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Move into Residential Care

The Reality

Tony Ramshaw

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Jane

• Diagnosed at 54 now 62• University Educated Mathematician• CEO of large voluntary organisation in

Netherlands• Big ticks on Mind your Mind• Now can’t read, write, tell time, dress

herself, or communicate• But still very fit and healthy

Residential Care Our Journey

• Early Decisions

• Preparing to enter Care

• One and a half years on

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Residential Care

Scary Process!

Want Help – But where ??

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Good for Jane?

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Residential Care

• How do I know facility will be good for Jane

• Visited 10 homes• Homes generally not welcoming• Needs now verses later !!• Chose 3 facilities

– BUT I will call you

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Residential Care Decision

• Triggers– Incontinence – Not recognising family– Aggressive behaviour– Danger to herself– Too many things Jane can’t do. E.g. not listening to

CDs, not enjoying TV– Decreases Tony’s quality of life unacceptably.– Deteriorating relationship between Jane and Tony

Need Residential Care• Jane’s Changing Situation Low to High

Care• Need to find a place • Change status from “I will call you” to

“Please call me”• Pick a few places and stay in contact• Immediate offer from place on the list

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Desperation

• NOT Coping – realised I couldn’t go on.• Checked every place within 30km of home

- 20+• A few places with space – but problems• Good places with 6 months+ waiting lists

or lists closed• Respite at Annesley• Offered Place at Annesley !!!!

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Annesley

• Dementia - 20 low and 20 high care beds• Large open central area• Plenty of space to walk around, wide

corridors• Several younger people• One and a half years on

– Jane appears Happy and so am I

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How did I Feel

• Surprisingly felt OK• BEST place for Jane• But feeling guilty for NOT feeling guilty.• Home on my own.

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Respite Care as Introduction

• MINUSOnly one or two rooms in an established home• PLUSSee the facility on an extended basisFacility sees the person

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Younger Person – My Views

• A specific facility ??

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Younger Person – My Views

BUT • Small numbers could mean a facility

remote from most carers• Do you move people on to another facility

when they age

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Younger Person – My Views

• Reality is what is needed is a facility that caters for their individual needs

and has a focus towards younger people

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Factors in Selecting Home• Manage people throughout the journey • Resident is an individual NOT a package• Staff care - go that extra mile• High ratio of OT staff - good range of activities• Wide passages, open spaces, • Minimise physical and chemical constraints.

Behaviour is a Management Issue.• Palliative care at facility• Continuous improvement process. • Actively engage with families

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Factors – Good to Have

• Have medical facility, pathology and pharmacy on site.

• Rooms where family can go with residents.

• Engage in research and teaching• Café for visitors

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Thank you for listening

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