MIL and 'care' home - admitted to hospital with severe dehydration.

[Pollyputthekettle]

My 88 year old MIL was admitted to a residential home at the start of the year due to her increasing inability to cope at home. It's a long, convoluted story but the short version is she developed dementia symptoms in the summer which have rapidly gone downhill to the point that she was no longer safe alone at home. We live 200 miles away and her nearest family seem not to give a toss. Social services found a home which seemed lovely and after a long , painful few months we breathed a sigh of relief.

She was found unconscious on Sunday morning and admitted to hospital from the home. The lovely nurse at the hospital said she was very alarmed by the residential home, MIL was 'severely' dehydrated and had a 'serious' kidney injury. She also had a very low blood sugar which suggested she had not been eating. She also has a pressure sore and an unexplained injury to her back. MIL has no money so the home is a council run home. I called her social worker and said I couldn't understand how MIL could become so seriously dehydrated in the home and therefore do not want her to return to that home. They are now looking for another home.

Am I right in thinking my MIL should not have got in this state?

The hospital have referred my MIL to the 'safe guarding team', What does that mean?

I want to report the home and escalate this even if it is only for the sake of other people who may not have a family to speak for them. How do I do this?

If you are the ones paying the fees, you report it to the Ombusman. If the govt is paying, you report it to social services. This is the advice of the Care Quality Commission, who are a imo rather useless at dealing with any kind of report, chiefly because they cannot act on individual comments from the public, and can only go on what they see on one of their twice yearly visits to a care home. And of course, there is no way of knowing whether any residents get regular hydration on their visits, which are in any case flagged up to 'help' the care home.

Slag off the home to the CQC by all means, but they will be using the info to help themselves to put the care home on the back foot generally, rather than to help you. It is like grassing your neighbour up to the Stasi - they will appreciate it, it's not for your benefit directly.

I left some straws with polite instructions on a beaker as to how to get my Mum to drink. All unused after two months. When I visit, regularly, she gets thru 500ml in four minutes thanks to the straws.

The CQC reviews of care homes are utter crap. The home my Mum is at, had full marks in the last review. Someone blew the whistle, an ex staff member, and now it is 'under review'. So it has gone from 'excellent' to rubbish suddenly? Or was it never excellent in the first place. The CareHome Uk website is a bit rubbish for reviews too, not allowing any negative reviews for litigious reasons, only positive ones - which it rather ludicrously attributes ratings to, so of course they all get about 8.5 or more out of a 10, as anything would if neg reviews aren't allowed.

You have my sympathy, and with all the things wrong to your Mum, you have to report this. Wouldn't go amiss to find out who the doctor is (a local GP is appointed to care homes) and raise it with him/bollock him. Or write a letter naming and shaming him and the care home to the local papers. But do be careful who you expend energy on, as many organisations 'welcome' feedback and do nothing about it. Complain only to the GP and he'll be delighted - only you and he will know about it...

Firstly, I am sorry you are going through this. Especially as you are so far away, which will make things much more difficult for you to monitor.

The problem with care homes is that they are only as good as the staff that are working there. That can change from shift to shift. You can never be sure that your MILs need will be met at all times. I say this as someone whose mum died recently (end stage dementia) and spent 12 months in a residential home then 6 months in a nursing home.

My mum had two falls, and was admitted to hospital severely dehydrated. I too had to use the straw trick and ended up supplying cartons of juice myself as it was the only way to get mum to drink. Even then, it required someone to put the straw into the carton and to encourage mum to drink it. The number of times I would arrive to find a cold cup of tea at the side of her and often a cold meal on the table that mum had not touched. It is not enough to put food and drink next to them, you then have to constantly remind them to eat/drink, and later to feed them yourself. If you are relying on staff to do this, it just does not happen.

You are absolutely right that this should not happen, but IME it does, all the time. I often asked what happened to the people who had no one to speak for them, no relatives visiting. It doesn't bear thinking about. It took my mum 6 months to die, after she started the not eating/ drinking voluntarily phase. I visited every day. The problem is that when they get to that stage, you get caught up in the dehydration, UTI, kidney damage cycle and getting meds into them is a nightmare. Taking them to hospital to be rehydrated is not always in best interests, for lots of reasons. I'm sorry I'm not being more positive.

Yes, look for a new home. How will you know it's better? I don't know. Is there a chance of your MIL coming closer to you so you can intervene? That's what we did with mum. The safe guarding team is a good first step but if you are not close by you will find it extremely difficult to keep an eye on what is happening.The fact is though, that even with me being there my mum still died of starvation, dehydration and multiple organ failure. The death certificate says end stage dementia! but that is no where near the truth of it.

Sadly MIL has taken a turn for the worse and is now unlikely to make it through the night.

So sorry Polly My thoughts are with you.

Really sorry Polly, this is so sad.

This absolutely should not happen. Not any one tiny bit of it.

You can speak to the safeguarding team yourself as well. In Nottinghamshire they are labelled M.A.S.H not sure where you are.

Sorry to read she has taken a turn for the worst. I work in a nursing home, if I can help you at all please PM me

X

Thank you so much. It's just good to know it's not acceptable even though I know it isn't. I am so shocked by this. I worked out earlier that MIL was in the home for 6 weeks. There is no further news.

I will take this further though. I just need to work out the where's and how's.

Most areas have multi agency safeguarding hubs (MASH) now. They will screen the 'safeguarding vulnerable adults alert' that the hospital have made and pass it to the local adult social care team to investigate the home. Google the words 'safeguarding adults' and your local council together to find out more specifically how things work in your area.

If the worst does happen then it it may be referred to the coroner to investigate as well.

Just wanted to check in. Been thinking about your mil all night

Sending some x

Is there an update on this Polly?

My Mum was admitted to hospital Saturday morning with similar symptoms - severe dehydration, urinary tract infection, pressure sore and sore on her back, could be identical! We nearly lost her Monday night as her blood pressure plumetted and she is not out of the woods yet.

But she is out of that nursing home, I can assure you. She will not be going back.

I flagged up my concerns about dehydration in the care home to the Care Quality Commission and they did nothing. My comments were 'not upheld'. What's more, another old dear died recently and the coroner raised concerns about her state and relatives may take legal aciton. That place has had a clean bill of health the last eight months. TBF, the thing is to contact social services not the useless CQC as I have said, but then you are really picking a fight with the very people looking after your mother, and in my experience nursing homes can be very defensive and frankly a bit odd in any circs, let alone when you get social services on their back. Besides, if it gets to that point you should really be thinking about another nursing home anyway.

Added to which, at least if your immediate family are not interested, then you have the pick of nursing homes. We have to find one in a two mile radius of home, not easy.

Sadly, it's hard to see what homes are like. Often, nursing homes can look lovely if they have a care home vibe, ie nice areas and residents and so on, but they may be good for those who can tend to their own needs while the far gone residents are left to dehydrate. At the other end, you have homes where it is a rubbish atmosphere, you wouldn't fancy being there yourself, it feels rubbish to visit, but the nursing might be good.

Maybe best enquire how many nursing staff is there, rather than just care staff. Also, how many staff are on duty at any given time, cos if there aren't many, your relative won't be getting time to be given drink.