Is it possible to change nursing home?

[ajandjjmum]

A close friend - in her 80's - is in a nursing home six weeks after a stroke. She is still losing weight and doesn't seem to be improving at all - we think partly down to the lack of support. Her food is 'thrown' at her with no-one helping her to eat, despite being on a soft diet and having lost the use of her dominant side. She has been having three physio sessions a week and no speech therapy.

Whilst being realistic about her age, she was a very active, vibrant person until this happened, and it's very hard to watch her being given no help when she needs it.

I want to look into the feasibility of changing the nursing home (assuming we can find one where staff are more 'present'), but wondered if anyone has any experience of this, how you go about doing it, and who would be the first point of contact to discuss?

TIA.

Who is paying for the nursing home currently, or is it covered by the NHS?

How do you know food is being ‘thrown’ at her? If you’re sat with her at mealtimes, can you assist her with feeding? When my sister had a stroke, she lost all sense of taste and smell, so as a result stopped eating and lost a massive amount of weight. Once her senses started to return, she regained her appetite.
Unless you have LPOA for health, then the decision to move her won’t be up to you. She will continue to be assessed where she is and then a decision will be made as to whether she’s well enough to return home with support or will need long term nursing care.

Surely it would be easier to speak to nursing team/management about this then disrupt an 80+ year old who is trying to recover as best they can from a serious stroke? Where is your voice?

Yes, it is. If she has a social worker they can support. Does she want to move and does she have capacity to decide?

If she's self funding, no problem at all. The person with PoA can organise for her if she is unable to do it herself. Otherwise, you're in for a long fight with SS or NHS depending on funding source. It may be easier to see if you can organise assistance at specific times.

AgeUK website is a good info source. However, you should be aware that a catastrophic incident in elderly people does usually mean the start of a rapid decline, even if someone was fit and healthy before.

Is she mentally competent? If so you need to have the discussion with her. If she is not mentally competent then you need to speak to whoever has PoA (if not you).

Speak to the nursing home first about the concerns over weight and well being and that she needs help eating. See how they respond.

I am sorry that I don't know the answer to your question, but may I just say that I think it is very kind of you to look out for your friend like this.

I wish you both well.

She can definitely move (if self funding it’s much easier) if you find somewhere suitable that will take her.
However have her next of kin or if a person has PoA emailed the manager of the current home raising concerns they have? I find raising any concerns in a nice tone usually works with my parent’s home plus there’s a written record.

I think that if you're seen to be around and letting them know how she used to be it will make the carers more interested in her welfare.

They prob don't think it's worth trying as she's old and done in.

You can let them know that she's not done yet. She shouldn't be losing weight. She should be getting those build up drinks. Perhaps you could make time to go in regularly and help feed her.

It's kind of you to help her. Nobody should be just deposited in a home and left to fade away.

Why do you assume they’re not interested in her welfare? Someone who’s had a stroke and needs continuing care will very often lose weight because they lose interest in eating. They may have problems with swallowing too. As someone else has already said, a catastrophic stroke frequently ends in the patient facing away as their brain is often massively damaged.

They prob don't think it's worth trying as she's old and done in.

What an appalling thing to say.

Yeah it is appalling. But I fully believe it's happening in some care homes that are understaffed and the ones that are there doing their best are exhausted and don't have time to sit and spoon feed people build up food and drinks when there are another 20 patients to be attended to and there aren't enough staff to do it all. Somethings got to give.

As for losing weight yes strokes can lead to that. As can many other things. The elderly seem to lose their sense of taste and smell. Combine that with no exercise and their body doesn't tell them they are hungry so they don't eat or think they already did and lose weight. Hence it takes a lot of staff to try and help them eat high calorie foods and stop them losing any more weight.

There is a big difference between a post saying “care home staff are overstretched” (agree, but probably the same in any other home OP might look at) and “They prob don't think it's worth trying as she's old and done in.”

@DeliciousApples what are you basing your claims on?

If some patients appear to be recovering or doing well I'm figuring they will get the most time invested in them.

Just seems like common sense. When there isn't enough staff to provide as much care as is needed something has to give.

My friend thought that when she was visiting her mum in a care home that got a poor rating. That's what I'm basing my assumptions on.

She too tried to get her out. And succeeded. But I don't know the details. Only that it seemed unsafe with residents climbing into other residents beds, taking each other's stuff, some 'escaping' and wandering off into the street, residents being horrible to each other, some barely eating and nobody helping or encouraging them. One apparently died as she got given lumpy soup when she was supposed to have it liquidised.

So yes I figure that those who are abandoned that nobody seems to be keeping an eye on that seem like they are nearing the end will be easier to not spend time on that those who have family up all the time keeping an eye on things as they will complain if mum is losing weight or whatever and the manager will be well fed up of them shouting loudest.

Are you sure it's a nursing home not rehab ? My mum went to a stroke rehab centre for months after her stroke then had loads of speech and physio therapy when she got home. They worked really really hard, none of it paid off but they really tried so hard. but it was all NHS provided and funded.

First thing is to speak to her and her family, see if anyone has power of attorney, if not then you can raise your concern with the manager. Was she transferred to the care home after hospital? Maybe it was decided it was the best place for her. If she's on a soft diet then speech therapy must have assessed her somewhere but she may have lost the ability to speak now.

So youre basing your claims on one isolated second hand report?

Sorry - should have said - the friend has no family, and we are probably closest to them. My DC hold POA for health and finance..

It is a nursing home as there are apparently no stroke rehabilitation centres in our area. Having said that, I had a long conversation with the physio team today, who seem to have great confidence that she is determined and doing well. Her speech seemed better today after just one session of speech therapy. They seem reasonably confident that in time she will be able to return home, which is great news.

When we are there visiting, along with her other friends, we obviously help her to eat. But there are occasions when we're not there. One evening last week - despite being on a pureed diet - she was given sausages. Fortunately DD was there to sort that out for her.

The nursing home is covered by the NHS.

I can assure you @colesr my voice is being used regularly.

As a response to our weight concerns, she has now been prescribed a protein drink. Still waiting for it to be delivered though from Tuesday!

As the physio team seem so good, we think we should stick with the current option for the time being, and review in a couple of weeks.

I hope I've answered all of the questions and queries - and thanks to those of you who have shared your experiences and given us ideas.

I hope things go on improving. Really shocked at the sausages (I'm a speech therapist in a stroke team).

I'm not surprised by the sausages at all, I've worked in hospitals and nursing homes, seen cake, biscuits, green beans, all sorts of drinks given to puree food and thick fluid clients despite my own RN and salt assessments, the staff excuse "well that's what the asked for", bloody ridiculous. With poa your dc can ask to go through the care plan and assessments. Sounds quite promising though.

I can assure you @colesr my voice is being used regularly.

Sorry, it really wasn't clear from the OP.