The Dementia Diaries
Top Tips for Dealing with a Care Home
In our article 'Top Tips for Choosing a Residential Home' we covered the things to look for in a good care home. However, the work does not stop there. You need to work with the care home to ensure your parent settles in and then retain a level of monitoring to ensure they continue to have the level of care and dignity all old people deserve.
The absolute essentials are that old people with dementia are:
Treated with calm and kindness
Kept clean at all time – this includes clothes as well as skin
Given any prescribed medication
Socialised as far as is possible within their limits and anxieties
We have all seen the depressing sight of lines of old people, seemingly stupefied, staring at a TV which blares out inane day-time TV. Of even more concern are the media stories of abuse, neglect, old people left unclean and uncared for. It terrifies us – not only for our parents but for ourselves.
So what can you do to ensure Mum or Dad are settling in and cared for as if they were at home?
Surround them with familiar objects and photos. For dementia patients strange surroundings are frightening. New colours, new bed, the bathroom has moved, people come in their room and there are sounds they have not heard before. A brain which cannot make sense of all this stimulation quickly moves to alarm. However, a routine, kind words and many familiar things will assist the settling process.
Talk to the staff about your parent’s character and likes/dislikes. A good care home – and I am lucky to have found the very best in my area – do a full interview and create a character folder for all staff to read. You need to include your parent’s background, their family connections, their friends, hobbies, pets, the TV they like, the music they like, how they like to dress, the hairstyle they want and the foods they will eat, refuse and tastes they will refuse. Agree any time of outings your parent might like or the activities which a good care home will have happening every day. Think of your parent as a child being left with a foster family – you would do everything you could to make sure that child felt at home. Do the same for your parent.
Visit and check. There is no embarrassment in asking about the care your parent is getting. In the UK, care homes can sign up to the Care Control system – a fantastic piece of software which means you can link to the care home monitoring system and, at any time of day, see what is happening with your parent – when they were woken, bathed, what they have eaten, the level of liquid they have had, any activity with staff, medication – everything. If you are concerned you can link direct to the Care Home with a comment.
Raise any concerns. We cannot pretend that a care home is going to be like a five star hotel with butler service. However, if you feel that care needs to increase or be adjusted, never be reticent to speak up. Things to look out for are:
- Finding that your parents incontinence pads are always wet or soiled
- No accessible liquid and no evidence of your parent drinking enough – dehydration has a crippling effect on an old brain
- Finding your parent in dirty clothes
- Noticing a fear reaction to any member of staff
- Finding your parent slumped over. This is bad for their back, breathing and causes pain and there is no reason for this if they are propped with pillow or specialist chairs
- Bed sores or rough patches of skin on their back or bottom – this means they are not being moved. It is more common in bed ridden patients and has to be addressed quickly to ensure your parent does not end up with a painful weeping sore.
If the staff react badly to your questions and checks, then you should be concerned. Ask to speak with a manager or staff nurse and set out your worries clearly and calmly. Excuses are not acceptable.
Final word – if you are very lucky you will have found a Care Home as good as the one my mother is in. Her days are filled with smiles, care and dignity and I never find her wet or unclean. She smiles when the care workers come to her. If you are not as lucky as me – do something and quickly. They care for me as much as my mother and my questions are met with a positive response and reassurance every time. There is help out there:
- Local council
- Care Quality Commission
Remember - the day you say goodbye you need to ensure you are not looking back with regret.