urgent help re nursing home

sitcom321

just need a quick bit of advice, my MIL has had to give up her home and go into a nursing home last Thursday, she wears a catheter 24 hours ogygen 24hours and has mild to moderate confusion (not all the time though)

Since she went in she has dirtied herself at least 6 times, she says they don't come quick enough when she presses the buzzer. my husband has been today and she needed the toilet just as he was leaving, he pressed her buzzer and also told the nursing staff at the station as he was passing. my daughter called in to see her a couple of hours later and she had dirtied herself again and fell, she now has what they say is an open wound on her arm which is bandaged so not sure how bad, whilst my daughter was there she needed the toilet again so my daughter pressed the buzzer, it took them 6 minutes to come into the room and she dirtied herself again as they came in so bad they had to strip her completely and shower her.

I am calling in tonight and I have no idea if this is normal or not or if I should be asking any questions regarding her care and if so what questions, surely they know by now she cant hold it for long and it must be easier to come to her asap and toilet her than to clean up all the mess. but, I don't know if 6 minutes is quick in a nursing home, we are really very naïve as this is our first encounter in elderly care. would really appreciate someones perspective

Nicki

I don't have any experience of nursing homes but do have some experience of looking after relatives with disabilities and terminal illnesses. I would say that if your MIL is not able to hold her bowels for 6 minutes, then she is probably in reality doubly incontinent, and perhaps it is time she were moved into incontinence pads. I am sorry to say this. 6 minutes is quite a short time to require a response to every call when staff may already be engaged looking after other patients.

Torry_Quine

Nicki wrote: »

I don't have any experience of nursing homes but do have some experience of looking after relatives with disabilities and terminal illnesses. I would say that if your MIL is not able to hold her bowels for 6 minutes, then she is probably in reality doubly incontinent, and perhaps it is time she were moved into incontinence pads. I am sorry to say this. 6 minutes is quite a short time to require a response to every call when staff may already be engaged looking after other patients.

I have to agree that this is a relatively short time to respond to a call.

As this seems to be a recent thing it could be due to the changes in her life recently and may settle in time. Not medical advice but it could be a result of medication. A word to her named nurse/care-worker is needed as how best to deal with this as it must be upsetting for her.

sitcom321

thanks for the advice, in my own mind I did think 6 minutes was a fairly reasonable time but as I say I have never ever had any experience of elderly care and it is certainly not a pleasant experience, I feel like we are in a minefield, she is the easiest of ladies and is already accusing staff of not liking her etc and its just so hard to know what to do for the best

Errata

Ask to have her continence assessed and a care plan drawn up.

RAS

There may be a couple of things that need looking at; whether she is able to identify the need to go earlier and press the buzzer sooner to allow more time for staff to react and whether the staff can plan regular toilet trips to pre-empt accidents.

And if her bowels are such that she needs stripping and showering, you might want to ask whether she needs to be seen by the GP, maybe with a referral to a specialist.

Is she eating half a ton of plums a day (or drinking lots of orange juice) or is this a sympton of digestive or bowels problems?

Nicki

sitcom321 wrote: »

thanks for the advice, in my own mind I did think 6 minutes was a fairly reasonable time but as I say I have never ever had any experience of elderly care and it is certainly not a pleasant experience, I feel like we are in a minefield, she is the easiest of ladies and is already accusing staff of not liking her etc and its just so hard to know what to do for the best

Its a massively stressful time for her if she has had to move into long term or permanent care. Its understandable that even if she wasn't struggling with continence, that she would feel vulnerable and upset. That might last for a while unfortunately. Added to this if she is only mildly to moderately confused and is aware of the soiling, then she is going to be embarrassed and upset by this, and inevitably is going to blame it on the staff for failing to respond quickly enough, as a face saving exercise.

I think all you can do is to try to preserve her dignity as best you can. Incontinence pads aren't the nicest thing to wear, but there is no dignity at all in having to have the bed stripped and be hosed down daily so they are the lesser of two evils and the most discreet option available. Wearing them doesn't mean she can't try to get to the toilet or commode in time, just that it isn't a catastrophe if she can't.

Sounds like a really difficult time for the whole family. I feel for you all.

Addiscomber

This may seem a rather odd suggestion, given that she is probably a bit 'loose' if she cannot hold on for the staff to come, but does she have access to water? If so does she drink a reasonable amount, as mild confusion can be a sign of dehydration.

GenericUsername

I have read your post with a lot of feeling for your situation as I have experience of elderly relatives. My mother was a carer for my grandmother for 14 years and it was difficult at times because whilst my grandmother had all her mental faculties, she was physically disabled. This lead to problems with getting her to and from the loo etc. Also sometimes she could be moody with my mother (I guess familiarity and all that). My mum would try to pre-empt my gran needing the toilet by taking her at reasonable intervals (although now and again accidents did happen).

She was lucky in that she never needed to go into residential care except for times when my mother needed a break. This would usually be for about a week at a time maybe twice a year. I know that my grandmother would not like this very much and 'play up' at these times.

However I wanted to just say two things. Firstly it is my opinion that 6 minutes is a reasonably long time to wait once the buzzer has been pressed. Obviously I know the nurses are busy, and six minutes may not be the norm. I just know that if I needed the loo and was waiting six minutes with nothing else to think about it would be difficult.

I think an assessment of your MIL's needs is a good idea. This may help to put particular care in place that isn't currently. An assessment of my grandmother helped to achieve an extra visit per day from the 'home help' nurses which was helpful for my mother.

I hope I haven't spoken out of turn but one final thing I would say is that when my grandparents (both grandmothers at this stage) got older to the point of needing assistance, my mother seemed to be more capable than my father of dealing with what was happening. I sense that you have inexperience with this situation and I understand how difficult it is, however please try
not to be afraid to ask the nurses of anything you are unsure about. It was a steep learning curve for my mother when she was looking after her mum, but at the end of the day if she had any concerns or fears she had to address them. More important than anything is making sure your MIL is receiving the best care possible and feeling assured yourself that everything is being done to the best of the nurses ability.

If you are unsure of what questions to ask just base them on your intuition regarding the situation. Anything you feel uneasy about or feel that you don't know enough about is worth politely asking the nurse to explain in a less busy moment. All questions you have will inadvertantly relate to achieving the best care possible for your MIL.

Something like this is not easy and I wish you and your family well. I had one grandmother with physical disability and my other grandmother (with whom I was extremely close) had dementia. I found both situations bewildering but all that mattered to me (when they were in hospital at different times) was that I could make both of them as comfortable as possible and understood what was going on regarding their care.

Wilma33

At home, did someone respond immediately to get her to the toilet or could she hold it longer there?

Amanda65

sitcom321 wrote: »

my husband has been today and she needed the toilet just as he was leaving, he pressed her buzzer and also told the nursing staff at the station as he was passing. my daughter called in to see her a couple of hours later and she had dirtied herself again and fell, she now has what they say is an open wound on her arm which is bandaged so not sure how bad, whilst my daughter was there she needed the toilet again so my daughter pressed the buzzer, it took them 6 minutes to come into the room and she dirtied herself again as they came in so bad they had to strip her completely and shower her.

That seems like an awful lot of times to go to the toilet in a few hours. I would definitely be asking to have her continence assessed. Also has she changed medication? Could it be upsetting her tummy?