Cockroach Cafe 🪳Autumn 2022 🪳

Long time lurker here.

I'm being worn down by the constant moaning from my Mum. I hate talking to her (phone, we live about 3 hours away) it's just a constant stream of moaning about her friends, moaning about her GP (who I actually think is very good, especially given the circs ATM!). I've reduced phone calls down to make it more bearable. I've tried distracting her but she isn't very interested in anything else or just wants to criticise things we're doing.

Just AARRGGHH.

That's so helpful Light thank you.

@Words that's right about individual complaints, but it should still be going through a process that has to be highly visible.
Regarding the 'on call' manager.. unfortunately they can indeed be anywhere. In that scenario the manager could be at home, out shopping etc, they are literally 'on call' for anything management level occuring (I spent 15 years as an administrator in care homes) But, regardless of that she should have been able to ring you back within 30 minutes to an hour at the most even if she's unable to action anything immediately. At night, there are normally 3 staff on duty, one should be a senior carer.
If she is known to 'walk purposefully' (don't get me started on the powers that be need to not have you say 'wandering' then there is a whole range of 'telecare' available to ensure that they know she is up and moving. Essential because nobody can have eyes in the backs of their heads.

Thanks @Lightuptheroom . I will check when it was last inspected. I have a friend who works for the CQC and am going to contact her.

Also hoping that the safeguarding will alert CQC.

They don't investigate individual complaints according to their website. The route is internal process followed by ombudsman it seems.

Thanks for the heads-up regarding additional costs!

Regardless of information governance, the on call manager should surely not have been in a place where she could not respond to , or action urgent issues regarding those in her care.

@Words the length of time to call you back is unacceptable, but it sounds like the manager is hiding behind information governance (which does indeed make it that you can't discuss residents in a public place)
Have you contacted CQC, when was the home last inspected.
Ask to see the sheets that staff have to sign when mum has been checked, there shouldn't be any gaps.
Also, if she is self funding, watch out that they don't try and charge extra for the checking, MIL care home tried this and we successfully fought it as it was a standard level of supervision.
No, bed rails/cot sides aren't recommended as you say but they should be taking steps to make sure that if she's rolling out of bed that the crash mats etc are properly in place.

Thanks for your kind words everyone. Mum has dementia and has been wandering in the night apparently unsupervised. She has an alarm mat and it is not clear whether this was working at the time.

I have requested the maintenance logs and a copy of their checking protocol, as well as a record of all incidents and hospital admissions since the new provider took over in Jan 2022. Yes, that is key, I think. Previously it was a family run home providing an excellent standard of care. Now it is staffed with agency carers from various African countries, many of whom have English as a second language, so communication can sometimes be difficult.

The second fall was a fall from bed. The other falls could possibly be low bp, that's quite common in the elderly. But over riding that is inadequate supervision.

I learned from an independent source that bed rails are not recommended for dementia patients as they can cause further injury with limbs stuck through, attempts to climb out etc. In their update yesterday after questioning they conceded she was still slipping out of bed onto the crash mat. 'I always try to be honest with my families' said the manager ( the one who didn't return my call because she was in a public place.) I told her I was relieved to hear it, but I think the irony was lost.

Mum was discharged last Friday on palliative care from the hospital with my consent with a package of drugs, including the ominous 'anticipatory' ones.

A further failing was that I called the on call manager from the site after I had seen the state Mum was in, and left a voicemail requesting an urgent call. That came seven hours later, with the subsequent excuse from her manager that thé on call staff member had been out in a public place where she couldn't discuss patient confidential matters. Words fail me.

However. I don't want to act in haste about the move. It's likely she is approaching the end of her life , although I know from previous experience that this stage can continue for longer than anyone would think possible.

Forgive the very tasteless comparison, but just as a place where an extreme incident has occurred is probably safer than most other places afterwards due to heightened vigilance, I am hoping that for now, the measures they have adopted will suffice to minimise risk in the short term. They know I am watching like a hawk, and I will not let it drop. The 15 min checks, if indeed they are happening, are some comfort at least.

A move now would be very distressing and disorientating for her, and the GP practice who have known her for decades is absolutely great. It's in a different health authority from my own, ( I would look to move her closer to me) and they are piloting all sorts of innovative things in elder care ( like the community matron service in addition to the district nurses, which I can't praise highly enough. )

However I will continue to explore all other options, alongside pursuing this complaint.

@Words that's horrific, your poor Mum. Do they know why she's falling? ie is it a medical condition, medication side effect, low blood pressure etc. My Dad had a fall when he moved into his nursing home but he now has a pressure mat and regular obs. And he has bed rails at night, with his bed almost on the floor.

It's bloody hard enough having someone in a home let alone when you're not feeling happy they're being cared for adequately. I posted earlier in the week about Dad's care but in fairness to the nursing home, they've really taken it on board and we've had a massive improvement in the last 2 days thankfully.

Words I'm horrified.

Your poor mum. I don't know where to start. In respite care my mum was also given a low bed with an option to pull up the sides.

I understand the care home would follow whatever meds the hospital gave, but how could the hospital not give anything? Is it possible she refused pills?

yikes in my mums home they all have the beds low and alarm mats in place not that mum is likely to go anywhere as she has no mobility really I thought all care homes had them they also have regular visits from gp district nurse and dementia care team

Hello everyone, cockroach all.

Sorry to jump in here but I need to offload.

On 31 Dec Mum fell in her room at her care home, unwitnessed, and was hospitalised. She was discharged the following Friday having been treated for a severe chest infection and I visited her the next day.

I was appalled at the state of her injuries. Black eye, swollen face, yellow brown bruising to the cheek, extensive black bruising to her neck, and a huge swelling above her left eyebrow. I am not medically trained but it was obvious to me that she was in pain and very, very tired.

Various senior members of staff saw the state she was in on return. No one at the home or the hospital mentioned how serious her injuries were, and no one at the home thought to involve the GP for additional pain relief. She was sitting in the lounge with the other residents, tv blaring, looking like a domestic abuse victim.

I was absolutely horrified, deeply concerned it was possibly non accidental and got the community matron out on the Monday who did a Video consult with the GP while I was there. I was reassured the injuries were consistent with an accident. A safeguarding concern has nevertheless been raised with the LA by the GP practice. I spoke to a senior manager who did not inspire confidence in me.

Driving over on Weds, I had a further call from the home. Unbelievably Mum had fallen a second time, out of bed, onto her face, and 'there was a lot of blood'. Indeed there was. I arrived to find her moaning in agony complaining of neck, hip and back pain, on the floor, bleeding from the nose. I actually thought she was dying in front of my eyes.

She was given morphine, taken to hospital and discharged with no broken bones thankfully.

Needless to say I am beyond livid with the home. I have established that her alarm went unanswered for nine minutes and she was found not by a member of staff, but by the district nurse who had called to check on her.

At my insistence she now has a crash mat, a low adjustable bed and is being checked, allegedly, every fifteen minutes. A relative who visited today commented that I had clearly put the fear of God into them. I do hope so.

Her poor face is in a terrible state as she has fallen twice onto the same area. I am taking photos to document it and they are very shocking to see. The GP practice are being brilliant and have texted me a link so I can send the photos through for uploading to her medical record.

Meanwhile I am researching other homes more local to me.

@MissMarplesNiece jumping in before you've finished...
I would keep it very simple. Something like 'i am worried that my mother is not giving the full picture when she talks to health professionals. I have seen myself that X and Y happens every day/at least once a week/constantly. This means that she avoids eating/doesn't go out/ etc etc. She also tells me that X happens daily but I have not seen this.

I know that you can't discuss this with me but I felt you should know about these things at her next appointment.'

I want to write to my mum's GP to draw attention to a couple of things I'd like him to discuss with her - things my DM doesn't raise but which I think will give a more complete picture than her GP currently gets. I don't know how to word it & would

@Lightuptheroom fingers crossed the district nurses can prompt some action.

I woke up feeling a bit rough this morning, and I've just done a covid test and it's positive. I think I've solved the mystery of mum's sudden deterioration on hospital discharge last week - there was COVID in the unit, and we had to do PPE & only one visitor while she was there, but she started being bad within 48 hours of hugging the nurses before coming home. And I've fallen ill within 48 hours of kissing her goodbye on Monday (no contact allowed while she was in hospital).

Good news is that she's much better, so if she can shake it off in a few days, I'm hoping I can too. Ironic though - I've managed to avoid it for 3 years to make sure I didn't give it to her, wearing masks long after everyone else stopped etc. And then she passes it to me!

Fingers crossed @Lightuptheroom

Light fingers crossed the district nurses can help.

And in true left hand has no clue what the right hand is doing ... The e consult form tells you to contact the surgery... Where they don't answer the phone...

@countrygirl99 thanks. We've tried that , the surgery just ignore it.
We've done an e consult so they will have to respond.
Not local @EmmaAgain22 but my number is the only one my mum will actually ring ... Everyone else should know automatically that she wants to speak to them.
Unfortunately dad's standard response to do you want to see the Dr is 'not at the moment ' then we end up with emergency situations instead

No, only that she doesnt want to deal with it, and somehow expects the Dr to magically know that they need an appointment as 'she can't be dealing with all that.
Further conversation gets the response that he's allowing 'it' to take over and he should be grateful to have reached 85!!!! (He has a lot of physical disabilities and lung disease)
We've managed to speak to district nurses who have said they need GP input so maybe that will get things moving

@Lightuptheroom when we were having trouble getting a face to face appointment for my dad who was deaf, partially sighted and frail I found an email with concerns bullet pointed got a better response than phone calls.

Light I can't remember if you live nearby or not

can your mum describe to you what the "going downhill" is?

Probably far less than what you are all dealing with... Bizarre phone calls from mum where she claims dad is 'going downhill' then refuses to call the Dr or speak to 111. Because he's profoundly deaf he doesn't speak on the phone at all. Spoke to his GP . Their triage is full, speak to 111... He CANT HEAR THEM and if mum has to answer questions about him it provokes a huge rage.. their triage is full.... Nobody seems to be listening to us at all.

Badger that is dreadful. I am so sorry.

Nightmare day yesterday, Dad was sick and it turns out that he's not being getting a medication to treat nausea even though it was prescribed last week. I went in late afternoon to find him slumped out of his chair almost on the floor as he'd been given an injection that knocked him out ... and the care staff took ages to reply to his callbell. I've had a rather irate phone call with the manager this morning as a result. She was horrified that he'd been left in a chair after being dosed with it, and is getting the nurse to arrange an urgent medication review with the GP but they warned me it could take a few days. As if losing your Dad to cancer isn't hard enough, fighting to get him adequately looked after shouldn't be on my effing radar.

I'm bone tired of this. Christ knows how my Dad is feeling

I think we're all frazzled to buggery. But don't discount your existing struggles, @EmmaEmerald . You matter too. I think sometimes, in the quest for the ideal outcome, we forget that, or think we're selfish if we remember.

thesandwich thank you.