Suggestions with moving into a care hone

Discussion in 'Recently diagnosed and early stages of dementia' started by Lookingafter, Aug 21, 2019.

  1. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    Hi

    Thanks in advance for any advice.
    I’ll try to keep it short.

    Father in Law has mild dementia (not diagnosed), repeating himself, forgetting what day it is, unable to hold a detailed conversation etc.

    His wife is bed bound from a stroke many years ago.

    I’m looking into care homes (self funders) and found a nice one by where the family lives. Attempting a managed move. MIL will have no issue with moving.

    I’ve asked him about moving and the reply is ‘I’m too old’ or ‘what will happen with the house’ or ‘you’re getting fed up of coming to see me’.

    Anyone any ideas of the hidden meanings so I reassure him all will be OK and positive move.

    I’m planning to take him for lunch there and a look round in a few days.

    Thanks
     
  2. Bunpoots

    Bunpoots Registered User

    Apr 1, 2016
    3,179
    Nottinghamshire
    Hello @Lookingafter welcome to DTP

    Most people with dementia are afraid of change so I'm not surprised to hear of the comments from your FIL. It's difficult to know what to say. I always avoided telling my dad about anything I knew he'd worry about until the last minute - usually after I'd got him in the car - and with the promise of lunch after so I think taking him for lunch is an excellent idea. Perhaps going for lunch several times would help with the move so that the place becomes familiar. It might be best not to mention it until closer to the time as it'll give your FIL less time to worry.

    My dad went to his care home straight from hospital so I'm afraid I don't have any experience of getting a loved one to make the move.
     
  3. Pete1

    Pete1 Registered User

    Jul 16, 2019
    184
    Male
    Hi, when I took Mum to look at a Care Home near me, she really liked it - unfortunately she had forgotten about it when we got home! Perhaps (with the homes permission) take some pictures or video of the room (and perhaps other areas if not occupied) that's what I did on an accompanied viewing, it proved helpful later. As I'm sure you appreciate things will only get worse, so if FIL still has capacity and is happy to move it will make things easier. I will say with Mum I really didn't want her to go into care but she was no longer safe at home and was increasingly fearful - she improved dramatically in the care home and had a better quality of life with all of the activities that they put on. I still went to see her every day and she used to wave with a smile from her room when I went past. I wish I had done it earlier rather than struggling on with increasing home care for some time.

    Are they both moving into the care home? If they are there was an old married couple that lived together in the care home where Mum was, they were lovely and really enjoyed the amenities there and treated it like their own home. I hope that helps!
     
  4. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    @Bunpoots, thanks so much for the advice. I can relate to the avoidance of telling him anything. The latest was buying a freezer, I just bought it, unpacked it and explained the benefits later - it took a while but so worth it.

    Sorry about your dad. Hope you’re OK?
     
  5. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    @Pete1 again, thanks for the advice. Taking pictures and a video (with permission) is a great idea also because MIL wanted to look around. ☹️ This is just not possible.

    I can also see their quality of life improving. Sorry Yes, moving them both. Can’t really do one without the other and if I said MIL is going without you, (I wouldn’t be that cruel), it might backfire and he’d say OK I’ll stay here and look after the house.

    Personally, I don’t want to break or reach crisis point. They have three call carers a day for meals and meds. Personal care for MIL. I do everything else.

    Again, hope you’re OK?
     
  6. Pete1

    Pete1 Registered User

    Jul 16, 2019
    184
    Male
    I'm good thanks . It sounds like a sensible planned approach as more often than not it is normally in a crisis situation. Heartbreaking though this invariably is, it will hopefully allow a better quality of life and a safer environment. The care home that looked after Mum also did respite which is potentially another option if they are not fully on board i.e. a trial run (which they also offered as a self-funder), although ideally a permanent move is probably easier.

    The pictures and video of the room helped Mum, certainly leading up to an on the day of the move (we had visited twice before) and I could also share with my sister who lives a fair distance away with a young family. Later also we had access to wifi at the home which enable us to do skype calls with the family which was really helpful.

    I hope it all works out well for you all, it's certainly a difficult time for all of you.
     
  7. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    @Pete1. I must admit, I have no reservations or guilt whatsoever in moving them. It’s the right thing to do in their best interests. Their only son (my late husband) passed away 10 years ago. I’ve been looking after them both for the last 10 years. Re-married for 7 of those and still going.

    Apart from the Terms and Conditions of the Care Home Contract, which I’ve yet to see . My only concern is how to get him to see it’s the right choice. It just feels like it’s not moving fast enough and I’ll lose momentum and give up.
     
  8. Bunpoots

    Bunpoots Registered User

    Apr 1, 2016
    3,179
    Nottinghamshire
    I'm ok thanks for asking @Lookingafter

    For what it's worth I think you're making a wise decision moving your in laws ASAP.
    I put it off with dad as I wasn't sure how long his money would last so we ended up with a nightmare last summer!

    He was much better in the home and had company and even joined in with some of the activities. He stayed there til he passed away at the end of last year.

    I hope the move goes smoothly and you don't lose momentum!
     
  9. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    So, FIL and I went for a visit and lunch today and it went well. He chatted to the staff and we mentioned where their furniture would go. He seemed really happy with the idea although he thought the living room was depressing.

    On route, he was pointing out motorways etc and knew the direction (ish) of my house. He was reading the signs on the back of lorries and telling me about his childhood. What if I’m wrong about dementia??

    The home had a lot of poorly people there and now I’m concerned he won’t really have any one to talk to (he doesn’t at the minute!) or he’s too well for the home.

    It’s not just about him though I have to consider MIL and me.

    Any advice, again, sorry?
     
  10. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    So FIL and myself went to the GP on Wed. He didn’t score very well on a 6CIT Assessment. 24/28 - Referred to memory clinic.

    (He’s not changing his clothes, turning over the TV, eating breakfast, washing himself and has no opinion or wants as before.)

    Friday was the moving in date for both for a two week trial. It went better than anticipated. He’s already fell over - probably disorientated in the night. I visited again today and he was in bed in his pyjamas, unshaven - when I asked him why - he said because he felt lazy and he enjoyed being waited on.

    Can’t really read MIL but she’s asleep most of the time. I know it’s only been two days but I thought things would ‘improve’ / ‘better quality of life’ - I thought I’d feel better knowing they are being looked after 24/7 and eating proper food but I don’t. I guess it’s just early days?
     
  11. jugglingmum

    jugglingmum Registered User

    Jan 5, 2014
    5,272
    Female
    Chester
    This is a phrase my mum uses, she is aware she should do things and isn't but ultimately I think it is because she no longer has enough processing skills to work out how to do it, or doesn't realise it needs doing. Maybe the care home staff need to give him some more prompts, and offer to help.

    My mum isn't in a care home yet so no experience of this per se, but I think it takes a while to fully settle (it did when I moved my mum into sheltered extra care and then she started joining in more - after a month or so), and past a certain point, which is where I think my mum is now, doing anything is too much for a PWD.

    They don't really understand what is going on and are actually content to just sit there. We have definitely found that too much stimulation isn't good eg we reduced the length of time my mum visited my house as she got overtired, much like a toddler would.
     
  12. canary

    canary Registered User

    Feb 25, 2014
    10,712
    Female
    South coast
    Its a hard time @Lookingafter . I think you are right, 2 days is not long and it will probably need more time. Quite often care homes let them settle in a bit to reduce their confusion before starting to make changes. It can take several weeks for them to settle.
    If you are concerned about it have a chat with the manager about how they are dealing with things.
     
  13. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    Thanks for the advice.

    You’re right about processing skills @jugglingmum and not knowing what to do next.

    The two million dollar question is, has he just suddenly deteriorated overnight and given up, will this now be his life! and I’ve made things worse by placing him in a home or was I just ignorant to the fact that he was just as unwell at home but I didn’t notice because of his routine.

    As I left the day before yesterday, he actually said to me ‘thanks for everything you’re doing for me and went to ‘hug’ me’. This was out of character.

    @canary - I think I’ll leave it a few more days, maybe you’re right about allowing them to settle first - last thing I want to do is say to them why aren’t you getting him up prompting to dress and join in with ‘something’. Feels like I’m telling them how to do their job.

    I’m crying as I write this - I know I haven’t been his FT Carer (and have so much respect for those of you on here who are!) BUT How hard is this??
     
  14. canary

    canary Registered User

    Feb 25, 2014
    10,712
    Female
    South coast
    I think its more likely that moving somewhere strange and being confused has thrown a cruel spotlight on the dementia and the problems that were already there are shown up more. When people with dementia go somewhere different eg on holiday, they usually seem so much worse, but its just the different environment.

    As he settles and gets used to the home layout and routine he will probably seem to improve again, but things dont happen overnight

    Tell yourself that he is safe and is being looked after - even if he is still in his pyjamas!
     
  15. Pete1

    Pete1 Registered User

    Jul 16, 2019
    184
    Male
    Hi, a difficult time for you for sure, I think many of us understand the tears. It might be worth having a chat with the manager later in the week (even over the phone if necessary) to put your mind at ease and also to get their perspective of how he is settling in too. It certainly takes a little while to settle and also for the staff to get to know him too. Take care of yourself.
     
  16. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,772
    Female
    Yes, as @canary says, absolutely this. People with dementia can often appear to function fairly well on familiar territory and when making choices about what they engage with (as per your journey with FIL) because they find ways of masking the things they can't do.

    I suspect getting dressed may have become one of the things he can no longer do - he may not be able to remember the sequencing. Next time if he's still in his PJs you could try saying "time to get dressed" and lay some clothes out of him to see if that helps. The staff will be watching to see what he can do and where he needs help or prompting, but will also want to leave him the space to settle in. My mother was in a total of heightened confusion for the first few days, and reluctant to join in very much. Within about 6-7 weeks she was well 'settled' and she genuinely thought of it as her home. It takes time to get familiar with the atmosphere of communal living and learn to rely on the carers.
     
  17. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    Thanks for the advice so far..

    So FIL and MIL have been in just over a week. He’s managed to get dressed with prompts but refuses personal care. Even from me.

    I’ve been every other day and he’s lying on his bed (albeit fully clothed). Today, I managed to get him into the garden and we played darts.

    But what really concerns me is that he’s not eating. He’s had about three halves of toast over the last 4 days and drinking fluids has deteriorated. His meal came today - a lovely Sunday roast and chocolate gataux, he basically turned his nose up at it, in my world I’d do that if I was feeling nauseous.

    I did ask whether he was in pain, due to his teeth, unable to go to loo etc but I got nothing from him. He was extremely thirsty though and drank 3 small glasses of water in one go.

    To be fair, I understood from the home carers that he was throwing his breakfast away at home so maybe he’s was with his lunch and dinner - who knows?

    The room is so hot and MIL (whose with him in same room) is asleep ALL the time! At least when she was at home we managed to get some conversation out of her.

    Aside from the requested blood test, how can I know why he’s not eating?

    Thanks again you lovely people! X
     
  18. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,772
    Female
    Reluctance to eat is a fairly common problem so I am sure the CH have a protocol to deal with it, have you asked what action they are taking? My mother is underweight and has phases of being reluctant to eat, which generally coincide with her being in pain of some type. But it can be very hard to find out what the problem is because the PWD can't say.

    Has your FIL been tried with finger food - cake, or chips, something easy to pick up? After a hospital stay my mother lost the ability to use cutlery. That is not something that would have occurred to me, but the CH staff recognised quickly what the issue was, and cut up her food and gave her things which were easy to pick up. They also gave her Ensure type drinks for a few weeks. She often needs prompting to eat though.

    Are the CH ensuring your dad is regularly prompted to drink fluids?

    Also, is he eating alone in his room? My mother tends to eat better if she is in the dining room, surrounded by other people eating at the same time.

    Re the heat in the room, is it possible to turn down the thermostat on the radiator so it's a bit cooler? People with dementia do tend to feel the cold though, so they may find the temperature fine.
     
  19. canary

    canary Registered User

    Feb 25, 2014
    10,712
    Female
    South coast
    I concur with that.
    In the later stages mum needed the visual cue of someone in front of her eating as well. Otherwise she didnt know what she had to do - Im not sure that she recognised it as food.
     
  20. Lookingafter

    Lookingafter Registered User

    Aug 21, 2019
    27
    Thanks for your messages, helpful as ever.

    He is presented with finger food at tea time but this is still refused. He’s refusing all hot drinks also.

    They are monitoring all fluids (and food) via a filled-in sheet.

    He’s in the same room as his wife and has eaten something when he first went in. I doubt they will get him to eat in the lounge.

    I have spoken to the nurse about it and the CH does know. I’ll ask what they are doing about it when I visit later?

    Thanks for the tip about them feeling the cold more. I’ll be careful not to open the windows fully next time I visit.

    I’m struggling to think that he doesn’t know what to do about the food however, he said ‘what’s this? i didn’t ask for this’.
     

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