My dad has recently (6 weeks ago) moved into a hospital care rest home.
This came about after a hospital visit for a chest infection and realising that with his reduced mobility (spinal stenosis and terribly weak legs) plus his agitation in the evenings with "sundown syndrome" (beginnings of dementia) that he would be too difficult for mum to care for.
6 weeks ago when I visited him in hospital he was telling me stories from the newspaper and remembering escapades from his youth. At times in the day he became vague but not too bad. His hospital report said "mild cognitive impairment".
He is now getting lovely care in the rest home, I know he is well looked after, however after seeing him last week I feel a bit unsettled about his rapid mental decline. He now just sleeps in his chair most of the time and if awake he can't follow a conversation at all nor look at a newspaper or anything else. He just sits with his head hanging. I realise that health deteriorates but as this has happened so quickly I feel worried that perhaps the residents are medicated to make them manageable. Is this foolish of me to be thinking of this and would it be appropriate to ask to see his medication chart? I don't want to ruffle feathers but he is my dad and I feel that if there was some lucidity left then it would be good to see it.



Edited 1 time(s). Last edit at 06/13/2021 02:31AM by helen.

Helen, this is such a sensitive subject and I understand your feelings (been there with my father). I would suggest something along the lines of making a time to see the head nurse to discuss his rapid decline, and somewhere in the conversation ask if he is on any medication (this may or may have been prescribed by a Doctor attached to the facility). It is such a shock to see a parent deteriorate. I was so lucky to be just around the corner from Dad and was able to do a great deal for him, but unfortunately you are not in that position. i wish you all the best for what ever may be ahead. Annie

Good reply Annie.
I had been wondering about the medication and I like Annie's suggestion.
Illness and tiredness do seem to go together. It is so hard to watch on and not be able to do anything more to help than what is already being done.
Best wishes to you and your family, Helen.

Thanks Annie and Marnie. I am realistic about dad's declining health as he has had arthritic pain, urinary incontinence etc... for some time.
I guess my only concern would be if I thought he was sedated with medication during the day. That would be sad.
I will give them a call tomorrow.

I have worked in ages care and I very much doubt he is being medicated to make him more manageable unless he was a risk to himself. You are entitled to read the patient's notes that staff write up daily and also entitled to see what medications he is on however your mother would be next of kin and it is she who can read the notes. I suggest you see the nurse in charge of the hospital wing and bring your mother in. Dont ask to see her early morning as there is med round d etc. An afternoon would be better.

It could well be that he is in a different environment and knows it. Make sure activity staff bring him into the lounge and get him to participate in activities.

Thanks Noeleen.
Mum has handed everything over to me to do. I have EPOA which has been activated.
I am guessing that the transition from home to the care has probably psychologically had an impact and perhaps he was about to have a rapid decline.
As he is in the hospital wing of the home the residents are all much of a muchness so it is very quiet.
There is a social coordinator though and I know that she works to stimulate them.
Dad seems peaceful and well cared for which is ultimately what is important.
Poor mum has had close to 60 years with dad so she is finding it hard being away from him. She does spend hours there each day and I have just organised for her to have a cooked lunch with him daily.

Hugs Helen, its a challenging journey seeing your parents start along this path.

And a huge change for your Mum too as she has in a sense lost her husband after so many years together every day (his care & many conversations during the day arent with her now), thinking of you

Helen, I have absolutely no advice to offer since my parents died relatively young a long time ago. However, I understand your concerns and how lost your Mum must be feeling with you so far away. I wish you and your Mum all the best and hope that you will know that the Foodlovers family will be thinking of you in this difficult time.

Just want to say congratulations on asking the question. Same logic with my grand parent. Managing independenly at home, had a fall, in a resthome and dead a year later. Sorry if that sounds insensitive, but have never rationalised increased rate of decline once in rest home.

Plates that is not often the case in a resthome. We often found that when folk came in after a few weeks they were better especially if they were living on their own. Suddenly they got morn n afternoon tea, lunch and dinner and were well fed. Company was always there and entertainment which they never got at home.

Helen, then you have the right to see the notes. I strongly suggest you see the head nurse and ask for what medication he is on.

You need to be careful for your mum. Dont let her stay all day it is not good for either of them and your mum needs to not lose touch with what she does or activities she does. It can also be a strain going up for long periods of time. Sure have lunch there but go home after that to let your father sleep or rest afterwards.

I'm sorry to hear of your father's decline, Helen. My mother died last year after 4 years in an aged care hospital facility (she had motor neurone disease though). I had EPOA too, and my father was next of kin. It is absolutely within your rights to ask to see the medication chart, and I would go further to suggest you familiarise yourself with it, and any medications he is on. If you're not the person notified when your father's medications changes (at my mum's facility, they only notified NoK, but the info was always available if I asked for it), I would ask for a copy monthly or every other month. You can also ask to meet with his GP, the nurse manager etc at any time. Please, ask questions, make yourself known around there. I hate to say it, and I do not mean to offend, but the more you're seen to be paying attention the better for your father.

I noticed similar in my mother -- she hadn't started on the mental decline part of MND when she was admitted, but within 6 months she was quite different. Not to the point of sleeping in a chair all day, but different.

I did notice a lot of the other hospital wing residents doing only that, and it is hard to tell if it is because of the medical conditions that led them to being in such a facility, the lack of stimulation that comes from every day life in the community, or who knows what.

It is an incredibly difficult time for everyone involved. I hope your father is receiving good care, and if at any moment you suspect he is not, speak up. Be noisy and make notes of everything. And do consider moving him if you're at all uncertain. There are very good places, and a lot of very average.

------------- Personal vent.

My family's experience with a large aged care provider was not a positive one - very much profit based rather than satisfactory care. The staff largely did their best, but were hamstrung by corporate policies and funding levels. Which pissed me off because of the thousands of dollars my family was paying per month for mum's care. It wasn't an underfunded public hospital, and each time I heard about 'we just don't have enough staff to get to her any quicker" it made my blood boil. My mother was completely locked in her body, could only move her head and 4 fingers on her left hand. She was ENTIRELY dependant on the staff and many times she would wait for 30 min or more to be taken to the bathroom (didn't end well). We're still considering an HDC complaint.



Edited 1 time(s). Last edit at 06/13/2021 09:38AM by Jenna.

Noeleen sadly mum's life is crossword puzzles and dad. She really doesn't do much else and hasn't for some years.
She gets a taxi to see dad and to be honest the warmth and comfort of the home is probably good for her. Mum has little need for conversation, she just does her puzzles and dad sits. I am thinking that with starting lunches for her too that she may just do one visit.
My sister lives with mum but that is pretty complex.

I certainly agree with Jenna. Famarilise yourself with what goes on. I am now retired but I know what should happen. My mother was in resthome care and then was transferred to hospital care in the same facility. It was dreadful, I had one major complaint then decided to shift mum to another facility close to me. Best thing I did. I can pop in each day and check. Dont be afraid to complain and if you dont feel listened to then fill in a complaint form which then goes all the way to top management.

It certainly will be a learning curve for you and your mother. He will be in the best care for him but just make sure you know what is going on. You can also sit in on Dr visits especially the 3monthly review that happen.

Thanks Jenna,
My parents are in a small town with only one rest home and for a number of reasons we wouldn't move them to another town.
Dad wasn't exactly lively when admitted but he wasn't catatonic and that part saddens me.
I think that there has always been a common thought in town that when you get to a certain age you go to - name of resthome - to die.
Perhaps that psychology knocked dad instantly. A couple of days before moving he was pointing through his hospital window to the hills he had climbed as a young man and commenting on things in the paper of interest. Now 6 weeks later he sits drooped with his mouth open not comprehending any conversation.
Its probably me just airing this as I process it as there isn't too much I can do. Dad needs hospital level care, he hasn't walked since moving into the home. I just want to feel that he is getting quality care. Maybe if he was more lucid it would be even worse as he would then have awareness and sadness at his environment.

Helen, I think such a sudden decline deserves a review by a medical professional, I do wonder if they are sedating him to make the sundowning easier to manage? Perhaps the frequent visits by your Mum could be her way of saying she would like to be there too?

Thanks Griz and yes I am going to check medication.
Mum has said she doesn't want to be there but I am keeping an eye on her. The non-hospital side would appall mum - way too social and chatty. haha.

So sorry to hear about your dad, Helen. I would say by all means ask to see his medication chart so you're better informed - after all, it's one less thing to worry about. Cognitive decline often can progress rapidly, though, especially after a change of circumstances. A doctor commented when this happened to my grandmother that it's often the case that in familiar circumstances it's easier for the person to hide their impairment or for it to be overlooked. It doesn't necessarily imply anything negative about the care home.