Residential home - no one's like Mum

Discussion in 'I care for a person with dementia' started by Libby*, Oct 20, 2018.

  1. Libby*

    Libby* Registered User

    Jul 9, 2016
    11
    My Mum moved to a lovely residential home almost 2 months ago after living with me for a year. She is very fast on her feet and quite physically fit (she's 76). She is on the dementia floor of the home and the other residents are mainly at a more advanced stage of dementia than Mum, many unable to communicate very well and many are asleep in their chairs when I visit. There are hardly any residents that she can engage with - Mum likes to talk to people but her sentences are very disjointed and it's hard to completely understand what Mum is trying to say. There are twice daily activities over the 3 floors of the home but Mum is mainly confined to the Dementia floor - she would probably try to leave the building if she wasn't. My concern is that Mum seems lonely and it's really hard for me to leave as she just looks around as if to say 'what can i do now?' It is like Mum is in an in-between stage of the illness where it had become too difficult for her to live at home with me and that she almost doesn't seem bad enough to be in the home? I guess I just need another chat with the staff to ask them to try and engage her in more things. Difficult one as I feel really guilty and sad when I have to leave her.
     
  2. Diannie

    Diannie Registered User

    Jun 2, 2015
    157
    Hi Libby. I have exactly he same problem. My husband moved into a really nice care home almost a month ago. He also has trouble with speech and communication. I have asked the Carers to take him to any activities. I go in every day to visit but he is always sitting on his own in front of the television. The other residents are usually confined to their rooms occasionally wandering but never with him. I am wondering whether to look for a more specialist dementia care home where he could interact with other people. How easy will this be?
     
  3. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,098
    Kent
    Hello @Libby*

    It was the same when my mother went onto residential care She was at risk at home but seemed too physically active to be in a care home. Its really hard to find exactly the right time for residential care without putting the person with dementia at risk or waiting until there is a crisis.

    I have heard in some homes staff ask new and active residents to help them with very light duties just to keep them occupied and give them a sense of value. This can only be done with the best level of staffing but maybe you could ask the staff what they suggest to help your mother feel less isolated.
     
  4. Libby*

    Libby* Registered User

    Jul 9, 2016
    11
    Thank you Diannie, sorry to hear that you have the same problem, it is a difficult one isn't it. I often think that that it would just take a few more people at Mum's stage to move in to give her some company but of course wherever you go you cannot guarantee who will be there or who will come in next! Maybe for both of us it's still early days and things might improve. Before Mum moved to the residential she used to go to a day centre a couple of times a week and used to be sat around a table with other dementia sufferers who did interact more but I guess they were at the day centre because they weren't advanced enough to be in residential. It is like they need in-between stage care but I'm not sure that that exists!
     
  5. Libby*

    Libby* Registered User

    Jul 9, 2016
    11
    Thanks Sylvia. Did your Mum stay at the residential home/were you able to overcome that situation with your Mum? Yes it's really hard getting the timing right. You've hit the nail on the head, isolated is how I think she feels and I think Mum would enjoy helping out with light duties so I will have a chat with them and suggest that and see what they come up with too. I think they are trying to work out ways of occupying Mum as I've mentioned politely a few time in the last couple of weeks that she seem bored. It is just so sad when your'e trying to leave and looking for a resident that she can go and talk to or sit with and there just isn't anyone able to do that most of the time other than staff. Thanks again.
     
  6. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,098
    Kent
    Yes @Libby*. We persevered because there was no option. My mother wasn't safe and I needed to work full time.

    She settled eventually but it was tough.
     
  7. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,739
    Salford
    The problem is that you're looking at a very specific window which may be a long time or may be short time and no one knows how long it will last.
    By te time my wife went into care she no longer knew who she was, who I was or where she was so it never really mattered to her, home to her was where ever there was somewhere to wander around shouting and someone to put food and drinks in her mouth at regular in intervals.
    We have a mix or residents and some I feel have to much capacity to be there, they can still talk, respond to their names and can't understand why all the other people there act so strangely all the time, saying strange things, shouting out, getting in their face/space all the time but many have been in other residential homes and asked to leave.
    "Care home" is an almost meaningless phrase, what one care home will accept another won't and the nice ones stay nice by getting rid of anyone that's even slightly challenging.
    The ones who can understand at least something of what's going on are the ones I feel most sorry for, they know they're somewhere they don't want to be and that where they want to be is in their own home, a lot tend to stay in their rooms most of the time.
    The one's without capacity don't really care, as long as they have somewhere they can wander around or sit and shout they're as happy as they can be, they can walk out of a room then come back 5 minutes later and never realise they've been in that room before so it's a whole new world to them.
    The grey area of you're mum's capacity is hard to cater for as it's a transient phase and so any home that might really suit her now would only be until if or when she declined then she'd no longer fit the specific demographic and have to move on to somewhere more like she is now.
    K
     
  8. Diannie

    Diannie Registered User

    Jun 2, 2015
    157
    Thank you, Libby and Kevini. I can identify with what you are both saying. I asked if there were any little jobs my husband could do but was told no , but he could fold some paper napkins. I take things in for him to do but there is no one else he can interact with. So I go in for about two hours every day so that he has someone to talk to . He also went to a day centre four days a week which he enjoyed. The care leader has said to me she thinks he would be better off in a more specialized place as he is still active and “looks normal”. I get the feeling too that they prefer the ones who stay quietly in their rooms. I get so upset seeing him on his own.
     
  9. Platinum

    Platinum Registered User

    Nov 7, 2017
    65
    Female
    South east
    I hope it is ok to post here as I too am worried about my OH who has been in a very “nice” residential home for the past three weeks. Prior to that he had been admitted to hospital via A&E which forced his assessment by the hospital social worker. Before that I looked after him 24/6 with one night off with increasing problems as he could not be left, was getting up 5 times a night, and trying to get out at night, was very agitated, all made worse by a permanent indwelling urinary catheter, and associated UTIs, etc etc. Whilst in hospital he was assessed by the manager of the residential home who agreed to take him. I think the SW and I were surprised as he had a DoLS in place (still does) and had not been cooperative on the ward but the manager said he engaged well and was happy to take him. His first night there was not good as he was totally disorientated, had arrived by ambulance later than he should have to a strange place and arrived in the dark, sundowning. That night he had apparently left his room and crawled outside leaving faecal matter on the carpet (he only had a pad on) and he pulled his catheter out. I had been advised not to visit in order to let him settle but called in with a spare catheter and talked to the manager who although not happy agreed there were mitigating circumstances. We were initially paying on a week by week basis but he agreed to four weekly as I found the former too stressful and uncertain. This home has ready access to local GPS and community nurses. I go in every day and try to get a sense of what is happening which is not always easy. He is being given Lorazepam which is obvious in his demeanour but I have no idea how much. They have never rung me but it transpires he is being aggressive with carers over personal care. He tends to get up early, dresses himself and leaves his room to wander about on his rollator. This means carers are remonstrating with him to get undressed and showered and presumably medication has not been given. If he refuses they tend to leave him. About 10 days ago he was in the room and didn't look good. His catheter bag was draining bloody urine and he had a large deep bruise affecting his buttock and flank but he couldn’t remember falling. The nurse did a bladder wash out and I gather he is being treated for a UTI but it occurred to me he could have bashed his kidney; he is on blood thinners. So the problem here is the carers can give up if he refuses personal care and don’t pursue it even though catheter care is important. He can be incontinent of faeces and yesterday I bed bathed him and changed all his clothes etc. An empty tube of barrier cream has been there for days and the chart on the door for this is ignored. I can get him to cooperate as we had a routine, but if he resists, the carers need to persuade/cajole him and clearly some do this and some don’t. He also needs to drink water but if he refuses personal care his bedside jug seems to remain empty. He is not happy there but he wouldn’t be anywhere. I’m hoping against hope he will settle as the mantra is everybody does. But do they? With a little more input I think things could be loads better for him and them. We agreed that the night staff could do his personal care so he hadn’t had time to get dressed but I’m not sure this is happening.
    My mother died of dementia in residential care but my sister and I were vocal if we felt things were not right. I am reluctant to do this with my OH as I am worried they will not keep him. I have made “uncritical” suggestions on how he can be better managed but the aggression to the carers seems to be reported but not much else. I am assuming the carers are dementIa trained. When not refusing personal care he seems to engage with all the carers in a positive way and can be charming but dementia behaviour is not consistent. He always wants me to take him home but it is to his childhood home not his own home. I will take him out for a drive in future if he settles but am concerned he will refuse to go back at present. There are a number of dementia residents who are much worse than him but possibly easier managed; communication is always going to be difficult between them. Any advice would be more than welcome.
     
  10. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,098
    Kent
    Hello @Platinum

    Is your husband`s home registered to care for people with dementia and are staff trained as dementia carers? You should not have to need to monitor his care . The care he is being given should give you more quality time with him when you visit.

    I would have a word with the manager and ask if the home is sufficiently staffed to meet your husbands needs and if all staff are trained in dementia care.

    My husband was in a small home which wasn't `smart` as far as furnishings went but when he was in a stroppy mood the staff were gentle with him. When he refused personal care they went away and returned after a while to see if he would be more compliant. He did not have the demanding needs your husband has but did resent personal care. After a while the staff gained his trust and even though he still had awkward moments they understood him and he became much more contented.

    I would consider looking for alternative care if the home your husband is in, however "nice" it is cannot meet his needs. I understand looking at care homes is soul destroying especially when your husband has challenging behaviour but he deserves better than the care he is currently getting.
     
  11. canary

    canary Registered User

    Feb 25, 2014
    9,867
    Female
    South coast
    I think that half the problem with choosing a care home is that we all tend to look at them and subconsciously think about whether we would like to be there, or think about how our PWD would once have felt about it - we sort of picture them doing things and/or using the facilities as they would have once done, so its all too easy to pick the "nice" ones without thinking about whether its the right one to meet their needs.

    @Platinum - it sounds like there were doubts about that care home right from the start. Your husband was obviously in "host" mode when he was assessed and if the manager didnt realise this then it sounds like he/she doesnt have much experience of dementia. Not all care homes are the same - they have their own criteria for who they accept and who they wont and it really doesnt sound to me as though this care home has dementia experience and can meet your husbands needs.I would go and look at at dementia /EMI units and ask the staff if they have experience of your husbands difficulties and what strategies they would use with him. Vague, woolly answers would indicate that they dont have much idea.
     
  12. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,414
    Female
    Hi @Libby* When my mother moved to her care home in February I thought the other residents seemed to have far more advanced dementia than her, but actually as time has gone on I realise that while there are several who are clearly end-stage, most of the others are at some point of mid stage like my mother, although they present differently/have different issues. Some of them are frail and use walking aids but my mother refuses to do so (despite having fallen and broken her hip in the summer) and she walks around the corridors and goes to see the staff in the office - they are always happy to chat to her. Her speech is often very muddled but they have got the hang of what she's talking about.

    The good thing about there being residents with more advanced dementia is that my mother should be able to stay there for the rest of her life - that by any means the case with all care homes. As Kevinl says, some care homes get rid of more challenging residents to 'keep it nice' for the others.

    Also, bear in mind you only see a snapshot of her life. Sometimes when I visit many of the residents are quiet and dozing in armchairs, but other times there are activities going on and most of them are actively engaging with it - it just depends what time/day I go.
     
  13. Libby*

    Libby* Registered User

    Jul 9, 2016
    11
    Thank you Kevin. That is interesting and helpful.
     
  14. Libby*

    Libby* Registered User

    Jul 9, 2016
    11
    Thank you. I guess that's true that It is only a snapshot of the day that I see Mum, I hadn't really thought of it like that. And what you both say about not having to move her later on as I can imagine that would be a very difficult situation.
     
  15. Diannie

    Diannie Registered User

    Jun 2, 2015
    157
    Further to my previous post. This afternoon I went to take my husband out as the weather is still nice here. He was still in his pyjamas. The care leader said he had refused personal care. I said I would help him to shower and clean teeth etc. he was soaking wet as he still had his night pad on. His bed was unmade and the wet sheet was still on. They say they are unable to insist on giving personal care if he resists. He is not aggressive and usually very compliant. He showered with no problem while I was there. My worry is that I darent miss a day visiting because I wonder what is going on. When I got back at 4.30 with him. The bed was still unmade so I asked for clean dry sheets and made the bed myself. I told them if necessary I would come in each day and shower him and make sure he is dry. They said “ Oh, but that’s our job”. But they are clearly not doing it. I would be grateful for anyone’s thoughts on this
     
  16. jimbo 111

    jimbo 111 Registered User

    Jan 23, 2009
    5,078
    North Bucks
     
  17. jimbo 111

    jimbo 111 Registered User

    Jan 23, 2009
    5,078
    North Bucks
     
  18. jimbo 111

    jimbo 111 Registered User

    Jan 23, 2009
    5,078
    North Bucks
    My sister in law was very unsettled and unhappy ,result was that she was aggressive and causing problems with residents and staff
    One day she was asked if she would help the staff prepare and serve afternoon tea to the residents
    The result was amazing , she became different woman,she was pleasant to everyone , helped the staff and residents always had a smile on her face and became very popular
     
  19. try again

    try again Registered User

    Jun 21, 2018
    270
    I think a few words with the manager are called for
     
  20. Libby*

    Libby* Registered User

    Jul 9, 2016
    11
    Thank you Jimbo, that's lovely, I can see that might work for my Mum too as I think it would make her feel good if she thought she was helping people. thanks again.
     

Share This Page

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.