What are good questions to ask care homes when starting to look for a dementia patient?

[Snowstorm]

A friend suggested asking about what they do to get the residents/patients out of bed and interested in the day - ie. are there activities or games rooms to help stimulate them? How they stop people wandering into each other's rooms and taking things.

We're new to this as my father is still early stages but my mother's got incurable cancer and so he's definitely going to need a home for when she can't look after him (or herself?) any more.

Any thoughts, suggestions, experiences would be very much appreciated.

TIA

Look for people like your dad and see what they are doing. For instance, my mum hates group activities, and doesn't talk, but would love a secure garden where she could lurch from bench to bench (she can only walk a short way and with crutches) and maybe do a little bit of pruning/ digging with a trowel in a raised bed. She's also young for her dementia level, so wartime themed activities wouldn't be appropriate.

OTOH, if your dad likes to chat, then are there gents of his age and dementia stage. Or activities he'd be interested in.

Agree with these. What are the nurses doing? Do they treat the patients well? Are they kind? What are the patients doing? Siting watching tv, or anything more exciting? Is there a garden or an outside area?

On the garden thing, check that it is usable - I've seen quite a lot of places (my mum isn't in a home yet, but she and dad cope on a knife edge so have researched a lot) where the garden looks pretty but isn't accessible independantly as it isn't properly secure.

Go and look around. Note the smell (actually v important, there is no need for a urine type smell if residents are kept clean etc) gives you a good idea how attentive staff are.

Be there for a meal time, what kind of food are they serving, would you eat it?

Are activities differentiated for dementia stages. Not everyone will be at the same stage. Is that catered for?

Great, thanks for all of these - all good ones but I wouldn't necessarily have thought of them for myself.

Thank you for taking the time to reply - much appreciated.

How do they manage challenging behaviours? I'd like to see them adapting the environment or allowing more time for someone to do something for example, rather than a one size fits all.

Yy to the smell! Mil went into a dementia ward of a new specialist care home last summer, and it's completely different to other care homes we have seen.

Small lounges not one huge room with everyone round the edges. Activities every afternoon. Staff are lovely and caring. Small tables and dining room with restaurant quality meals and choice. Kitchen so residents and visitors can make their own drinks and help themselves to fruit and biscuits during the day. A huge balcony with tables and chairs so they can go outside and enjoy the sun.

Also, mil can get up when she feels like it - you don't have to get up at a set time.

YY to having a careful look at the garden. I worked in a brand new dementia unit with a brand new and expensive wheelchair accessible garden. All ramps with a rough surface. Trouble is the ramps were quite steep for anyone not in a wheelchair and as a lot of the patients were shufflers, the staff were scared to let the patients out alone as they'd trip! It was crap.

Marking my place as I have got to do this.

Ask if they have a specific activities coordinator. Homes where organising activities are left to the care staff often don't happen as the carers are so busy.

Ask if there are any other services that come into the home ie mobile hairdresser, aromatherapy etc. I worked in a place which had a lovely lady who came in once a week and did hand massages with essential oils, painted nails etc and chatted to the residents. It was lovely and the touch aspect was nice.

Music services/Sunday hymns are also good as old songs can sometimes come back and be enjoyed despite advanced dementia.

On other aspects, ask about food choices, how often baths are offered and how many other residents have a similar level of dementia to your relative for socialising etc.

Don't know if you will get anywhere asking this but asking about staff turnover is a good indicator of whether the staff are likely to be happy, know the residents etc. You could always phrase it by asking who the longest serving carer is and how long she/he has worked there. Then go chat to that person.

If it's any help, I worked in a care home for eight months and loved some of the residents like my own during that time. I still miss them sometimes although the work is hard and emotional. You do get nice places and nice kind staff.

HTH

If you are visiting a home try and get someone to go with you, make sure one of you watches how staff talk to residents. If your relative is a smoker what arrangements do they have for this. Is there a choice of meals, some people will want a choice (although I know if my DH had dementia he would struggle with being given a choice of meals).

This is all incredibly helpful - thank you so much - I shall make up a list and feel more confident and less wet behind the ears when we go and have a look. I'm sorry that you've all had to go through what you have on this front but really appreciate your experience as it's all quite daunting when you're starting from scratch.

Thank you.

Have a look at the Alzheimer's Society This is Me tool which should help the Care Home form a picture about your dad. Somewhere where you can make the rooms as personal as possible. Can you ask how many falls have occurred?
Can you visit any time, can you have lunch or tea with your family member?
Will they provide a range of stimulating activities?
Go with your gut instinct. My dad ended his days in an emi home and was loved. Oh and do the staff appear to like their jobs (and the residents?).

We'll do that - thanks Lolimax.
Sorry to hear about your father but it sounded as though he was in a good place.

I had a meeting recently with the dementia support worker for our area - I think they are funded by Alzheimer's UK.

She was very helpful and gave me a list of support group meetings - one is specifically on the theme of choosing care homes and I'm going to that one next week.

Unfortunately I learned that the 'best' one in our area has a huge waiting list and it may be effectively ruled out. If you have time it would be worthwhile getting names down early. Good luck!

Ask if there's visiting times.
You want to know you can pop in anytime, unannounced.
And yes, ask the odd member of staff how long they've worked there.

I would suggest that you begin by making a list of your dads likes and dislikes.

Is he a loner, does he like company. Will he be allowed to sit in His room if he wants to. Can he bring a TV and radio. Is he happy to be given a meal or would he prefer to choose from a menu.

Can he furnish and decorate his room. How many of his personal belongings can he bring.

My mum went in as an emergency case. I cried so much the first day as it was an old delapidated building, with loads of old fashioned furniture.

However my Initial reaction was completely wrong. My mum was very happy there for 5 years, because it all felt very familiar. The old oak furniture the decor was just what she was used to. She always went on about how lovely it smelt, I think it was the furniture polish. Her dementia made her very outspoken and I would say MUM!!!! To which she replied, " its my house I can say what I like". Could not ask for better than that. The staff were all middle aged and were very kind. They were all long standing. It was very small, only 18 residents and I would definitely say small is better.

One lady had a budgerigar in her room. Which the family cleaned for her.

After 6 weeks we were asked if we wanted to look elsewhere. We did look at other homes, but no matter what they offered in terms of activities, modern buildings, and outings I knew she would not have liked them.

My mum spent most of her childhood in hospital. She had an absolutely fear of clinics, doctors surgery and was phobic about corridors.

One place we looked at was lovely but the corridors were long, and I knew she would never leave her room if she was there.

Don't forget that he does not have to 'put up with' anything he does not like. Once he is settled, never be afraid to raise issues, ask questions or move him to another home if a appropriate.

My mum's home handed out regular surveys to get to understand the visitors thoughts and needs. The care home manager had his desk in the residents lounge. He and the assistant manager were always ready to speak to visitors.

Definitely a big no if it smells of anything unpleasant. Watch the staff,,are they gossiping to each other, expressing discontent with the managements.
Are they officious or friendly. They do have to be assertive but not harsh.
Look at how residents relate to the staff. The amount of banter and joking that went on in my mums home was lovely.

Finally, I know this is a very worrying time for you. My mum was in such poor state for a year before she went to the home. Within weeks she had a new lease of life. Regular, meds and food plus the company. She looked years younger. All her visitors remarked on it.

Sorry this was much much longer than I meant it to be.

Just logged back on and seen the new messages. Appreciate every bit of all your advice, so another thank you for taking the time to reply to me. I'm sure other people in similar situations will end up reading this thread too and will also benefit from your collective experiences.

FlossieTurner - please do not apologise for the length of your message. Everything you wrote was of interest and as I read it I felt for you so much. I can absolutely understand your first days trauma's of hating where your mother was and can imagine how awful that must have felt her being there. I'm so very glad that your mother was so fortunate as to end up somewhere that sounded as though it suited her so well though, we can all only hope to be so lucky.

Hi Snowstorm,

My mum's been living with Alzheimer's for the past 5 years and has lived in a nursing home in Battersea for the past 2 - I found a good indicator is asking how they get to know the people living there - if they really take the time to find out who they are! Also check what activities they have going on daily.

This article might be helpful :) www.unforgettable.org/blog/how-do-i-pick-a-care-home/

Prior to the care home stage my mother used to go to a dementia day centre once a week. It was really just a few hours where they'd do activities and things, but as it happened the staff had a recommended and not so recommended care homes list they passed on to my sister.
Would be worth enquiring to see if any such respite options are available in your area and even if they don't give a list they may be able to advise that n an 'informal' capacity. It became apparent that the list we were given was more than accurate. Oh, and the lack of outdoor access sounds about right. Tbh I'd concentrate on the communal and sleeping arrangements things. Bright and airy with loads of natural light definitely helped my mums moods having been in a dark depressing dungeon type home initially as it was all that was available.

Ask how many staff they have on during the day / at night.

If possible avoid a ch with rhe dementia unit upstairs. I feel like I caged my mum up for over three years. I don't think any dementia patient should be upstairs in a locked facility. They should be downstairs with an unlocked door into a secure garden.
She's now in a nh and I made it my mission to find one with a downstairs unit.
Mum has challenging behaviour and seems much calmer now.

If I was to do this again , i would skip ch stage and go straight to nh. Also choose best p,ace for your mum. I chose the best one nearest to me. She's now ten miles away and I think it's a better place. It's more spacious and more room to walk if agitated.
Get their names down early. This illness can make them go downhill rapidly.

A good pointer is mouldy food in the fridge. Wandering out of the house. Constantly calling on neighbours. Getting messy in the bathroom . Not going to bed. Not showering/ noticing clothes are stained.