Nursing homes

[Loopyloo97]

Hi we might have to find a nursing home for my mother who is bed Bound , how do we go about finding a good one where she would be well looked after . We could look at some but it doesn't really give you an idea of what they are like
Any advice please ?

[hatgirl]

Speak to other relatives.

Look up the latest CQC report.

Ask about what their staffing level is like at night.

Look at menus for the week and if possible observe what the food actually looks like in comparison to what is on the menu.

Ask what activities they do during the week and what is done to stimulate bed bound residents.

Use your senses - smell in particular.

[TeamSJ]

We've just been through and it did feel like a massive decision. Some great advice here from hatgirl. I'd add.....go a few times and pick different times. The Homes should understand and welcome you coming. I'd say it's a bit like buying your own home - you need to see it at different times each day. You may also want to check in with people like your GP receptionist and I'm assuming your Mum has
has staff like District Nurses visiting her. Officially they probably cant comment but most will talk to you about their experiences. In terms of costs it is really key to make sure that that they break down the weekly charge as we found that there were quite big differences in what they provided for the weekly charge so one might seem cheaper at first but then add on the things that they describe as 'extra' and the financial comparisons become very different. Know its a big big decision - good luck with it all.

[hatgirl]

Yeah, I'm a social worker and whilst I can't officially recommend one home over another I would always suggest the points above to any relatives asking the question and give them a general overview of the home.

They can usually make an educated decision from what is said....

To be honest most care homes are much of a muchness but there are some really good ones and some absolutely shocking ones out there, and sadly it's not always easy to distinguish which is which.

It's also important to make sure any information you gather is as up to date as possible. Good care homes can become bad ones within months due to staff or management changes. Equally ones with poor reputations historically can work really hard with social services and the CQC to improve and become really good homes, but for years still get stuck with a reputation for being bad from ex staff or relatives.

That being said, if your mother currently have carers from another setting it's worth asking them as there is a lot of movement of carers between different agencies in the community and care homes and they tend to have a fairly good idea of what's going on, usually before social services and the CQC do.

[Loopyloo97]

Thankyou all so much for your helpful advice , my mum is currently in hospital suffering with confusion the consultant has told us that her knee replacement op could have unmasked dementia .
We are waiting to see if she qualifies for CHC at the moment my dad really wanted her home but after a lot of consideration he feels that he wouldn't be able to manage all her needs.. He would also have to adapt their home for a hospital bed etc .. Its an awful time for us all and the thought of a nursing home terrifies us

[hatgirl]

Were there any signs of dementia prior to her operation?

If not my first thought would be to rule out delirium rather than dementia, it's quite common in older people following surgery. Definitely worth clarifying anyway. Particularly if the comment was made by her knee surgery consultant rather than a geriatric mental health care professional... people who do knees won't necessarily have the training to recognise the difference between dementia and delirium.

[lostfrequencies]

Has your mum been seen by the mental health team in the hospital, and has post operative delirium been ruled out?

[Logans]

I agree with others regarding delirium vs dementia Dementia does not normally come on quickly and is normally diagnosed with multiple assessments over a period of time. Our relative’s doctor just assumed dementia and wrote this in the medical notes. There was actually no history of dementia and it was delirium. Dementia is a very convenient diagnosis however.

As for nursing homes, I would go to visit a lot of them. You will learn to get a sense for which are good and which aren’t. I would look in particular at the number of staff you see and if they have time or inclination to talk to the residents or if they appear very rushed and stressed.

[Loopyloo97]

My mum has been in hospital for 9 weeks now, initially her consultant in the geriatric ward said it was delirium at the beginning but all her meds have been checked and any infections ruled out .. The physio stopped after a few weeks as my mums confusion was a risk she has now been confirmed bed bound doubly incontinent and is now on warafin it just seems being bed bound comes with health risks .. It was just my parents at home and my poor dad is very nervous about bringing her home now as it would mean 24 hour care ... The house would also have to be adapted .... I'm in such a turmoil and don't know what to do for the best as mentioned there are some awful care homes as well as good and what with my mums state of mind I'm really worried . Social services have approached me & suggested that we start looking before my mum is discharged at least that way we could pick a few and then see what the budget is.
I just don't want my mum put into a room & left to wither.

[Logans]

Sometimes delirium can persist even after the initial cause has gone. If she had no signs of dementia before going to hospital she can’t have just developed it overnight. It doesn’t work like that.

My best advice is to start looking at homes ASAP. in my experience all of the good ones have big waiting lists, although I would say that waiting lists do tend to have a lot of movement and if you can say “I want a place in 2 weeks” you may just jump ahead of 10 people on the list who are not yet ready to take up a place or who ended up taking one elsewhere. When I was calling around the waiting lists ranged from 30 people / 2 years to having multiple rooms sitting empty waiting to be filled.

Any idea how her place will be funded yet? Whatever you do, don’t let an assessment happen until you’ve worked out what needs to be said and are present to say it, assuming you are looking for some funding for her.

[AvonCallingBarksdale]

Check the latest CQC report, and, if they do it in your area, look at Healthwatch’s enter and view reports for care homes. Not sure if they do that in every area though. Don’t assume that a “fancy” Home means a better Home - it very often doesn’t. Enquire about staff and management turnover too.

[bluejelly]

to you. I know it’s stressful but try and stay positive. There are some excellent homes out there and you will find one. Also your dad will be able to visit her a lot hopefully and enjoy time with her, rather than worrying about her care - which is what would happen if she came home.