Potentially Abusive?

[Jannie]

On Friday I attended the first Care Plan meeting regarding my Mum. I was told by the Care Manager that Mum would be present and actively involved, as well as myself and the solicitor.
The Care Manager discussed the provisions that had been made for my Mum and then, quite out of the blue said :
" Now we need to talk about death and dying".
Mum, who was very quick on the uptake in this instance, replied with:
" There are 2 types of dying, I presume you are referring to the 'colouring' variety!!" (Good one Mum!)
The Care Manager told her that she was not and that she was talking about 'the sort that was to do with death'.
She then went on to say that she had spoken previously to my Mum regarding this and had understood that Mum was not sure whether she wanted to be cremated or buried.
My dear Mum, by this time was in floods of tears.
Could someone please tell me if this is part of a care plan procedure? I cannot believe the mercenary way in which this was handled. If it has to be spoken about, surely there are 'guidelines' for dealing with it so that the client feels safe, dignified and respected. I feel it was abusive. Why on earth did the Care Manager, having spoken on a previous occasion to my Mother, not talk in private with myself, rather than making Mum re-visit it. Poor Mum spent the rest of the meeting apologising for crying all the time.
If anyone has any thoughts or additional knowledge on this, please let me know.
Thanks again for listening.

 

[Shakey1961a]

I think this should have certainly been dealt with in private with just yourself present, not your mother.

Did you know what you mother would want when she did pass on? Had you ever discussed this? If so it would have been fine just coming from you.

If not, you could have mentioned the subject in a more sensitive manner with your mother than the care home.

I hate to defend care homes, but they do need to know what arrangements she would like in the awful instance of others not being around and they have to soley take care of arrangements.

 

[Norman]

Jannie
I feel this was rather,no not rather, very tactless.
My Mother died in a care home,they rang me early morning to tell me that she had died,asked should they make the arrangements, and what did we require,burial or cremation and what other requests.
I did all the official business and finalised arrangements with the undertaker.
Why did the home need to know in advance?
Norman

 

[Jannie]

Not unknown territory

Thank you both for your responses. Yes I do know what my Mother would like when she dies. When my Dad died which is now 17 years ago, we discussed it at the time and so I was already aware of her wishes. Pity the care home did not ask me this prior to putting her through it in front of an audience.

 

[Brucie]

Classic case of a 'going through the tick boxes' person who has no empathy for the persons for whom they are responsible. Happens in all professions but is particularly unforgiveable in this one.

 

[Canadian Joanne]

This could also be a case of misguided "keeping the AD patient involved with as much in the early stages." This doesn't sense to me - even if you didn't know your mother's preferences, it would be down to the family anyways. The home certainly wouldn't need to know. Any discussion about that with your mother should be with you, not a stranger.

I think you should have a chat with this woman - sounds like sheer nosiness to me. If it isn't, and she honestly thinks she's doing a good thing, she should be informed that she isn't. She's probably doing this all the time. I would ask her if she always gets lots of tears - asking a person who knows he / she has a terminal disease - what kind of response was she expecting? Tap dancing & great glee??

Honestly, some people are morons.

 

[jc141265]

Some suggestions

I agree with Joanne, this woman needs to be talked to privately, and if she is not willing to answer then you should speak to her superiors, whoever they may be. That kind of intrusive, tactless questioning, is just not on, she needs to talk to family in private or even your mother in private, to find out what you all want to do (if it is indeed necessary to find out) and in a much more tactful way.

What is frustrating when you are in this kind of situation however is that it is hard to be assertive for several reasons. The two main ones for me are:
1. I'm always concerned about making the people at my Dad's home angry because I worry if it will come back on him;
2. I always find that as I'm strung out already I have trouble being assertive without bursting into tears (probably what happened to your Mum);

So I guess you have to get what you want to say clear in your mind, make sure it is not open to criticism or someone saying you are being overly emotional, make it full of 'I messages', when this was said my mother and I.... , I felt, she felt...don't use the you, you, you, or that person (the questioner) as people tend to automatically run to the defense of a person under attack, whether it be themselves or the person they are in charge of. Make them have to deal with how it made you feel, and put in something like, I'm also bringing this up because I am concerned that if I don't, it may happen to others....(its not easy to attack or disregard someone who is concerned for others).

I'm so sorry that you and your mother, had to go through this, as if this disease is not enough!?

 

[Sandy]

Hi Jannie,

Discussions in this area were not handled well at all - obviously because it upset your mum so much.

However, the Care Manager was not just being nosy, knowing the person's wishes regarding death are part of the Minimum Care Standards for Care Homes for Older People:

http://www.dh.gov.uk/assetRoot/04/05/40/07/04054007.pdf

11.3 The service user's wishes concerning terminal care and arrangements after death are discussed and carried out.

There were probably a number of ways in which that could have been done more sensitively - so I'm not defending that person AT ALL! I'm just pointing out that it is part of the minimum standards (which I think are worth reading through for anyone with a loved one in a care home) and needed to be documented in some way.

Take care,

Sandy

 

[Sally]

difficult questions

We are all going to die but unfortunately there is still a certain amount of taboo around this fact. As with many aspects of life, different people would prefer different approaches and in my view it is more the fact that the topic was handled badly than that it was handled at all.
Care homes sometimes find that a resident dies without family or friends to advise them on what that person would have wanted at their funeral so I actually think it was quite sensible of the home to try to ascertain this info. It can also be the case that families are too distraught to discuss funeral arrangements when someone dies and it can be a relief to know that the matter has been discussed and resolved some months/years ago.
I do agree that this woman ought to be made aware of how her approach rankles (although with a resident in tears in front of her one would have hoped she might have got the message) but I think that care homes should continue to address this topic and to involve the person with dementia wherever possible.

Sally
xx x x xx