi Feezee,

My dad too deteriorated in the care home, became immobile and doubly incontinent. Of course it's hard to say how much of the decline was simply due to the progression of the disease itself.

Hello

Is there anything else I should be asking/doing? Should I be asking for a complete review by the doctor or even a consultant?

Yes, I think a review of meds should be requested. Some meds that may have been appropriate when the person was mobile and in my dad's case aggressive, may no longer be necessary now, and may be counter-productive.

If your dad is sitting most of the day he is at risk of pressure sores and a suitable pad should be considered now as a preventative measure.

Have you seen your dad's care plan recently? It may be out of date and need to be reviewed by the home. I would ask to be present at the review and bring up the issues about personal care that are a concern to you.

 

[Feezee]

Thanks Sue
At least I feel like I am on the right lines.

His care plan was reviewed about 4 months ago, but yes, I think I should ask for a complete review inc meds.
Thanks for the hint about the seat pads. I worry as I can only get there once a week due to working and having a young family so want to be sure they are doing what they should be doing in advance of it becioming a problem if you see what I mean.

Thanks again for replying.

Take care
Feezee

 

[Vonny]

Hi Feezee, I agree you should have a review of your dad's care plan including meds, and definitely get that chair sorted!

It may be worth asking the manager if you can have a regular review with him/her, say once a month, to address any concerns. That will hopefully keep them on their toes and ensure that your dad is getting the proper attention and medication.

Good luck xx

 

[Feezee]

Thanks Vonny
At the moment they are set for every 4 months but at the rate he's declining you are right - once a month is better. The home manager leave reviews to a named nurse to do. Although she's nice she doesn't seem to really "know" my dad or his particular intricacies personally and seems to have to read the care plan to tell me things that I either already know or that she should know if she took any notice of him. Hence my lack of confidence in them.

Feezee