Where do we go from here?

[GnomeDePlume]

Up until 4 weeks ago DM(85) was doing fine. Lived alone in a bungalow with family member close by calling in regularly (most days) for general chit chat.

Then she took a fall and broke her leg requiring surgery.

In these 4 weeks DM has declined so much. Her short-term memory is shot. She has stopped eating, she still chooses food but then just pushes it around a bit without managing more than a mouthful. She still drinks water but isn't interested in any other drink (she used to be a big tea drinker).

DM is now in a ward waiting for discharge to another hospital where she will do some physiotherapy.

It all seems too little, too late. She isn't getting out of bed. Her world has shrunk from bungalow, well tended garden, clubs, to the tray over her bed.

Is there any coming back?

I'm not sure what answers I'm looking for. It all feels a bit miserable at the moment.

If it's any comfort to you @GnomeDePlume my mother hasn't had a UTI since moving to her home three months ago. She had them virtually back-to-back in the hospital, I really don't know why. Perhaps hygiene procedures are better in homes; washing someone in bed or just cursory wet-wiping in a hospital toilet is a messy business and probably conducive to infections in women, especially. My mum is showered regularly and hasn't had any problems, fingers crossed.

@AInightingale thank you. Your suggestion that it is a general hygiene problem makes sense.

@Holesintheground the community hospital DM is in right now doesn't have a doctor on site, so everything will have to wait until morning. Major emergencies have to travel by ambulance to the main hospital in the next town.

So I suppose a care home isn't less well situated. At least it is in the same town as the main hospital.

My mind is cycling through a lot of 'what ifs...' at the moment. Not least of which is who will spot if DM is ill while in her room.

DM will have a buzzer but all her recent illnesses have been characterised by confusion. Not recognising that she is in hospital, that she is unwell.

Morning! Take a pause, dear @GnomeDePlume and breathe 💐
Agree fully with the notion re hygiene and infections. Even with a mo lift, mum should be able to be transferred to a shower chair. Mum sits on a glide-about shower chair for her showers ( a waterproof, draining wheelchair basically which moves sideways as well as backwards and forwards)
The carers and cleaners are in and out of her room all the time. She's fairly reliable in using the buzzer now ( it's like a life line round her neck) but they don't ignore her, and check in anyway.
The other thing is that as there are nurses there, they can do the urine dip tests and call the GP ( and get taken seriously more readily than the rest of us ever can)
I know what you mean about the purpose built homes vs the ones in Victorian houses. I've worked in the latter ( some years ago) and while the care is still excellent, the facilities in these corporate type ones make the experience much easier.

OT in the rehabilitation unit did a lot of work regarding orientation, but mum has taken a leap forward now she's surrounded by some of her own things and has more stability. Highly recommend getting her an orientation clock. I bought one from amazon and i noticed her checking it while we chatted yesterday, confidently commenting on it being Sunday. The whole set up is helping her feel more independent and empowered than she was in the hospital. I appreciate that it can't fix her health issues but i very much hope that the home as a good an outcome for your mum as it has been for mine 🙏

Thank you so much @WinterFrog 💐wise words.

I will add personal alarms to my lengthening list of questions to ask.

Orientation clock is going on the list of things DM will need when she moves. That and a complete new wardrobe. DM has lost so much weight.

DM assessed by the care home today so fingers crossed they are able to meet her needs. I spoke with the nurse who deals with moves and she said all went well. According to her the move could be this week.

DB thinks the move wont be until next week. But I suspect that is because that is fast going in his head!

We shall see!

That’s great news @GnomeDePlume, I hope it all goes smoothly!

I was able to visit mum today for the first time in a few days (I came down with the dreaded norovirus!). She’s doing well, but everything is frustratingly slow… She’s starting to get some movement and feeling back in her left hand, but because of all the complications she has, they aren’t doing any physio.. I’ve asked for a meeting tomorrow so we can discuss next steps - ideally I’d like her out of hospital and in a care home but I’m not sure when they will class her as medically stable. The hospital have been great, but they are so understaffed they are struggling to meet her basic needs and it’s taking its toll on her, both mentally and physically.

@Randommother 💐 that is good that your DM is able to get some movement and feeling back.

Are they not able to give your DM some small exercises which she can do in bed? Mind, it took a few asks to extract even a leaflet for my DM.

It is difficult to know what the best answer is. Discharge to a care home but knowing you are risking a dash to A&E. Or stay in hospital where at least your DM is on a ward but the care is basic.

The geological speed at which everything happens in hospital is so frustrating. Things get promised (such as physio) but then don't happen because a name is missed from a list or the patient was away from the ward having something else done when that particular specialist called by.

It is under resourcing at such a fundamental level. There is no 'spare' in the system anywhere. So when a team member is off, even the basics can get missed. Nobody notices that Bed 8 hasn't had taken a drink in several hours.

Hello! From a weary WinterFrog. Your mum may well move this week @GnomeDePlume Mine was assessed and moved within 4 days.
I get what you're saying about the underfunding. It's abhorrent!
My mother threw me yesterday by returning to her old self becoming a bit demanding. Suddenly it feels like nothing is good enough, despite our very best efforts. Suspect she's overtired, and reality is dawning. I feel desperate for her in her sadness at her loss of independence and mobility, alongside frustration.
I have chased up one or two referrals and learned that it's the home's responsibility going forward. I have taken to my bed for the afternoon, feeling utterly frazzled. A rare and decadent thing, but I'm going with it as all the recent responsibility has caught up with me (and the feeling of never quite being good enough)
The moment will pass, so i will just send solidarity to all of you here 💐

@WinterFrog I send 🌻🌻🌻 back (sunflowers are my favourite flower). I totally get your feeling of being frazzled and run ragged. With a side order of not doing 'enough'.

DM isn't really sure who I am now, just someone who visits so in that sense she doesn't blame me for anything because I haven't done anything.

I suppose your DM is lashing out at you because she knows that you are safe and won't retaliate.

Doesn't make it easier though does it?

I expect it's a form of induction crisis. Like a new starter in a job looking back at their old job with rose tinted spectacles. Is the care home aware? I'm sure they will have seen this many times before. They may have strategies to help.

Moving in day is now set for Monday all being well.

Thank you for your post and the sunflowers 🌻 too@GnomeDePlume I am sure you're right. I just need to regroup, and get a handle on my emotions. Nearly had a cry at the receptionist, but I managed to keep it in check, and got myself a cup of tea instead.
Very best wishes for the move. I hope it works out for the best!
Grateful for this forum and the lovely people who understand! 💐

@WinterFrog I’m all for some self preservation and if it’s needed don’t fight it. I hope you feel better for it. It’s relentless especially when you think you are walking into one scenario and you are presented with another. You are giving your all, remember that and it’s ok to take a step back sometimes however small.
@GnomeDePlume Sounds like things are moving well. I hope the move goes as planned and that it gives you all some relief. The environment will be better for DM and you all. Visiting will be more calm and you will be able to get some actual information on what’s happening. I hope it works out well.

Thank you @Anjo2011 I hope you are doing ok. I'm feeling rested and ready to face the world again 😊

Well done @WinterFrog .

I'm visiting DM after work tonight. First job is to clear a big stack of newspapers. DB has been kindly bringing a daily paper to DM but not taking the old one away with him. Mind, this is how he lives so doesn't see the problem.

DB is flapping about DM's move. He's being tricky about DM, who, according to nurses, is aware of what's going on. So DM is pussy footing round DB who is pussy footing round her!

DB's flapping is, in the main, unproductive and sometimes downright annoying. Gets himself worked up about admin details, fires off an officious and angry text to me, reads the thing I sent to him properly then calms down and sometimes apologises.

I am sore tempted to get him a room in the secure part of the care home and then deny all knowledge of him!

He sounds a handful all right @GnomeDePlume!
Do you think your mother is aware?
My brothers pussyfoot too, so I get things done and then my mother tells me I'm bossy.
It's quite exhausting isn't it?
I like your plan for brother. Oh so tempting 😂

@WinterFrog he can be! He means well and he is very caring of mum.

The difficulty comes because he feels he has to control things without actually doing anything. He doesn't like being told what to do especially by women.

DM knows she is moving. But she has moved many times over the last 3 months so I don't think she is fully aware that this move is likely to be a permanent one.

What DM craves is stability, feeling settled. She has said this many times. There is such an impermanent feel in hospital. Nothing is nailed down. Beds get moved, you can fall asleep in one room and wake up in another.

I've only just come across your thread '@GnomeDePlume . I'm keeping all things crossed that the move happens smoothly and your DM settles very quickly.

My 'D'B went AWOL when DM became ill 3 years ago so it's all down to me to advocate for her (no LPA for health/welfare; I don't want to have it) and my DF who has been her main carer since and is also deteriorating very very quickly these days. It's very hard work caring for someone even if they're bed bound with 4 x carers in every day. I hope your DB appreciates the work that you've put in to finding the best potential care home for your DM but given he's a 'Controller Of All Things Important' you'll be waiting a while for the thanks!

@Projectme that must be so hard for you💐

The problem with my DB is that he doesn't like change, of any sort. It makes him anxious. He wants everything to stay as it is even if it is massively inconvenient for everyone.

We have LPAs for DM but they havent really been of much use so far.

DM is now in her new home. Seems happy to be there. Or at least happy to not be in hospital.

The care home is very pleasant. Not homely exactly but lots of thought has been given to residents' comfort.

I was just thinking about you. I hope mum settles in well!

That’s good to hear @GnomeDePlume, I hope she settles in well

Hospitals are horrible for old people, very disorientating and undignified. Nursing homes are very calm and quiet and routine-led which is probably what she needs.

I hope this works well for you DM and allows you all some quality visiting time.

Thank you all.

Had a slightly worrying message from DB last night. DM was getting distressed, wanting to leave with DB etc. All seemingly triggered by a disappointing evening meal offering.

Managing this sort of thing is going to be tricky as I think that DB is a big part of the problem:

• DM takes her emotional lead from DB, if he is in anyway cross about something (and he gets cross about lots of things) she will be upset.
• DB faffs around when leaving (I've seen this many times). DM gets upset so DB faffs around more so DM gets more upset.
• I did suggest that DM needs to be given space to settle into her new home, make some friends. DB was doubtful about this.

Last night was the first time DB had seen DM in the evening so had seen her properly tired. All his previous visits have been daytime. As most of my visits have been in the evening I have been very aware of how tiredness impacts on DM.

Visiting at the care home is open. Getting DM in was only the start. Getting DB out is going to be the next challenge.

Just sending a hand hold @GnomeDePlume Nothing is straightforward, is it? I do know what you mean about how much difference there is between daytime and evening visits. @AInightingale is right about nursing homes being routine led. We've found this and mum is more settled. I hope brother can start a settled routine with her of his own. I have a brother who needs routine. Also older than me and retired.
Ah the disappointing meals....see also, favoured and non- favoured carers. X can do nothing wrong and Y can do nothing right.
I am trying to remain gracious as the last three months have been so much upheaval for mum, but she's currently pressing all my buttons!
Wishing your mum peace and contentment in her new home, and the very same for you and the rest of your family as you all come to terms with these changes 💐