Reporting a fall in a Care Home - AIBU?

[cowatthegate]

Short background is DM (54) is about 6-8 weeks away from death (Brain Tumour ) and lives in a Care Home.
She had a stay in hospital 2 weeks ago where she had a fall (previously very mobile and no issues) , which they informed me about straightaway by phone although it was in the night.
I rang her this morn and she said she had a fall yesterday eve at the Home (she is back there now) and pressed her alarm pendant and they came and helped her up , back to bed etc and now she is in a lot of pain and can't really move.
AIBU to think they should've called to inform me as her daughter ? She is struggling a lot with memory and sounded distressed at what had happened.

Firstly, OP I’m really sorry to hear about your Mum.

Contacting family will depend on a lot of things (was fall serious etc) - so no one can say if they should have called or not. I would give Home a call. Ask to speak to nurse in charge/ward manager and ask what happened and say you are concerned your Mum is distressed and in a lot of pain. Find out if the doctor is visiting (in a lot of Homes GP comes on a Monday) so she may be on a list to be seen. You may feel reassured once you’ve spoke to them.

She should really have been checked over by paramedics and she should at least be seen by the GP as she is in pain from the fall, I would have expected to be informed as a matter of courtesy and would be asking the home how they have recorded it and what is being done in respect of her ongoing pain.

The home will have its own policy. If it's in her care plan to notify you at the time then they should but if not then they will probably tell you next time you visit or expect her to. She should be checked over if she is indicating pain anywhere

Yeah I'd definitely check she has been seen by the doctor, and appropriate pain meds prescribed.

But it's not unreasonable for them not to call you about a fall unless the fall caused some serious harm. It's hard to hear, but old people who are confused or unsteady on their feet fall frequently, and usually it's minor. Check they have appropriate care plans in place to minimise risk of falls. And, if she's still mentally there, make sure she knows to press her help buzzer to get up in future.

@RoomOfRequirement she's only 54! I don't know why the hospital rang me straight away but the Care Home haven't. She does know to press her buzzer but that knowledge will probably go at some point.

They may have asked her at the time if she wanted you called and she may have said no.

It is not usual to phone at night to inform next if kin about a fall unless its serious. It is usual to let them know next day IF the patient agrees.

Ask them why you werent called.

Is it possible that if shes struggling with memory that shes remembering the previous fall?

No it definitely happened , she pressed the buzzer and they attended , her parents confirmed this to me today.
She doesn't remember the previous fall in hospital 2 weeks ago though, her memory is really terrible now.

Normally nurses will do a fall assessment and that'll dictate how urgently they will be seen by a doc. If all looks fine they'll just go on the gp list for a medicine review.

If the fall caused pain a physical assessment by a doc may happen sooner

I would call and let them know that you wish to be notified in these circumstances.

You are right.
My dm died as a result of a similar incident.
I am certain they didnt call me because there was somethng on the tv they wanted to watch.

You just have to ask them. We dont know what assessments and referrals were or werent done.

Not unusual to not be phoned at night. Are you the ONLY listed first contact? Is it possible they phoned someone else? Is it possible she asked them not to bother you?

They should have called you. Do you have medical power of attorney? If she’s so close to the end with a brain tumour then it’s likely that her faculties are not what they used to be. My DF died from a brain tumour a few years back. He was fine at Xmas, couldn’t use his leg at the end of January (his neighbour thought he’d had a stroke and called an ambulance), was in a wheelchair by March and needed to be hoisted as he’d lost control of his limbs, save for one arm. He was extremely confused, repetitive and his short term memory was shot to pieces. He would agree to anything the carers at his home suggested as he thought they’d treat him nicely if he was polite to them. for you. It’s an appalling way to end a life.

her parents confirmed this to me today.
Are they first contact?
They wont phone everyone.

As an aside - to everyone saying that the DM might have asked for the OP not to be contacted, at this stage it’s likely that she isn’t of sound mind and hence, there needs to be a plan in place so that the OP is notified of incidents such as this. There will be falls and trips and slips. Limbs that work fine one day suddenly don’t the next, and as memory fades and confusion sets in, it often becomes impossible for the person with the tumour to express their needs/pain/discomfort.

My dad had a fall in hospital which really was their fault. He was very unsteady on his feet after three months of being bed bound. Got up on his own to go to the loo and the nurses for some reason had propped the toilet door open with an oxygen cylinder. Which he tried to move on his own as he didn’t want to bother anyone, fell over, broke a rib and then got pneumonia.

Hospital didn’t ring me either. But to be honest in the 12months he was an inpatient they didn’t ring about anything because he was deemed to be an adult with capacity (even though at times he thought he was in boarding school) and I had no power of attorney, etc. I could barely get them to talk about his illness and he couldn’t remember what he was told.

Sprinklestar its not as black and white as that.
Just because someones memory is poor doesnt mean they have to lose ALL autonomy. They often can still make immediate decisions about themselves, and it is right that they are helped to make as many decisions for themselves as possible for as long as possible.

I

If she asked them not to ring you, they have to abide by your wishes

And endofthelinefinally, I understand your sadness, but you have clearly never seen a nightshift in a nursing home. There is no television watching, they are frantic.

Even with power of autourney you dont get to override what wishes and requests someone CAN still make, even if there are some other things they cant grasp any more.

Pancake - you’ve clearly misunderstood my post. My point was that someone with impaired capacity may well not understand what they are asking. In my own relative’s case, they were times when he sounded absolutely lucid but as to what he was saying, it was nonsensical, dangerous, made zero sense... As I explained, he would agree to anything the carers in the home suggested, so ‘you’re warm enough, aren’t you?’ would always result in him saying yes, even if he was obviously freezing cold and shivering. Sadly the patient is often incapable of having their own best interests at heart and someone else has to step in.

Or even if someone's sectioned. You still let them make what choices they can.

She may well be able to fully understand the question "do you want us to call your daughter" even if she doesnt remember what happened last month.

Family members often missunderstand this and thinks that if someones capacity is reduced it means that ALL decisions go straight to them over the persons head.

Sprinklestar given the phone conversation the OP described with her mother, it doesnt sound like shes incapable of making sense in the present tense.

I dont know of course. Im just saying that reduced capacity or memory does not automatically = overrride all choice and requests from the individual. The paperwork is very clear on this, you give them what choices they can still make.

But Pancake - who are you to judge whether someone is of sound mind or not? It’s all very well letting people make their own choices, but if those choices are not made in an informed way due to significant mental deterioration, that’s not a choice at all. It’s simply someone saying words they may believe to be appropriate to the situation based on previous knowledge, but as to whether they understand the implications and significance, that’s another matter.

Anyway its just a possibility. She might not have asked them not to call.
We dont know
OP needs to ask the home what actually happened.

Im just saying that calls are not always appropriate.

Qvar it depends on the nursing home. The one I used to work in had nightstaff who regularly slept for long periods. Not just a nap at break time, a proper sleep. They used to take it in turns. Another place I worked at, I found a bedroll in the comfy cinema room. A night inspection there found one person awake,out of 5 on duty. That did at least get staff suspended. Not sacked though.

But Pancake - who are you to judge whether someone is of sound mind or not

I'M not. I'm just saying ask, there are variables we dont know.