I haven’t felt like writing after my last blog post ‘Finding a good care home (part 2)’. Mum’s move to a new care home has been more traumatic than I imagined. It felt at times that all the months of preparation, shortlisting, interviews and visits were a complete waste of time. Conscious that this blog is supposed to be about supporting the wellbeing of someone you love, I’m not sure I’ve got much useful advice to share. But for the sake of completing my series of blog posts on ‘Finding a good care home’ here goes…
Mum was on her feet, by herself, with a zimmer frame in a big living room when I visited her for the first time at the new care home. I said hello casually, as if I had seen her just yesterday, and gave her a kiss. I concealed my sadness at how unkempt she looked. Mum appeared happy to see me, then a bit emotional. I gave her a hug, and her tears triggered mine. My pent-up emotions bubbled over. A lot has happened to her since I brought her to the home two weeks ago. We laughed that we were both in tears, and quickly moved on.
In my last blog post we had the choice of two care homes. Both were asking mum to stay, in one case for a few hours and in the other for a couple of nights, so they could assess her.
Dismissed one of my top two care homes
On collecting mum from one of my top two original care homes (Care Home B, as I called it in my last post), I realised I wouldn’t feel happy to have mum stay there permanently. I was struggling to get over the shabby interiors and ramshackle feel of the place, even though I do realise in the scheme of things this is not that important. It didn’t bode well that on arriving mum instantly recognised she was at an “old people’s home”, the last place she wants to be. When I went to collect her after her assessment, I was concerned to find her sitting on her own, feeling anxious. In spite of my original positive assessment, I feared this place was no different from any other care home that I had seen.
Respite planned at another care home
Meanwhile, another care home, which wasn’t on my original shortlist, had agreed to have mum for respite. I thought that if respite worked, we would extend her stay. It’s a dementia specialist care home and it had been recommended to me. The grounds are lovely, and they have two spacious lounges with big windows that look onto beautiful gardens. Residents are taken into the gardens when staff availability allows. The care staff and managers seem caring. I was particularly impressed with the activity coordinator. The home is a short walk from mum’s old home; so it would be close enough to get visits from her friends and to attend services at two local churches.
This care home had lots of reservations about whether they could accommodate mum and had asked her to stay for increasing amounts of time so they could “assess” her. When they finally agreed to two week’s respite, I moved mum in. Packing mum’s stuff and taking her there without telling her that the move might be permanent was traumatic for me. There was no point in making her unnecessarily anxious, but it felt duplicitous and wrong. There was no opportunity to acknowledge the huge thing that was happening, the end of our year together.
Mum has two falls
Things quickly went from bad to worse…
The morning after I dropped mum off, she had a fall. I spent a long day and evening with her in A&E, with my sister and cousin relieving me for breaks, until she was moved to a ward shortly before midnight. She spent five nights in hospital mostly waiting for an MRI scan and physio. When she was finally discharged back to the care home, she had another fall, again within 24 hours of arriving back.
Care home reluctantly takes mum back
Mum was sent back to the hospital in an ambulance. A doctor discovered from the previous MRI scan she had a hairline fracture from the first fall and recommended 4-6 weeks rest.
The care home manager informed the hospital that they wouldn’t be able to take mum back. They felt they couldn’t “accommodate” her needs. The combination of her high levels of anxiety, being unsteady on her feet and her inability to remember that she had reduced mobility, meant that a member of staff had to be with her all the time. The care home was understaffed; the manager felt they wouldn’t be able to cope. Fortunately the hospital consultant intervened and offered out of hours support to the care home (I have acknowledged this consultant’s engagement and progressive thinking in a previous post). Our social worker reminded the manager that they charge extra for their dementia care, and the care home (reluctantly) agreed to take mum back.
Frequent visits thwarted
Now mum was finally back at the home, my sister and I were keen to visit frequently to help her settle. It’s important to create the sense that family is nearby, in the other room, just around the corner, so your loved one associates the place with family, and feels more relaxed. “The best homes now encourage lots of family presence especially over the first 72hrs,” explained Shirley Pearce, founder of Understanding Dementia on twitter.
However, before my sister could visit on the first day there was an outbreak of dysentery, and the home was closed for what turned out to be over a week. No family or friends could visit the home. Fortunately, mum did not catch the stomach bug, but she had no visits for the first nine days.
Reservations and positive signs
The encounter with mum that I describe above was therefore her first visit from anybody since she arrived back at the care home. During the time the home was closed for dysentery, I was away, returning home to pick up the strands of my former life. I’m now back here for a week, and have visited mum several times every day since Friday when I arrived. Although I have reservations about the home, there are positive signs too.
I will work with the home to help them tailor mum’s care to support her wellbeing. I am painfully conscious I have been here before. I started this blog over two years ago to share what I learn about improving mum’s wellbeing at the care home she lived in then. I’ve come full circle.