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yet another care home query

Discussion in 'I care for a person with dementia' started by JackyS, Aug 12, 2015.

  1. JackyS

    JackyS Registered User

    Mar 14, 2010
    175
    Cheshire
    Hello again - I feel a little nervous as this is my first post for a couple of years - but i know I'm among friends.
    My Mum was diagnosed with Alzheimers and VD about 5 years ago. She went into a care home around 3 years ago and, all things considered, things haven't been too bad. Well, she's been generally physically well, I've continued to take her out for tea and cake or lunch once a week for most weeks and we've had lots of laughs (laughter is my Mum's signature emotion!)
    The care home is not the most glamorous but the staff are lovely and - although overworked and underpaid - I think they do a really good job and Mum has grown very fond of many of them.
    But recently I've just felt things are going a bit downhill. There never seems to be enough staff on - it takes ages for anyone to answer the door to let me in (I usually visit once a week in the evening after work and once a week at the weekend during the day) - and even longer for anyone to be around to let me out again. Mum's incontinence is developing at a pace and the smell of urine (or poo) is getting worse. She is increasingly having UTIs - but I don't always know if/when she's on antibiotics and she hasn't always got an incontinence pad in. There doesn't seem to be a lot of activity - they're usually all in lounge watching TV no matter what time i arrive. Then she's been attacked by other residents 3 times (the manager told me after the first time that it was only the second time she'd experienced it in all the time she's been at the home - and she was there before Mum arrived). The staff (as opposed to the manager) assure me that Mum is not aggressive or argumentative when I'm not there (she's never been like that when I am, so I would have been surprised to hear otherwise) - so it was the other residents that caused the problem. And, for the first time in 5 years (other than the first few weeks when she went into the home), Mum is asking to go out from the home and/or come home with me).

    Is all this just the disease progressing and to be expected? She's 91. Or has the home now got fewer (or less experienced) staff? And, should I be notified when Mum is on medication? And should it always be me pressing them to take a urine sample and get it checked when she doesn't seem herself? A couple of weeks ago when I visited, I heard her crying in the loo and when I went in, her wee was dark brown (sorry, but I know you won't mind these details). And why does she only get a bath once a week when she has "accidents" daily and quite clearly needs it more often? I don't blame the staff at all - I really believe they do their best - but they're clearly stretched and ....... oh I guess I just feel there's something more I should be doing, but is that just guilt?
    I feel so guilty sitting here in my clean home (well, cleanish!), wearing my clean clothes (all of which are mine), sipping my wine while waiting for my husband to pick up the take-away. I don't exactly think Mum is "suffering" - I just worry i should do more to ensure she is being properly looked after - and kept healthy, engaged and happy. The problem is I simply don't know what my rights are!
    Help? Advice?? Please????
     
  2. marionq

    marionq Registered User

    Apr 24, 2013
    5,860
    Female
    Scotland
    I have only recently begun looking at care homes and some of the points you mention are the ones which troubled me. Not enough attention or activities. Residents in rooms with no member of staff to intervene if necessary. Washing of residents not done routinely. Appalling smell of urine from carpeted floors.

    Staff were all pleasant and friendly but seemed overwhelmed. I'm not sure what you can do other than look for a better place if you think this one has backslided
     
  3. Lilac Blossom

    Lilac Blossom Registered User

    Oct 6, 2014
    520
    Scotland
    Hello Jacky

    I do not have experience of care/nursing home yet as I still care for hubby at home but I am alarmed to read that your mum has been attacked by other residents - this can't be allowed to continue!

    You mention that her wee was dark brown. OH is taking antibiotics, MacroBID, at present, he has UTIs from time to time, and one of the likely side effects is that urine may well be dark brown so maybe your mum'sUTI is being treated - no harm in asking.

    Lilac
     
  4. JackyS

    JackyS Registered User

    Mar 14, 2010
    175
    Cheshire
    Thanks Lilac - the current UTI is being treated but when I noticed her wee was dark brown and mentioned it to the carers, she wasn't on any meds - and it was only because I mentioned it that they then did a MSU and got her started on antibiotics.

    And yes, Marionq, I guess I could start looking elsewhere. But she is in an ordinary care home rather than a dementia specialist one (even though at least 70% of the residents clearly have some form of dementia) - and I worry that moving her at this stage could do more harm than good.

    I've decided to take the bull by the horns and ask for a meeting with the manager to discuss whether Mum can have more frequent baths and whether they can keep me informed if she is started on any meds etc Currently I only find out if I ask the carers.

    Has anyone got a handy list of what you SHOULD expect from a care home - both as a resident and as a family member?
    xx
     
  5. canary

    canary Registered User

    Feb 25, 2014
    10,569
    Female
    South coast
    #5 canary, Aug 13, 2015
    Last edited: Aug 13, 2015
    A lot of care homes that are not specifically for dementia residents take the view that although they can ask, or remind, people about personal care if the person refuses then they cant insist. This is fine for early stage dementia, but once there are problems with incontinence and/or personal hygiene it really needs better techniques.

    It may be that your mum is reaching the stage on her dementia journey when her difficulties are becoming more challenging and her present CH cannot meet these needs. When you meet up with the manager ask them what behaviours they would consider inappropriate for living in her present CH. You may find that you will have to move her as her dementia advances anyway and perhaps it will be better sooner rather than later.
     
  6. JackyS

    JackyS Registered User

    Mar 14, 2010
    175
    Cheshire
    Yes, thanks canary- that's sound advice.

    I've put a call in to my Mum's GP and will ask him if he thinks it's time to make a move for Mum. I don't know why I didn't think of it before (funny how your emotions can totally cloud your judgements!:D) He should know all her current (and recent) medical issues - and, hopefully, will be able to advise whether Mum is likely to get more 1to1 care in another local home (there is a dementia one near by). And, he should be able to advise whether moving Mum now might do more harm than good.

    And if he can't do all that, I'll ask if he can get the nurse specialist in to see Mum and take a judgement accordingly?

    Oh, feel so much better now that I have a plan - and now that I will be taking advice from the experts. And I'm going to do all this BEFORE I meet with the manager at Mum's current home.

    Thank you everyone for helping me get my head back in gear! I feel I've got my mojo back xx
     
  7. JLSW

    JLSW Registered User

    Jul 23, 2015
    14
    You could check the Care Quality Commission website - cqc.org.uk - for details of the most recent inspection of the care home in question. Has there been a change in ownership recently? Or a new manager? Something that may explain the change in standards of care being provided.

    In terms of what to look for in a care home - Age UK have some good information about what to look for and the types of questons to ask.

    You should always be able to approach the manager / deputy manager / lead nurse of a care home with your concerns. If you have serious concerns please contact the safeguarding team at your local authority; details will be on your local authority's website, under Adult Social Care.

    Good luck
     
  8. Girlonthehill

    Girlonthehill Registered User

    Jan 1, 2015
    32
    Dorset
    #8 Girlonthehill, Aug 16, 2015
    Last edited: Aug 16, 2015
    Bringing mum home from a care home.

    I
     
  9. Soobee

    Soobee Registered User

    Aug 22, 2009
    2,734
    South
    #9 Soobee, Aug 16, 2015
    Last edited: Aug 16, 2015
    Please check out the factsheet about choosing care homes (see Alz Soc resources on the right hand side of your screen below the blue bar)

    http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=150

    there's a factsheet about UTIs too

    http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=1777

    and this guide to what to look for when choosing care homes:

    http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=1597

    I moved my mum to another care home and she was looked after much better there (it wasn't great but a vast improvement on the previous one). I think it's similar to moving your child from one school to another - you are doing it for the right reasons, and hope that you are doing the right thing, but you don't actually know for sure until you try.

    I would strongly consider looking around and if you find something that you think would be more suitable then you have your answer.

    My mum's fluid intake was monitored at certain points because her urine was dark-coloured she was obviously dehydrated. Please ask the care home to note how much she is drinking and be able to show you this chart on her care plan.
     

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