What does excellent dementia care look like?

[LaBelleSauvage123]

The nursing home my dad is in is described as providing ‘dementia care’. Today I found him lying on his bed with no trousers on in distress. He said ‘LaBelle I’m really scared’
( this is a highly reserved man who very rarely talks about his feelings). He thought that he was being forced to entertain the other residents in some kind of show. I pretended to go out and talk to the staff about it, then came back and said I’d told them he wasn’t to take part, which seemed to calm him down. Later I spoke to the member of staff on duty and asked why he was in his room. She said that he kept trying to remove his trousers in the lounge, and had been ‘very rude’ when asked not too, so they had told him he had a choice: clothed in the lounge, or trousers off in his room. I asked what he had said and she said he had been ‘threatening’ towards another member of staff, telling her ‘it was a good job she wasn’t a man’. My dad is the most peaceable man and has never been in a fight ( or even many arguments) in his life. Surely staff should recognise that this is the dementia talking and not him - and not use words like ‘rude’? They are aware that he’s very confused as he’s not making sense most of the time.
Does anyone here have a relative with dementia in a home which they feel provides excellent, sensitive and understanding care? Is it too much to hope for that places exist that actually help with the effects of dementia, rather than just providing physical care?

In the very short term, maybe some dungarees?

It's such a worry, isn't it.

My Dad was in a specialist dementia home, and what we thought made it excellent was:

• High staff ratio so they didn't have to rush the residents. I saw one spend 20 minutes gently coaxing him to eat about 4 spoonfuls of yoghurt. When he first arrived it was taking 2 of them ages to wash, dress and get him up as he was terrified due to previous bad experiences, but they were so patient and let him set the pace.
• completely open to visitors, you could just turn up at any time

-kitchen making really nice food from scratch, tailored to individual preferences. They even made my Mum 2 meals a day for a small fee as she was with him all day.

• asked lots of questions about his hobbies and interests and tried really hard to do things he enjoyed. He really wasn't interested in 'activities' by then so they didn't keep pushing it, but made sure there were relevant things in his room for him to look at.
• Big on dignity. Spoke to him respectfully. He was clean and smart, hair brushed and shaved every day. He went in looking a mess, it made my cry to see him looking himself again.

It's tough. My grandad had a habit of removing his clothes, he was abusive to female staff (to the extent they had to only have male carers) and we had to get some sort of court order for medication because he became so violent and unmanageable. Years later we managed to access court documents from when he was young and it turns out he wasn't the gentle grandad I knew! Dementia reduces inhibitions so you unfortunately can see true underlying character. I've been through this disease twice, so cruel and hats off to the staff. Perhaps they could be clearer with families over the challenges but they are so busy

I presume you have never worked in care

I’ve worked in a dementia home @Silverswirl and that is absolutely terrible. He should not be unfed or dehydrated. That’s a bare minimum standard of care. I think I would be looking for somewhere else.

I worked for decades with children/teens with severe learning difficulties, a few of whom needed adaptive clothing to manage some of their behaviours.

That’s a really good point about risk assessments - I’ll ask when I go in tomorrow. He has a pressure mat in his bedroom. He’s got a GP assessment next week and my list of questions is getting longer!

Thank you so much for all your responses - they are really helping.

In that case you will know choses braces you suggest would only add to his distress .
If He's distressed and trying to remove his clothes putting him in clothing very difficult to remove will inflame the situation .
And any restrictive particle would possibly need a DOLS order .

It does sound like your relative may need specialist dementia care rather than a home that accepts people with dementia. I originally worked in a nursing/residential home and we used to have people who had dementia but in all honesty we didn't know what to do with them when things became challenging even after dementia training (which wasn't a great deal btw) I then worked in a specialist dementia care home and what I know now in comparison is huge! The training that I received in the dementia home was amazing and the care that the residents received was brilliant. It may be worth talking to the manager about whether they feel they can cope with your relatives needs now. I know that it isn't an easy task moving someone from one care home to another but the appropriate care that he would receive would help him so much.
I wish you lots of luck with it all.
Also there are many other things that should be tried when someone is undressing in communal areas, sending a grown man off to his room like a naughty child isn't one of them!