Settling Period at Care Home

[moochops]

Hi, I'm hoping someone may be able to advise.

My mum has Alzheimer's and has recently moved to a care home. She has been there almost a month, but I am not sure she is particularly well settled. The care home staff all seem lovely, the home has a wonderful warm vibe, but whenever I visit, mum is stressed and unhappy about something or someone. I am also getting frequent calls from the home asking if I can talk to mum (she then demands that I go and collect her, or she'll tell me that something isn't right but she refuses to say what until I go and get her).

Mum has always been a very negative person, often using passive aggression to get me to do what she wants, but right now I'm not sure whether she has reason to be genuinely upset or not. The care home staff have been wonderful, very reassuring, but I'm just feeling concerned that mum isn't settling and I don't know what to do to help her.

I'm not sure what stage of Alzheimer's she is at; she has little/no short term memory and seems to be very delusional (tells me that she has been shopping, doing housework and laundry when these couldn't be happening in the care home setting). I suppose what I am asking is, should I wait this out and could I reasonably expect her to settle soon?

How often are you visiting or calling? Often it's best to just leave people to settle for a few weeks with minimal disturbance - no more than 1 contact a week - so they can get into the new routine.

I've been visiting twice a week and I was concerned that this was too little - I was mum's sole carer before she went into the care home, she wouldn't accept any help from other care providers, so it feels odd not seeing her every day. I felt that visiting twice per week was a bit neglectful of me.

I agree with PP once a week is fine, especially if she's upset. I'd also be telling the Home that no, I won't be coming to settle her. It might seem harsh but the home need to get used to dealing with your DM themselves. My colleague had her Mum in a home after she had wondered a few times. The home were calling her day and night, multiple times to ask her to come and settle her Mum. My colleague also has MS and works. The decline in her own health was visible.

It's also perfectly normal for your DM to ask to be taken out. She's not aware of the chaos the disease causes and she will have a very limited understanding, if any, of why she's there. It doesn't mean that she isn't being well looked after.

How are you now @moochops

Thank you for checking in @CadyEastman All seems well, there are some issues, but nothing unusual (apparently). Mum thinks the whole care home is her house and gets angry at other people being there! Or she asks the carers to call me in the evening so she can ask me to collect her and bring her home.

I spoke to the care home manager last week, and she was confident that mum will settle, she also expressed some surprise that mum has not had any medication prescribed previously (she was prescribed Donepezil, but refused to take it, so the prescription was stopped). The plan is to try her on something that will help her settle and sleep better - which should help her mood. Things seem like they are moving in the right direction and it is slowly dawning on me that I am no longer responsible for the daily food/drink/bathing battle!

Things seem like they are moving in the right direction and it is slowly dawning on me that I am no longer responsible for the daily food/drink/bathing battle!

That much be such a huge relief. I hope you're managing to plan a few nice things for yourself

When your DM calls to ask to be picked up, we found that saying the last bus had gone and we'll get everything packed for her in the morning and catch the bus home. She'd long forgotten that we had cats and seemed quite content with catching the bus the next day.

Thanks @CadyEastman , I am trying to be a bit clever in how I respond to those requests, but it is difficult. I'm raised on a culture of 'don't lie to your mum' (as we all are) and I feel like I have to try to reason with her instead of fibbing. I say, This is your home now mum, you have a lovely room upstairs... &c. But I am starting to see how the rational/truthful response doesn't always lead to calm!

I am learning a lot from listening to the other residents, too. I hear them talk about doing all sorts of things they couldn't have done (been to Sainsbury's, walked the dog, roasted a chicken...) and I wonder how much I took at face value when I was struggling with mum's care before moving into the care home. It is worrying to think that I could have gone on indefinitely believing her when she maintained that she had been out and about running errands, seeing these things as evidence that she was coping far better than she was.

@moochops
I think it may help you to try to read up a bit around dementia -'as in the different forms, how it can present, why people with dementia do and say what they do, and how best to respond.

There will be a combination of info from the NHS, books or even free courses .

For example - when my mum first had it I was quite frustrated that she was saying she had done things she plainly hadn't, and I kept contradicting her - which I now know isn't the right way to deal with it. And also when my dad then went on to get it I hadn't realised for ages as it was different symptoms to mum .

I am actually surprised that the home keeps calling you in TBH. When my mum first moved into care I was advised not to visit for the first few days to let her get accustomed to it. That said - due to the nature of the illness there will be many people who never do seem to settle, just how the illness presents in them. I hope for you and for your mum that she has one of the more benign forms of the illness.

I think you are on the right lines in gradually stepping back the number of times you visit. After the first weekend I visited every other day and then stepped back to twice a week, then weekly .

@moochops with your second point, I think lots of us don't want to see our once infallible DP start to deteriorate and it's fairly normal for us to assume they are doing better than they actually are. You might see me post occasionally saying that usually, they've reached a stage further down than we are accepting. Please don't beat yourself up about that.

As for the lying. I can understand that your DM probably brought you up not to lie but I'm suspecting that she didn't bring you up to be unnecessarily cruel either, especially to those you love?

We had massive problems with DFIL when DMIL was alive and had Vascular Dementia. He took the stance that "She's my Wife and I'm a Christian and I will never lie to her" despite every person with experience of Dementia saying that it was much more kind to tell a white lie to keep her content than he honest and truthful as much as possible and cause her upset. He had to be asked by the home to stop visits a few times so that they could settle her again.

Look on it as telling your DM something she really wants to hear but will very soon forget.

So if you tell her there's no buses today but you can both get the bus together in the morning, she will probably become calmer as she will, in that moment, look forward to the bus trip but will very soon forget she's asked the question abs your response.

Have you read any books yet on Dementia like Contented Dementia?

Ah, @CadyEastman I'm reading Contented Dementia at the moment (I think it may have been recommended on another thread, probably by you?). I also have Sally Magnusson's book lined up, too.

Although you'd be forgiven for thinking otherwise (with my daft questions), I have read quite a bit about dementia, and have accessed a lot of resources that were signposted by the Admiral Nursing team. I think I am just struggling to apply what I have read in the abstract, to my mum in the here and now. She wasn't an easy person to live with before she became ill, so I have to learn to put a lot of history aside in order to be helpful and useful to her in a way that she needs at the moment. I'm learning. I talk to the care home manager a lot, and I keep my eyes and ears open when I visit as watching the other residents is also helping me to understand mum a lot better.

@ShinyAppleDreamingOfTheSea The care home have stepped back with the phone calls, I think this may be because she is settling better and taking some prescribed medication now (I'll find out more when I visit at the weekend). In defence of the care home, I was complicit in allowing them/encouraging them to let her call me if it would help her settle. After visiting her multiple times each day in her flat, constantly battling to get her to eat, drink, bathe, being her only carer... a phone call in the evening didn't seem like a big thing to ask of me.

When DM asks to talk to you, suggest staff tell her you’re away for the weekend.

Rinse and repeat for 10 days. She needs to be bedding in, and she ought to be on meds for her agitation.

I can totally understand you finding it difficult in the here and now, especially if she's been difficult for a while.

I'm glad she's settling better and seems more content with her new medication

Think of your mum like a toddler playing make believe games - you wouldnt contradict a 2/3 year old who wanted you to take part in a pretend tea party would you? You would play along.