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Nursing homes – specialist dementia or not? Advice wanted.

dora

Registered User
Aug 1, 2007
148
0
England
We are looking for a nursing home for MIL and vacancies are few and far between. SW has advised her nursing needs are paramount and we shouldn’t worry if they don’t cater specifically for dementia.
MIL is in moderate to advanced stage. Doesn’t know where she is etc etc. Has lost mobility and needs to be hoisted and has complicated meds regime, but otherwise health is not bad. However she is very verbal, 90% of which is confabulation; she is mostly placid, but there are times when she flatly refuses to cooperate.
I am concerned that un-dementia-trained staff will not understand confabulation and not be tolerant of her stubborn moods.

Has anyone any experience / advice?
 

Pheath

Registered User
Dec 31, 2009
1,094
0
UK
Hi Dora
Can see why you're a little worried as we'd all like our relatives to go to a home that has dementia trained staff as it's quite a specialist area. I could be wrong but would have thought that many nursing homes would cater for dementia residents although know there are different categories of homes so it's something you'd need to look into thoroughly. I'd be inclined to trust your own instincts rather than go by what the SW thinks as you know your mum better than anyone and am sure are completely tuned into her needs. My dad is in a mixed residential home which works fairly well although he is pretty much the most advanced one there now and do worry there might come a time when they're unable to manage him. About 60% of the residents have dementia and the rest just physical problems and the staff are pretty skilled in all areas.
You could also try posting on this site for a recommendation of a nursing home in your area asking people to send you a private message if they could suggest somewhere as we're not allowed to name homes on the main forum. I know a few have been successful finding suitable homes this way as word of mouth is always a good lead. Hope you'll get more clarity soon. Good luck.
 
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SimbaWim

Registered User
Dec 12, 2011
2
0
Hi Dora

In my very recent experience of this I would choose the dementia Nursing route if at all possible. We were advised after Mum broke her hip & had a spell in hospital that she should go into a General Nursing unit, because her medical needs outweighed her dementia care needs, however it was very clear within a couple of weeks that she needed specialist dementia nursing. She has mod- severe AD, loss of mobility and gets quite agitated at times. We are now having to move her again after she's had another stay in hospital. General Nursing units are staffed by RGN's, who may have some experience in deal with dementia but can be quite challenged by the demands of dementia. Dementia Nursing units are staffed by RMN's specifical trained in dementia & other mental problems. The care staff have often worked in both types of unit. Hope this helps. Good luck, it's a minefield and I know just how you feel.
 

copsham

Registered User
Oct 11, 2012
586
0
Oxfordshire
Dementia or nursing

I went through what you are going through six months ago. What I learnt was first, that was she will need a nursing home rather than residential care home if she will be receiving an NHS financial contribution.

Then within her current home there are small units for nursing needs and small units for dementia needs. My mother is in the nursing needs and I am so glad that she is, although she has dementia. In the nursing needs unit about 50% have dementia as well.

Although it is a nursing unit rather than a dementia unit the staff are fully competent with all aspects of dementia and it is the best place for her to be. BUT this is because the nursing home is a good one with lots of compassion and enthusiasm.

My observation is that the dementia units are more noisy and more challenging. It sounds that your mother is physically quite vulnerable and providing a nursing/ medical unit rather than a dementia unit might be the answer for this reason.

Go by your vibes when you visit, visit as many as you can, spend time talking with care staff as well as the head of home.

If you are in Buckinghamshire - chance in a million - do PM me and I can share the details with you.

Best of luck
 

at wits end

Registered User
Nov 9, 2012
753
0
East Anglia
I'd like to say that my gran has mixed dementia and is in the nursing section of a NH rather than the dementia section too. Because she is not a 'trouble' to them so to speak they are happy and she is happy. Her issues are memory and confabulation, but she is only verbally aggressive with me and never physically with anyone. The staff know how to deal with her because in truth many elderly in need of nursing have dementia issues of some sort or other, but not all dementia patients have nursing issues.
 

Saffie

Registered User
Mar 26, 2011
22,516
0
Near Southampton
My husband is on the 'nursing' wing of a nursing home which is EMI registered. All the staff in the home are experienced with dementia or are undergoing training if new. Pesonally, I wouldn't like my husband to be in a home where the staff were not familiar with dementia. It makes a difference in their expectation and understanding of the resident, their mood and their abilities.
 

dora

Registered User
Aug 1, 2007
148
0
England
Thank you

Thank you all for your thoughtful replies. Having looked at a couple of homes, I think there is actually a 3rd issue on top of nursing and dementia in MIL's case, which is her personality - we need a home that can do all that's necessary, but are prepared to be flexible. Still looking for somewhere with a vacancy.

Good luck to everyone else who is looking!
 

lilysmybabypup

Registered User
May 21, 2012
1,263
0
Sydney, Australia
Hi Dora, I've just been in a similar situation to you, however I'm not in the UK so homes can be differently categorised here, in Australia.

My dad had to spend 4 weeks in hospital for an episode of delirium which I believe stemmed from a medication. He was walking with a walker, speaking well, understanding us, not abusive or aggressive in any way, not a wanderer. While in hospital he seemed to lose his mobility, and stopped eating. Mum had been caring for him with additional support from me, but his immobility, size, (6'4") and Mum's health issues meant he couldn't return home, a devastating situation for our family. My sister and I started looking into homes and had some in the area not recommended so had to look a little further afield. While in hospital, Dad had been difficult and abusive with staff who didn't know how to deal with dementia, and an altered sense of reality. Why would he have people wiping his private parts in the bed? This made him very angry, and vulnerable, especially if it was a man since he has a wife and two daughters. He was continent at home but with laxatives and no mobility couldn't get to the toilet.

We assumed, and after the assessment done in hospital that he needed a dementia unit where we expected staff to be trained and adept. We also had trouble with waiting lists and no vacancies but found a more expensive one about half an hour from home with a dementia unit. Dad has been there for 10 days and it's very unpleasant for him, because it has all the most advanced and difficult residents. People wandering everywhere, including in his room which drives me wild, moaning, singing, screaming, blood curdling screams sometimes. All this is upsetting Dad terribly, he can't walk so wandering isn't an issue, he is almost blind so the noise distresses him, he really isn't aggressive, just uncooperative at times, like a child. However, he has high care needs since he can't do anything for himself, needs the lifter to be moved and it terrifies him. This home has many levels of care and the staff seem to rotate about the different sections. It has low care for people who just need help with showering, a dining area with cooked meals, and laundry and cleaning done, it also has high care non-dementia, low care dementia, and high care dementia, where he is now. We asked for him to be moved to non-dementia high care and I believe they've agreed following some assessments. They said there are many non-dementia residents who are difficult, obstructive and cantankerous, so that won't be an issue. There have been countless different staff in the secure dementia unit and they say they work in other sections too so it's not like there's a consistent and small team of dedicated dementia staff, except for the 7-3pm Monday to Friday team, which is always the same.

My long tale (sorry) is to say we thought he had to be in a dementia unit but it has not turned out appropriate for his situation, so see where there are spots free that you can live with, discuss with the home whether they think your mum would be managed well in non-dementia, and then when she is placed, and you see how she settles and copes, keep looking and get her name down elsewhere if it doesn't work out so she can be exactly where she fits. It's so hard to know what any place is like until you're there regularly.

Good luck, Stephanie, xxx
 
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dora

Registered User
Aug 1, 2007
148
0
England
Stephanie, thank you for taking the time to post.

We've had to go well out of area to find any vacancies at all, but have been most impressed by the dementia-and-nursing homes. Residents tend to be fairly immobile and if very noisy, they are kept away from the others. As you say, until you've visited several times, you really don't know. We managed to speak to a relative of one resident, who said it was the least bad home she had found!
 

nerak

Account Closed
Jul 4, 2013
180
0
ireland
Here in Ireland you cannot put a dementia patient into a Normal nursing home?? They have to go into specia:confused:lised homes that cater for dementia?? maybe not so in england?
 

Saffie

Registered User
Mar 26, 2011
22,516
0
Near Southampton
Actuallly, a prospective resident has to be assessed by a care/nursing home and if the home is not EMI registered and the resident has dementia, they will quite likely refuse to take them.
It would, of course, depend on how far down the dementia road the prospective resident is but an assessment is the key.
 

nerak

Account Closed
Jul 4, 2013
180
0
ireland
youre right sassie and now ive to keep stum!! the district nurse is hovering around me as my mum will not be allowed into this lovely nursing home if they think she has dementia so am avoiding her and have just said actually the doc wants to check her bloods first!!!!!!!!!!(phew!!) what a life:(

The district nurse is very keen to talk nursing home I was disgusted and told her that it will be a family decision and not hers:mad::mad:

they will do anything to save the nhs money yeh just dump her in a home then we can save money(harsh but true now):(
 

Wirralson

Account Closed
May 30, 2012
658
0
Dora,

I see why you're worried. In my mum's case she was verbal, confabulated and stubborn (and that was on a good day). But she went to an EMI (Elderly Mentally Ill) dementia registered nursing home because of her challenging behaviour. It worries my father as few of the other residents currently have speech, and it is pretty grim at times - a sort of surreal TravelLodge. But there was simply no alternative. One nursing home I thought pleasant (it looked like a somewhat dated seaside hotel - I'd also been at school when very young with a relative of the owners, so there was a connection) simply wouldn't have been able to handle my mother. So choices tend to be limited.

The only piece of advice I can offer from experience is listen to what you can about the assessment - the nursing home will assess whether they can take her and will need some access to her medical history. Ultimately this is a progressive illness and you will probably find that the dementia specialist home is the route you are likely to end up following.

Wirralson
 

dora

Registered User
Aug 1, 2007
148
0
England
Only one choice

Well, in the end there was only one home that we would consider, that had a vacancy. All the others said it wasn't worth looking round as they had massive waiting lists!

This home had failed the CQC inspection because a third of the staff had not been dementia trained, and also there was concern around incomplete care plans. However, we liked the homely atmosphere and the attitude of the staff we saw interacting with the residents; also there were a lot of relatives around.

MIL has been there for a week now, and settled straight in, which is a great relief.

So keeping fingers crossed for the future.....

Thanks again to all who replied.

Dora
 

faithy

Registered User
Jul 31, 2013
61
0
Worcester, Massachusetts
We are looking for a nursing home for MIL and vacancies are few and far between. SW has advised her nursing needs are paramount and we shouldn’t worry if they don’t cater specifically for dementia.
MIL is in moderate to advanced stage. Doesn’t know where she is etc etc. Has lost mobility and needs to be hoisted and has complicated meds regime, but otherwise health is not bad. However she is very verbal, 90% of which is confabulation; she is mostly placid, but there are times when she flatly refuses to cooperate.
I am concerned that un-dementia-trained staff will not understand confabulation and not be tolerant of her stubborn moods.

Has anyone any experience / advice?
My husband is in a nursing home that treats dementia, and on the first floor is a specialized Alzheimer's unit. It makes a difference and it has helped me these last 4 and 1/2 years. I understand the disease a lot better than when he was at home. He also has anxiety issues, which they are trying to treat, but to no avail. he gets very anxious when it comes to bedtime (1:30) after lunch - he plays his computer (rarely) but he watches tv. I guess it is a control thing, one of the last things that he is trying to control. It is so sad, but knowing the staff can handle it, makes a world of difference.
Hope this helps!