Care home refusing to cooperate

Hello,

I'm sorry to hear about the challenges your husband is facing. It sounds like a complex situation. Considering the hesitation in trying again, perhaps having a discussion with both the care home staff and NHS physios might offer insights. Express your concerns about the cautious approach and inquire about alternative strategies or assessments. Additionally, you may want to seek a second opinion from another healthcare professional to ensure all possible avenues are explored for your husband's comfort and well-being.

Wishing you and your husband the best during this time.

I have personally had excellent HHS physio treatment after various bone breakages, and cannot praise them enough. In the first case, particularly, I had a nasty wrist fracture and the physio who was on duty when the external fixator was removed thought I might be left with little mobility in that wrist, but after lengthy treatment - with the same physio - my wrist is as good as new.

On the other hand, my mother was discharged from hospital to a care home, and we were told that physio would be given for 6 weeks by physios visiting the home - noone ever turned up, despite repeated requests from my brother.

So I wonder if their limited resources are prioritised for younger patients?

Glorianny

I think besides being overworked care staff also have to obtain the person's permission before they can move or do exercises with them. Sometimes the way they ask the question means that they will usually get a refusal. Then the old person may forget they have been asked and just say they haven't moved.

I agree about care homes. They are awful places.

I have worked in my particular care home for over five years now and I can assure you it is not “an awful” place. We have a team of dedicated staff who really do care for our residents
and I can assure you we do not do it for the money!
Someone else was saying their relative was left in a wheelchair that is not the correct policy in our home at all, we transfer people with a wheelchair and then assist them to a comfortable chair..

Glorianny

I think besides being overworked care staff also have to obtain the person's permission before they can move or do exercises with them. Sometimes the way they ask the question means that they will usually get a refusal. Then the old person may forget they have been asked and just say they haven't moved.

I agree about care homes. They are awful places.

Not all care homes are awful places. My Mum had a few months in one which was spotlessly clean but the staff were uninterested and uncaring. I looked at 14, turning up unannounced and some of them WERE awful. The better ones where I was allowed to talk to residents and where you could feel good vibes had waiting lists.

I can truthfully tell you that the last 3 years of my Mum’s life were spent in a care home where they all loved her, treated her with respect and were genuinely interested in her. I could go in whenever I liked, take her out, enjoy meals there with her etc. she had a lovely light, sunny room and enjoyed watching dog walkers and schoolchildren passing by. All the food was homecooked and I could never have looked after her 24/7 like they did.

Try looking on Facebook, Rights for Residents. Created in lockdown thousands of people who can help and help you, including care home managers. Good luck

I think besides being overworked care staff also have to obtain the person's permission before they can move or do exercises with them. Sometimes the way they ask the question means that they will usually get a refusal. Then the old person may forget they have been asked and just say they haven't moved.

I agree about care homes. They are awful places.

My feeling were that it was too much bother for the staff.

To be fair, the staff ratio has become more and more difficult over the years because it has become so hard to recruit. I visited up to 25 homes before I placed Mum into her second home. I eventually put her into a place where it is £2000 per week but the staff ratio is so much higher; the difference is phenomenal. The moment I walked into the home, you could tell the difference. It isn't one of these big Corporate places where the staff look professional but seem quite distant nor was it a privately run place which looks shabby but the staff are warmer and overworked. It was only when I started needing care for Mum, I realised how shamefully we treat our elderly and sick.

The less he is mobilised the stiffer he will become
This happened to my Mum.
Went into respite and was promised physio which didn’t happen- left in a chair and ultimately a wheelchair. My feeling were that it was too much bother for the staff.

No fancy tilting chair for dad, even though they had those! Most times he was left scrunch up in the wheelchair, even though there was plenty of comfortable armchairs - I am convinced he would died in that home if we hadn’t taken him home sooner than those six weeks were up.

Dad was placed in a home for continuous care to get him walking, physio visited to give him exercises & told care staff to follow the exercises through, LSS, they said they weren’t allowed to & also they didn’t have time! Mum & I visited him every day to make sure we could walk him.. with our determination we eventually got him home😊

If the staff have been given a plan by the physio and that doesn't include the bending of legs that's what they will adhere to. If tge staff go ahead and as you say, try, and anything goes wrong they will be liable. Ask to speak with the physio, express your concerns but be orepared to listen too. Perhaps it will take longer than the 6 weeks to achieve what you are hoping for.

GANNET

Had great NHS physios for my dad. The physios themselves are frustrated at the high case loads and the lack of time they get per patient. In terms of rehabilitation it is also up to the patient to help themselves as well by following advice and adhering to the specific exercises for their condition. Too many people think that someone can just cure them in a single session. Too many people with chronic conditions so demand is higher than supply.

As Pearlsaminger said above if people are very old they often cannot help themselves! My Mum was left in bed for 3 weeks and when the physio came to her bedside all he did was chat. No examination, no manipulation, nothing.

Ten years earlier she had a knee replacement and I took her to all her appointments. She was about 80 then. She was given a booklet with exercises to do at home which she did religiously but the physio in the hospital was almost non existent.

Had great NHS physios for my dad. The physios themselves are frustrated at the high case loads and the lack of time they get per patient. In terms of rehabilitation it is also up to the patient to help themselves as well by following advice and adhering to the specific exercises for their condition. Too many people think that someone can just cure them in a single session. Too many people with chronic conditions so demand is higher than supply.

Had the same this year with my elderly neighbour, I was her next of kin as she was alone in the world, and fought so hard for her.

She was 84, also in a care home temporarily for 6 weeks. Same scenario with hoist, and we even took her rise recliner chair in, so she could sit on that.

In 6 weeks, they put her in a ‘normal’ armchair chair once. She was uncomfortable and was found a hour later, sliding off it by a visitor passing her room. She’d been shouting for help as her call button was out of reach.

Staff said it took ‘too much time’ to move her into her own chair. They didn’t even try. Not once.

At a hospital appt (which she went to on a trolley in an ambulance) her consultant said she needed intense physio to get more movement. Stuck in her bed all day long was causing big problems. They still did nothing. And their physiotherapist didn’t turn up for 3 appts.

Last day of her 6 weeks she was found ‘unresponsive’ but breathing. 999 to hospital and tests said no stroke. Five days later we learnt she’d had a double stroke, either side of her head.

Sadly she died 18 days later. She’d had a blood clot behind her knee the previous year from not being moved while in rehab, and not being moved again probably didn’t help.

My old lady had a private physio but the care home said they were ‘worried about her being there!’ We never got any reason why, or permission for her to go in.

We only spoke to the Manager of the care home. I wish we’d gone above them to their Head Office or spoken to the Care Quality Commission about it. Too late for her now.

Don’t let it go - keep fighting it.

Grantanow

I have had some excellent hands on physio from the NHS - there may be poor examples of treatment but in my experience the physiotherapists are very good.

How long ago and where was your NHS physio?

It has been the case for many years that NHS hands on physio either doesn’t happen at all or is very little. They just hand out leaflets. this confirms it

optimalphysio.co.uk/whats-the-difference-between-private-physiotherapy-and-the-nhs/

Casdon

In your mum’s case then Glorianny the nurse would have been the care coordinator, or at least that is the norm in most community teams. I’d assume without knowing the individual circumstances that the physio was covering some of the OT duties as well because the team was short staffed. In integrated community teams the social worker would coordinate homecare cover ie care staff who were not part of the nursing team, but who would assist with personal care tasks.

The hospital social worker and the hospital physio were involved in her discharge. The hospital physio came to her flat and measured up to make sure there was room for her bed and a hoist in the living room. The hospital social worker was arranging for the equipment she would need and the care teams that would support her.
I'd really be grateful Casdon if you could stop telling me what should have happened and let the matter drop. I spent three months visiting the hospital practically every day. I had numerous meetings. I know what happened. I know there were no OT staff on my mum's ward or involved in her ward conferences. Could you please just accept that .

Glorianny

Casdon

In your mum’s case then Glorianny the nurse would have been the care coordinator, or at least that is the norm in most community teams. I’d assume without knowing the individual circumstances that the physio was covering some of the OT duties as well because the team was short staffed. In integrated community teams the social worker would coordinate homecare cover ie care staff who were not part of the nursing team, but who would assist with personal care tasks.

No the social worker was dealing with things. I had many meetings with the team who were treating her in the hospital and with the social worker about her discharge. No nurse was involved in the discussion about her homecoming, although she would have needed nursing care.

It would be unusual for the Nursing Team not to be involved but was probably behind the scenes. Very often the Nursing staff's views are taken into account by the notes they make on the ward which is fine unless the notes are wrong!
We dealt with the Social Worker with my Mum until we came to a stand off and then the world and his wife seemed to become involved. We had a family meeting where we were faced with about 8 people to discuss a way forward.
I think different hospitals do things different ways. We were also involved with an external team who were outsourced to help the hospital find the right care home. Sometimes I felt that I was getting a hundred phone calls and emails a day chasing me to put her in a home, any home! It was a very pressurised situation.

what tilting chair is it

...... is it an armchair with a lever to raise you out of the chair or a perch chair to sit at a worktop with?

I have had some excellent hands on physio from the NHS - there may be poor examples of treatment but in my experience the physiotherapists are very good.

Tilting chairs have been banned in the NHS for years. I’ll try to find the paper and post it. Not safe

You could try getting in touch with your local Carers' Association. They are very helpful in giving advice to carers and being 'at your elbow' if you need to write letters or make a formal complaint. It is very hard: I have been there with my husband and my dad, and you don't want to upset staff, but you do want them to do their job! Good luck.

Casdon

To be honest that sounds like a dysfunctional team set up to me, care should be integrated to get the best outcomes for patients, and if the nurses were the primary care givers they should have been leading the discussions. I hope your mum did receive good care regardless.

It was an excellent team who worked hard to ensure mum's needs and her wishes were catered for. She never left hospital she died waiting for care teams to be available.

My Mum only died in 2020 so I am not that out of date. Mind you she spent 3 years in a care home prior to that so I guess that’s 6 years. 🤭

We never, ever had a visit from a physio. The only visit we had was an OT who came out to see about rails, ramps etc to make Mum safer in her own home following major surgery.

In our area if GPs refer you to physio most people I know decline it because it is so hopeless. I hear it over and over again.

To be honest that sounds like a dysfunctional team set up to me, care should be integrated to get the best outcomes for patients, and if the nurses were the primary care givers they should have been leading the discussions. I hope your mum did receive good care regardless.

Casdon

In your mum’s case then Glorianny the nurse would have been the care coordinator, or at least that is the norm in most community teams. I’d assume without knowing the individual circumstances that the physio was covering some of the OT duties as well because the team was short staffed. In integrated community teams the social worker would coordinate homecare cover ie care staff who were not part of the nursing team, but who would assist with personal care tasks.

No the social worker was dealing with things. I had many meetings with the team who were treating her in the hospital and with the social worker about her discharge. No nurse was involved in the discussion about her homecoming, although she would have needed nursing care.