Sunday, 25 April 2010

turbulence ahead

I had a phone call on Thursday to tell me that Mum had "had a fall" just outside her room and was on her way to hospital to be x-rayed. I was tempted to get in the car straight away but I was advised to wait until the results were in. It turned out that there were no broken bones and Mum was back by the evening. I resolved to drive over on Friday.

I arrived in the early afternoon, and found Mum quite happy and not suffering any pain. Sitting in the Lounge, we had a cheerful conversation with a few of the other residents. Mum's face darkened a couple of times when she told me that she hadn't fallen but had "been pushed over by two girls". It was clear to me that she was referencing a childhood story that she repeats frequently, but the Home had launched an investigation into the incident on the basis of Mum's allegation. I was able to add some context there, hopefully saving them some trouble.

Life in the household is very calm these days. A couple of the more troublesome residents have moved on (one died, the other was placed in another home), and the atmosphere has noticeably improved. The staff have more time to spend with the residents and the residents, in turn, aren't annoyed or distressed by the old troublemakers.

However, there's a problem ahead.

The Home has decided to create a "High Dependency Dementia Unit" to cope with exactly such difficult cases. And they have decided that they want to base this Unit in Mum's household. The Relatives were "consulted" last week (I was unable to attend), but apparently the meeting went badly. The Home presented a fait accompli, telling the Relatives that the plan was going ahead - the specialist staff had already been hired. In turn, the Relatives told the Home that their elderly charges were happy and settled and were NOT to be moved. It seems that the Managers were a little stunned by the vehemence of the reaction. This might look like a stalemate, but I was told that they will simply wait for natural attrition and then move more "challenging" cases into the vacated rooms.

This means that the idyll is doomed.

Of course, this all comes down to money. There is FAR more money to be earned from the State in looking after difficult charges. I am bitterly disappointed that this organisation - a charity - is behaving in a fashion more suited to a business in seeking to maximise profit ahead of the wellbeing of its existing residents. I'm all for them starting up a new unit, but I wish they would leave their existing clients to enjoy a peaceful and relaxing end to their days. If only a "calm and pleasant" unit was prized (and priced) as highly as a "complex and unpredictable" one.

Mum could, of course, be moved to another household in the Home, but she would lose contact with the staff members on whom she currently depends, to whom she has grown close. Also, I chose Mum's room very carefully - it is at the end of the household, away from the noise of the Lounge and with a very pleasant view over the garden and a field. If Mum were to be moved to the first available room in another household, she is bound to suffer from the upheaval and she would inevitably be placed in a less advantageous room. As someone who is paying full whack for Mum's care, I feel outraged that decisions like this have been taken without my consent. It's like paying for a good hotel room and then being switched to a budget chain after a few nights.

I have made several attempts to speak to someone at the Home about this but have been fobbed off, told that someone will call me back, which doesn't happen. On Friday, I was told that the person who had been avoiding my calls was now on leave, but that the General Manager would speak to me later - he then left early. I am becoming annoyed about this. I intend to pursue this one and raise some publicity about what's happening.


Lily said...

Damn right Greg, raise a stink! Local papers and councillors, even the MP - such a cavalier attitude should not go unchallenged. Do you think the other residents' relatives will join in? Best of luck x
PS I'm not sure that I'd recommend the Aldi knee supports for cycling, they're probably better for support when weight lifting or similar - they're very tight and thick neoprene (like wetsuit material) with a small hole in the middle that's meant to go over the kneecap - it feels as though they interfere with blood flow when pedalling and the leg is bent most of the time. Ah well, worth a try!

Gavin said...

I just found out about a similar plan at my Mom's place. Although it sounds like they are going to erect a whole new building. Not sure how it will play out, but it sounds like there's plenty of time. At least with my Mom, she doesn't even know she has a room where she is now. I'm sure a move would be disruptive since she's now familiar with the halls that she paces and the faces she meets along the way.

In our case, it may be a financial decision where they can charge more, but the long term care insurance here is only two-tiered... nursing home and assisted living. I think the gov't reimbursement is similar. They may be able to charge more and the families will have to make up the difference, or those like you paying full boat, will have to face increases.

karen said...

Good luck and I hope you get to talk to someone soon. Since your paying the bill and not the state or goverment you have all the rights in the world and you will be heard.

Sorata said...

Hmm... that is a change of an event... I hope you get to speak with someone soon and at least get your opinions and concerns across.

So let me get this clear, if/when the HDDU going to move in, the current tenants do not have to move, but the HDDU will slowly take over when there is vacancy? Or I'm missing the point here?

I just hope that they would understand that elderly can be very fragile and will not take changes well at times, major changes could decline their health significantly. They must not take these type of changes lightly.

Greg said...

Thanks, everyone.

I had just about got to the point where I felt I had sorted out my Mother's situation and could turn my attention back to my own car crash of a life, but no...

Sorata/Humphrey, you are correct in your understanding of the situation, and you're absolutely right about the potential impact of the HDDU on existing residents. I guess the Home will argue that we were all alerted to the coming change and were given the opportunity to move our elderly relatives. If our relatives stay and are adversely affected then it will be our own fault.

I spoke to D&G, Mum's other visiting relatives, yesterday. G reckoned that I should get Mum's name down to be moved to another household before the first "challenging" resident arrives and EVERYONE decides that they want their relative moved immediately.

My initial reaction was to fight this but I think it's going to happen anyway - I doubt that any argument I raise will be more persuasive than a balance sheet. And a move WITHIN the Home to another household would be less of an upheaval for Mum than a completely new Care Home elsewhere if I really push things.

citygirl said...

First, good to hear that your mom's fall was not serious and that she is ok in that regard. Also good that you are helping the Home fill in the blanks about your mom's childhood fall - I know my mom had one such story and when she told it, you'd believe it happened that day (not 70 years before).

Onto the Home's idea of a HDDU based in your mom's unit - yikes! I'd definitely be against this and working on avoiding it. If there is no way to avoid it happening, I guess moving your mom to another unit within the Home is the next alternative.

That said, my mom started out in a quiet unit at her last home and it was QUIET. Almost deadly quiet. She was bored and lonely (and probably a bit scared because it was an odd atmosphere, almost morgue like) and everyone there was so ill that there were next to no activities or interaction. We talked to the Home about this and they offered that mom could go to a more "lively" unit where there were more active residents but also some difficult and aggressive people. We were terrified. The Home reassured us that it would be ok. OMG, we were not feeling easy. It turned out to be a great unit. There were a couple of more difficult cases but nothing out of control. Overall, it was a great move as mom got the interaction and activities she needed but still remained well cared for and safe.

Greg said...

Hi Citygirl! I take your point about units with a bit more life to them. Mum isn't interested in TV these days but LOVES to watch the bustle of the staff, and listen in to their conversation as they go about their work, so I know what you're talking about. Yes, her current household can be a bit quiet, but then Mum seems to like that, too. The behaviour of the other residents is a key consideration - Mum's always strongly critical of anyone who is behaving odd in any way and is easily annoyed by any resident who gets in her face.

On Friday, Mum's key Care Worker took me downstairs to view a ground floor unit which she recommended as the next most favourable after our current situation. This one would have the advantage of easy access into the courtyard garden, which Mum might like, but it's less spacious by at least half in the common areas and was a good deal noisier when we visited.

I think the next time I visit I'll ask if Mum and I can go down to that household together, and see how she reacts to going out into the garden. Her current household has a LARGE balcony overlooking the grounds, but I've never seen anyone using it. I guess there's never a day in the UK that won't feel chilly as you exit a Care Home! That probably explains it ;)

accidental carer said...

I really hope that there is minimal disruption to Mums life; and subsequently yours.
The powers that be have a lot to answer for.
Is it always about money?

Sorata said...

I wonder whether you can at least suggest for those who are requesting to move (seems like everyone, but...) to have a chance to add additional comment and pair them up in another house. Like... if your mum gets along with another friend of hers, the least they can do is try to accommodate that.

I know they probably can't do that for everyone, but they can try. The less impact they have on the residents, the less potential problems for them anyway. Ultimately, it will affect everyone including them. They should do some "damage control".

LSL said...

Greg, I was so sorry to hear about this. It's always about money, isn't it? At first I was feeling like you shouldn't move her, but after reading through the comments quickly, I think there's something to moving her sooner than later and avoiding the rush since the change is inevitable. I hope you're able to transition your Mom with minimal disruptions, and perhaps she'll take to the garden area.

I'm so frustrated about this for you!