Should we say anything!

[karen_white]

I wonder if anyone could give me some advice.
My Dad is in a nursing home and has vascular dementia. He's in an EMI unit and has been for just over 2 years now. Since he's been at the home he's had some mini strokes which we have accepted and coped with. One of them has limited the use of his right hand and arm. This was his prominent hand and he's had to get used to using his left. He's done really well, and uses his left well.
His right hand has turned into a bit of a claw which he has a lot of difficulty opening. We try encourage some excercise with it, but to no avail.
Mum and I visisted on Tuesday and his right hand looked swollen and bruised (had a green tinge to it). We couldn't get Dad to open his hand so I had to get a mirror to look underneath as his fingers to see if they were ok.
I was shocked to find that Dad's middle finger was completely black/dark red and very swollen. To the point where his skin was tight and shiny.
Dad seemed embarrassed, but I finally encouraged him to open his hand. I was so upset with what I saw.
It was like he had caught it somewhere. I know that Dad can be agreesive and lash out, but this seemed more than that and it was isolated to this middle finger.
Mum went to question the sister on charge who said that it was noticed in the morning, but they did not catch it in time to put an ice pack on it. They'd offered Dad an aspirin to help with the pain, but he had refused and passed her off with the fact that Dad is 'always thrashing around'.
When Mum asked if he'd caught it somewhere, they immediately went on the defensive. Mum wasn't saying that they had caught it, but they seemed a bit to defensive and immediately said that there was no way this could of happened (even though they have no idea how he did it!!!!).
Mum spoke to the ward manager today and again was waved off as being an overprotective wife.
They don't seem to realise (no matter who much we tell them), that we are in no way questioning there care, but we do have a vested interest in our dad/husband and have a right to ask when he's had an injury.
I wouldn't think they are treating him badly, but we don't feel we can say anything to the owner as they may take it out on Dad. We could not of course prove this, but Dad cannot speak anymore so he would be able to tell us anyway.

Also, on a side point, while we were there we were talking to one of the nursing staff and discussing light heartedly about a conversation between Dad and one of the other patients (they had had an arguement). Dad kept pressing mum's leg with his as if to ask her to be quiet. Which I find worrying. Dad can understand and can decifer what he wants with yes and no. It was like he didn't want us discussing anything with the staff....as if he would pay for it later.

I know I'm probably over reacting, but I worry so much. Can anyone help with this. Tell me I'm being silly and re assure me - please.

thanks for reading
Karen

 

[Chesca]

Dear Karen

Being concerned about the welfare of your Dad is never a silly matter, so put that idea right out of your head. You need to leave Dad in safety and security, not walk away worrying your day away.

I had a similar incident some months ago, when I was called to Mum's nursing home 9.00 p.m. to accompany her to hospital as she had cut her leg. Gouged was more like it - needed stitches and, possible at the time, a skin graft! Nobody had an answer! Although I did raise cain after so much buck passing. The only conclusion was that there were only three people on duty that night (daytime there are six) - one of them unable to speak much English and a temp, although the soul of kindness - so vigilance was at an all time low. That's the responsibility of the management. However, Mum is in a nursing home which is part of a very large group. Is your Dad's a privately run home?

I had noticed on several occasions people in the wars - black eyes, bruised arms, limbs in plaster sufficient to prepare me that in the event of it happening to Mum I wouldn't let it lie. And I didn't. Mum is in a nursing home because she requires 24 hour nursing care as she may be risk outside of that environment - the consultant's diagnoses at any rate. Many of the staff don't like me for asking questions, but many others are of the opinion that their reaction would have been similar had it been their relative.

One of the practices of mine is to visit Mum at all kinds of hours, not a fixed routine. I get a better view of what goes on around the clock that way and have discovered some things I didn't like. So much so that the Matron got the lot when she went on the defensive (I had her hauled out of her bed at 4 in the morning) - like the time one of the patients was locked out in the garden in November and only an incoming duty nurse had noticed him - he wasn't missed. I happened to be there at the time, said nothing. Then there were the staff having tea whilst the very less able were falling out of chairs......I could go on, and often do.

The matron was recently replaced, whether as a result of that I don't know, but she won't be missed (even by some of the staff!). Even the smell of the place has improved. I haven't seen so many wounded since and I do make a point of looking.

Yes, the residents are vulnerable and unsteady on their feet, yes they can have accidents, and yes they can injure themselves if they lash out if they are feeling particularly aggressive. But I should tell you, in a situation where one of the residents was so terribly ill and consequently violent the nursing home had him returned to the hospital as it was unsafe for everybody concerned.

Perhaps if you approach the manager from the standpoint of understanding the difficulties that arise but that you need to know in the interests of everybody, but principally Dad (between clenched teeth but quite calm, of course). A good home will have a management prepared to listen and reassure, a bad one won't - there's a lot of money involved as you probably well know. If it cannot be resolved perhaps you may have to look elsewhere for peace of mind. But he has been there for two years. Have you before felt uneasy about similar incidents? It may well be that the staff don't like to say Dad may have been cutting up rough (you should have seen my formerly gentle mother kick it up prior to medication) and are trying to spare your feelings.

You and your Mum will know best. If Dad is fairly aware though unable to speak, perhaps you could develop some kind of code - eyes right for yes, left for no, that kind of thing. I really do feel for you. It's distressing enough to see our loved ones so vulnerable but to see them injured brings out the fighting lion, I know.

I'm sure others will have thoughts and suggestions and get back to you. Sorry to have gone on so, but it is a subject very close to my heart.

Thinking of you all, take good care
Chesca

 

[Sheila]

Hi Karen, Chesca is right about going at different times, keep them on their toes, I did that too and you learn a lot. As you say, no one seems to know waht happened to your Dads hand, but by asking about it, at least you know they are aware you will be watching any further mishaps. It is a very tricky situation as Chesca says, but your main concern is the welfare of your Dad, they should understand that and appreciate your concern. If they don't, like Ches says, you may have to look elsewhere. I do hope it is all quickly resolved, these things usually are. A lot of the time the staff feel uncomfortable because they are just as upset about it as you are, caring staff grow to love their charges. If they don't know how it happened, it can make them feel inadequate and that can in turn make them a bit twitchy. Only time will tell, try to keep any quieries friendly, even if you don't feel it, you'll get a better response than if it's seen as critism. After all, their aim is to ensure your Dad is safe and cared for isn't it. Thinking of you, love She. XX

 

[Brucie]

Yes I agree with all above.

Even in the best care homes things do happen. It is not possible to stop falls etc ALL the time.

Just this week I found that Jan had a bad graze on her shoulder that I had not been told about and muttered almost to myself - "I wonder if the level of care is dropping because the PCT has not paid the home for Jan's 1-to-1 care for 4 months" [appalling!].

One of the staff heard and the next day the manager asked me to step into her office!

Not to cause trouble but genuinely to try and understand if there was a problem. In this case I apologised because 1) the care staff don't know about the financial stuff and shouldn't be involved 2) I had over-reacted because the wet dressing they had put on the graze looked really appalling [I'd not seen one like that before and thought it was her flesh!] and scared me rigid.

We agreed that the care is not getting worse, and also the manager agreed to reaffirm that I would be told about EVERY injury that Jan has.

There's never any rest is there?

Final worry is that the PCT now questions whether Jan should be at the home at all, and would like to offload her because the payments are so high. Another battle, another year!

 

[nikita]

bloody money

as if you havent got enough to worry about bruice where are they wanting to off load jan to ??, things shouldnt come down to pound signs there seems to be money around for trivial things its time the government got their priorities right.

 

[Norman]

Bruce and Nikita
So sorry to hear of the problems Bruce it's awful to have to start and worry all over again.
What's wrong with this country of ours,where's the cradle to grave care we were all promised?
When will people not have to sell up there lifetime of saving,their houses and anything else they may have worked for.
Every thing is wonderful until you ask for help,then the treadmill starts.
Having to battle for everthing,to threaten,cajole,it's all wrong.
It really makes me mad to think of folks with no one to back them up, trying to get help,they have no chance.
Lets hope the new year will be better for all of us,the elections are on the way the time to question MPs.
Day to Day
Norman

 

[karen_white]

Thanks for all your replies. Dad's finger is getting a lot better. The ward manager tried to pass it off now saying that she thinks he layed on in during the night.
She must think we're a bunch of morons!
The Doctor has seen him again and he happy with the condition of his finger.

I guess it's just the way we are treated and the fact that they are very dismissive when we ask about Dad's health. We know that he will get bruises from time to time and hurt himself. I just wish they'd understand that we're bound to have an interest in his life, he's our Dad, husband, etc.

Thankfully he say he's not feeling much pain from it either. He's really as strong as an Oxo my dad. they had a new year party ready for the 2nd Jan, but had to canx as most of the patients have come down with a chest infection or a new strain of the flu. Dad looks positively glowing and has managed to stay fit and strong throughout.

Warm regards
Karen

 

[Chesca]

Dear Karen

Delighted that Dad seems a lot brighter and your problems have eased a little. It's always good to be able to share the better times, too.

Best wishes
Chesca
x

 

[Sheila]

Hi Karen, glad things are on the mend, love She. XX