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To move care home to be nearer to family

iain123

New member
May 14, 2022
6
0
Hello Forum

The family have the dilemma of would moving my aunt of 89 years who has dementia and unable to weight bear at all to a nursing home nearer to us.
Contractures developed in her knees while at the nursing home, so unable weight bear.
We live over 200 miles away and have poor communication with nursing home at the ward level at present, i have involved sociol services, but this has not helped so far.

My aunt has been a resident for just over a year in her first care home.
Before this she was living at home independently and subsequent to falls in early 2021 discharged from NHS to this nursing home.

There appears to have been step declines in her mental ability on each of the two falls and UTI ... and major step decline on transfer from the NHS to the nursing home, "transfer trauma".



More upsetting than the confusion is the verbal distress my aunt often displays about 50% of the time.

My aunt was very quite person before the decline, but now often talks constantly if more awake and 50% of this time in a distressed manner.

My aunts talking can upset other residents a bit.



Triggers for the distress talking seem to be, so she trying to get help

Dirty pad very distressed

Wanting to go home

Currently to help as intervention i am trying to arrange for a paid for visitor.



iain
 

Jaded'n'faded

Registered User
Jan 23, 2019
3,208
0
High Peak
Is she self-funding? If so, this is fairly easy and you can just find somewhere near you that's happy to accept her and move her.

If her care is paid for by the LA it's a lot more difficult but still possible.

It's far easier if she's in a care home is near you, for lots of reasons.
 

Sarasa

Volunteer Host
Apr 13, 2018
4,854
0
Nottinghamshire
Hi @iain123 and a warm welcome to Dementia Talking Point.
As @Jaded'n'faded said if your aunt is self-funding I'd just arrange the move. It would be best to look at a few places first as not all homes are the same and you'll know what would suit your aunt and what would not. I moved my mum from a care home near where I used to live in London to one near where I live now in the East Midlands last year. My main reason for the move included not being able to get there quickly if there was a crisis, but also the ease of being able to visit without a three hour plus journey.
If your aunt is being funded by social services I guess you'd need to talk to them about why you want to move her, I haven't any experience of this, but I'm sure those that have will be along shortly with their input.
I used a private ambulance to move mum and the journey was smooth and easy, so I think doing similar is probably the way to go, specially as she has mobility problems.
Mum has declined quite a bit since the move, but I think this is the natural progression of the disease and not caused by the change of home. In fact I'm not sure that she notices she's moved.
 

iain123

New member
May 14, 2022
6
0
Hello thank you for the replies
Sorry I did not make my concerns clear
We are concerned that a move to a new care home may be traumatic for my aunt and result in a further step decline cognitively and emotionally. As previously the move from the NHS to the current care home resulted in "transfer trauma" a clear step decline.

The funding part was not really why posted for feedback, but i will give some details
My aunt is self-funding + NHS nursing care award
The home has very poor communication and would not talk to a prospective new home eg permission, answer questions.
I think this could be sorted by contacting management
Very few nursing homes local to us two in total
 

Sarasa

Volunteer Host
Apr 13, 2018
4,854
0
Nottinghamshire
Hi @iain123, I think if the move was well managed it shouldn't result in any trauma for your aunt. I don't think my mother has noticed she has moved, as I deliberately chose a home very similar to her old one. We also moved my mother in law into care last year. One of the worries the family had was over the trauma of the move. The home went out of their way to make sure every thing was as much like her home as possible and she too doesn't really seem to have noticed she's moved. At the time she moved your aunt had had two falls and a UTI which probably contributed to the decline. Also decline is inevitable with dementia I'm afraid. The distress you mention is also part and parcel of dementia, though a good home will try and limit the distress caused.
 

Jaded'n'faded

Registered User
Jan 23, 2019
3,208
0
High Peak
It's impossible to say how a move will affect the person with dementia. Much depends on the stage she is at and everyone is different.

Although your aunt has been in her current home for a year, she doesn't sound very settled and it doesn't sound like the staff are dealing with things very well. If you move her near you, you will be able to visit a few homes first to find one you like. You'll also be able to visit regularly and keep an eye on things. Unfortunately, care homes are often poor when it comes to communication but they don't have much choice when there's a visiting relative asking questions, so you'll have more control.

I'd also suggest you refer her to the GP re. the constant talking. It sounds as though she is anxious/agitated and the doc could probably prescribe something that will help her mood.

The move itself should not cause her to deteriorate but she is clearly going downhill, as you have seen, so there may not be any obvious positive changes. At least you will know she safe and nearby should you be called to go there urgently, which will give you peace of mind.

Falls are very much a part of dementia and are hard to prevent, even in the best homes. My mother was talking to a carer with another carer standing nearby, but another resident pushed her and mum went down on her bum, broke her hip. It took everyone by surprise and could not have been prevented.
 

MartinWL

Registered User
Jun 12, 2020
2,029
0
65
London
To offer my fourpenthworth on this, the most important thing is to get the most suitable care home for your aunt, offering the best care. The location is not unimportant but is a secondary consideration. She will be there all the time, your visits will be presumably only from time to time. Less frequent visits would be a sensible price to pay for a better home.
 

iain123

New member
May 14, 2022
6
0
Regarding my aunt's current distress, this bothers me a lot.
She was an anxious and quiet person before the dementia

Previously I contacted the community mental health team, who "look at my aunt's situation" and told them of constantly wanting to leave and appearing distressed, I was not aware of the pad issue at this point.
The upshot of this was as the home did not report any behavioral issues eg my aunt physically trying to leave the home (as she cannot stand) or fighting staff when they care for her. The community mental health team did not want to prescribe any medication as it could worsen my aunt's confusion
So my aunt was discharged by community mental health.

If my aunt was local one of us could visit at least once a week,
covid created added problems with think of moving my aunt.
The problem with visiting is my aunt will want you to help her leave to go home often on the occasions I have seen her.
And she will get more and more agitated while you sit with her as you are not helping her to go home.
Or wants you to help with the pad
So getting her settled not distressed if possible would be a great help.

My aunt being distressed "does not bother the care staff", as they can sit away from the residents get or get on with other issues. However, I have noticed other residents getting fed up with my aunt's distress, and one verbally telling her to shut up.
 

Susan11

Registered User
Nov 18, 2018
4,295
0
Well I tried this. I looked at 12 homes and chose the best one for my Mum about 20 mins from my home. We arranged everything and brought her down from Lancashire to the new home in Harrow. She complained constantly on the 3 and a half hour journey. She asked us to drop her on the side of the road so someone would take her back to the CH where she had been for 6 weeks since my father died. We got to the home and she hated the room (whuch was bigger) and told me that under no circumstances was I to leave get there. I rang the previous CH and luckily her room was still available so my husband drove the three and a half hours back. We couldn't have left her at the new home without contacting a Dr to give her a sedative. The truth of the situation was that the people at the care home didn't look or sound like her . She felt comfortable in the original CH with the residents and staff. Moves like this are not easy. And of course people with Dementia dont always react how you hope they will. Good luck with whatever you decide.
Susan
 

Frank24

Registered User
Feb 13, 2018
346
0
Been there thought that. Very hard situation for you totally understand. My Mum in Wales and me in London. Sadly my mum is now EOL.. and I’m so glad I did keep her here as they have been amazing. It sounds like your not convinced the care is good. It’s NEVER good enough when your seeing a loved one distressed by this disease. Possibly not making much sense but I wanted to say I hear you, understand the issues and feel for you xx
 

iain123

New member
May 14, 2022
6
0
Thank you for all your replies and support
confirms that any move is very personal and unpredictable and guess work to major extent.

I was thinking if my aunt was sedated to travel,
they awake in their new home if this environment change could be traumatic, different carer voices, feel to the bed routine, etc
especially when your relative can not tell you anything
 

Sarasa

Volunteer Host
Apr 13, 2018
4,854
0
Nottinghamshire
I can see your dilemma @iain123 as you obviously don't want to cause your aunt any more distress than she is already experiencing. Has she been checked by a GP lately as I wonder if she is in pain?
That is sometimes overlooked as a cause of distress.
As I said above your aunt might not notice the move or it might in some way ‘reset’ how she feels about things. My mum moved floors in her previous care home, and she settled much better than she had done up to that point, with different carers, different residents to interact with and a different feel to the place.
At the moment while you decide what is best maybe try to have a proper discussion about it all with the manager at her current home to see if there is anything they can do to help her settle better.
 

iain123

New member
May 14, 2022
6
0
Yes, I am currently seeing if we can do anything about getting my aunt more settled as a resident in her current place.
Thank you for reminding me about pain, on my last 4 visits pain did not seem to be the main issue for the distress it was the pad.

I have been trying to arrange a paid visitor, but my aunt often gets agitated as she tries to get the visitor people to help change her pad or go home ...and this builds up the longer you are with her. So the visitor might not work as a friend for my aunt but would give some feedback.
 

iain123

New member
May 14, 2022
6
0
shes not sore from wearing the pad, maybe thrush perhaps that can irritate and is sore and itchy.
Hello Jennifer
I think one of the reasons my aunt talks in a constant distressing way is when she definitely needs a pad change.
I think it's the delay of time between requiring the pad change and the actual pad change that is one of the causes of distress as her talking gradually builds up say over an hour.
As you say It could be other problems that aggravate the desire for a pad change but have to trust the staff.
Therefore a review by the NHS incontinence team (independent of the home) would seem worth asking for in case there is anything aggravating.
 

jennifer1967

Registered User
Mar 15, 2020
11,801
0
Southampton
Hello Jennifer
I think one of the reasons my aunt talks in a constant distressing way is when she definitely needs a pad change.
I think it's the delay of time between requiring the pad change and the actual pad change that is one of the causes of distress as her talking gradually builds up say over an hour.
As you say It could be other problems that aggravate the desire for a pad change but have to trust the staff.
Therefore a review by the NHS incontinence team (independent of the home) would seem worth asking for in case there is anything aggravating.
the care home themselves can refer her to the continence team and would be better coming from them as they can tell them the problem. it maybe also that a doctor could prescribe a barrier cream so the skin is protected from urine. the carehome can ask for a visit as well. they could take a look as well to make sure there is nothing else going on.
 

AlifieBow

Registered User
Oct 21, 2021
27
0
I have had a similar situation with my mum. I spoke to an Admiral Nurse who, obviously could not give specific advise as she did not know mum, but was very helpful. For me, I have a sibling near her who would not want her moved so slightly different from you. However, Admiral Nurse pointed out that all homes are different, and if mum was relatively happy where she was and I felt well cared for, that the risk could be the new care home was less suitable. Mum can be challenging.

If I was you I would go look at the two near you, really get a good idea of what they are like. Continue to do the best with the bad communication where she is and then make your choice. Based solely on where you then think she will be cared for best. Hope that makes sense. She will manage the move if the new care home is better than the last, any initial problems will pass.

Good luck and look after yourself too.