Care home visit frequency advice

[papillonpotato]

My grandmother, who is 91 years old, currently resides in a care facility. My mother anticipates my visits every other day, and on the days when she can't make it, I'm expected to fill in, which occasionally results in two consecutive days of visits or more. It's been several months since my grandmother moved into the care home, and I'm attempting to convey to my mother that maintaining such a rigid schedule might not be sustainable. We should have the flexibility to visit when we can, without adhering to such a strict routine. My Mum doesn't take this well and gets very short with me and angry. I don't really know what to think.

I would say every day is extremely unusual, unless you have a big family who all live locally.

We did go every day for one DGM — she was in for four weeks after a hospital stay for intensive physio, and hated it because a lot of the others had dementia and wouldn't leave her alone and she couldn't walk to escape! We'd go and play cards or chat or take her for a coffee and fend off the other residents for a bit.

But we knew there was an end point or that.

Other DGM has dementia, and she has a regular "big visit" every weekend. Then somebody might go mid-week, but it's less usual now she's moved homes. The first one was very local so people would pop in for 20 mins on their way home from work.

I don’t understand this at all! My mum lives hundreds of miles away and I see her once every couple of months.
Why does your gran need to see you so often?

And that's a lot more than other people have visitors — often if families aren't local, or have young children etc, it's very difficult to go.

I think your DM needs to work out that she doesn't need somebody to go every day and it will all be fine. Maybe she could video call instead one day if your DGM can do that? Or just phone the home to ask how she is.

And perhaps you'll have to be a bit more unavailable. So neither of you go and she sees that nothing bad happens.

"You can pay a solicitor to visit monthly (this is if they're under a Deprivation of Liberty order as someone has to check on their welfare monthly). "

Do people really appoint a solicitor as the Relevant Person's Representative? Normally it is a family member or friend, or an independent advocate if no one else is available. Also I don't think it has to be monthly - I queried this with the social worker as my brother is mum's RPR and he visits around every 3 months but they said it was fine.

I don't mean the above in a snippy way, just wondering about it as I think an independent person would be better in our case.

No idea as we haven't needed to do it yet! We were told monthly was the expectation by the social worker and there are only three people who can visit so once one of those drops out or reduces frequency (two of the three are elderly) then we'd look into it further. At the moment it works out at one visit a month for the coldest part of the year and 1-3 times per month the rest of the time.

We have one person as the RPR but they check in with the other two after visits to see if there are any concerns. Might be different if the RPR isn't in touch with other visitors?

@EmotionalBlackmail ah ok, thanks.

It is tricky.

FIL visits MIL every day in the nursing home. He feels guilty at her being there (idk why as he would not be able to care for her at home). He also worries that she won’t get any interaction if he’s not there. His visit frequency has actually increased over the three years she’s been there but I think that’s mostly for him as he doesn’t have much else to do. If he can’t make it he puts pressure on SIL to take his place. DH and I live abroad so don’t get sucked in. Both FIL and SIL live quite close to the home.

i don’t think MIL would know either way (Parkinson’s, dementia) tbh. I know that I would not fill in as SIL does, and if my own mum was in this condition I would not visit daily. SIL gives in too easily: for me each person should be here to decide how often they visit, rather than being put unwillingly on some rota.

My initial hope would be that my mum would be in a home within walking distance of my house so that I could visit frequently but that didn't happen and from what I have heard of local homes it is probably just as well. When mum moved in she was in quarantine for 10days so we did go every day then but that was not planned to be permanent.

It's very tricky to manage both your own guilt and the expectations of others, who doubtless feel their own guilt too. MIL's home has around 40 residents, and I'd estimate that less than a quarter of them get visits more than once a week.

DH has decided to cut back his visits to two or three times a week for now. There will be no discussion about this with the rest of the family. He does as much as he feels will benefit her. A lot of the time just now she's either asleep or actively distressed to see us, which makes her angry and agitated. He'll review things when this stage passes.

When my dad was in a care home I saw him pretty much every day-BUT it was less than 5 minutes from my house, and me not doing the caring meant I was able to nip in for half an hour for a cuppa.

Some of my most treasured last memories of him are the evenings I nipped in for an hour before I went to nightshift, and I lounged on his bed while he sat in his chair, just watching tv together. For as much as I hated him having to live in a care home it did give us back a bit of a father/daughter relationship instead of me being his carer

@Appleofmyeye2023 your post I noticed. I'm a independent mental health advocate- has your dad had access to this. If he is detained under section then this is his rights. Very often an advocate would observe and talk about day to day things if appropriate to get an idea as to a persons wishes. That's his right and a IMHA could really support him whilst detained under the MHA in advocating for him and being the link between medical staff and himself. One being is the section appropriate and could he be dropped to informal. Also things like section 17 leave- escorted or unescorted leave off ward (even ward garden) as this is his right and could do the world of good for him.
Hope this helps.
OP- your relative has the right to a independent care act advocate

^
This

It depends on the home and how poorly the person is but certainly the one we used had a lot of activities on and things happening so the person would have missed out on fun things if they'd had relatives visiting daily.

It does vary though. This was definitely not one of those homes where they all just sit round in chairs with the TV blaring and no interaction.

I couldn't imagine trying to guilt-trip my own daughter like this. I'd just be grateful if she could do anything in the way of visiting 🤷‍♀️

My DM was in a care home a short drive away, and I hardly ever visited more than once a week. In the beginning it was very stressful - as soon as she saw me it was, ‘Have you come to take me home?’ - she was v angry with us for putting her there and with already fairly bad dementia could not understand that she’d been completely unable to manage - could no longer even make herself a cup of tea.

Sounds awful to say it, but TBH visits were easier when she no longer knew me - I was just a ‘nice lady’ who made her cups of tea and brought her chocolate. 🙁

OP, daily visits do sound unnecessary to me, though if your DM wants to do them, that’s up to her. I’d never expect it of a Gdd. Does she even remember that you’ve been? Even before she moved to the CH my DM would tell me she hadn’t seen my Dbro for weeks - ‘He never comes near!’ - when I’d met him just leaving as I was arriving! She honestly believed it - her short term memory was zero.

I used to visit 4 times a week. Hundred mile round trip.
I soon discovered that if I said something about my previous visit, mum would deny I’d been or that she hadn’t had visitors for weeks.

The care home staff saw how this was affecting me and said not to visit for 2 weeks. It broke my heart but was much needed.

Your GM won’t know who comes when.
Trust me. It’s so hard and I get it.

Mum passed away in February and I still visit the care home as the staff became family to us. X

My mum expected my dad (who had dementia) would have a lengthy visit every single afternoon. She would want me to go one weekend day and my sister to go the other and take her too as she would never allow herself a day off. We were both working full time and had other commitments. I, like other relatives I got to know dreaded visiting, had to fake a smile at the entrance and didn't let the mask slip till I got home. Often my dad would say mum came 'Last week', my sister 'A few weeks ago' even when they had been there less than 24 hours earlier so nothing gained by so much visiting. I think you have to be really clear to your mum that you will visit but not as often and you don't think it is reasonable or necessary to go as much as you have. Honestly, please look after yourself first, your mum may follow your lead in time but that is a matter for her. People can live a long time with dementia and in the meantime their relatives can be stressed beyond measure

I always hope when we visit that MIL will have some benefit at the time. Usually that's not the case, but we live in hope. She doesn't remember when other people have visited, even when they left less than an hour before we arrived.

Care home staff have said to me that the length of visits doesn't matter. What is important is that the person feels cared about and they will even if they don't remember individual visits. If someone pops in for half an hour or less a couple of times a week they will know that 'people' visit and staff will say to them ' wasn't it nice Sally came to see you a couple of days ago'

I can’t get away from my Dad in less than an hour!

pre-Covid, I visited every 3 days for 2-3 hours. Then I wasn’t allowed to visit for the best part if a year, now I write once a week (they read it to him) and visit once for an hour.

I like @HeddaGarbled's approach. You get to decide when you go and when you don't. It sounds as though your mother is unhappy anyway; in any case, she doesn't get to delegate visits to you. And her expectations are unreasonable.

As another poster (sorry, don't have the name to hand) says, you need to find a visit rhythm that can be maintained for years if necessary without driving you into the ground. Use this time to work out what that might be for you. (Tbh, I think even a weekly visit is ambitious if you are too strict about it; most weeks might be possible, but you need to keep flexibility - what about when you're ill? When you go away on holiday? Your own self-care is essential).