Changing Roles - Director of a Care Home -Tui, choosing Care for her own Father.

“Not many people are thinking to themselves – ‘oh I can’t wait to move into a care home’…..

It was a surreal and valuable experience being ‘on the other side of the fence’ when my father had a major stroke (on the other side of the world). I needed to call on all of my experience to support his best chance of survival and recovery.

It started like this.

Having not seen, only spoken to my father for the past eighteen months I just had ‘that feeling’ I needed to get down (to New Zealand) to see him. With my busy life and responsibilities in the UK I could only be away for just over two weeks – but off I went, keen to catch up with family and friends on the other side of the world who I had not seen for four years. Sure enough – in that weird way that life has, the day after I arrived Dad (unknowingly to us all) had a TIA (mini stroke). I wish I had known then what I know now….

The following day we took a two hour flight to the very south of the South Island – the city of Dunedin, for a little six nights away to visit a few places of interest, including calling on my aunt in New Plymouth on our way back to Auckland.

On the flight down my father said his leg had gone numb and that he had ‘pins and needles’ (it was the same thing that had occurred the day before that at the time we had not realised was actually a TIA).

As we got up to get off the aircraft my father could barely hold himself up, his leg was collapsing under him. It was horrendous to witness. He stumbled and fell to the top of the aircraft jetty where I called for medics. Long, slow story, short - we drove ourselves straight to Dunedin hospital – and sadly from there he has been receiving intensive medical care followed by rehabilitation since. It was eleven days before he could be transported back to Auckland by air ambulance. The experience for my father was devastating. From active and independent to having his strength, independence and mobility stripped away was just the most awful thing to witness.

Dad’s stroke progressed, slowly worsening over the first four days in hospital. Now both legs went leaving him unable to weight bear, two days later his right arm, the following day his speech was affected with his face dropping. It was horrendous. My heart broke for him. It is so important that people are made aware that the usual signs of a stroke did not appear until three or four days of being admitted into hospital. I thank the hospitals, especially physio and speech and language for the immediate intervention that helped Dad to recover his speech and facial muscles.

The time came for us to look for somewhere longer term to provide the care and rehabilitation my father now required. This is not what Dad wanted. He wanted to go back to a home of his own. However, my mother not physically able to provide the support Dad would need and he needed 24 hour support still. I was at least able to take a more positive view about of the benefits that a comfortable care setting could offer. I knew he would have people on hand to support him and this provided the greatest chance of a fuller recovery. My mother couldn’t do this, nor could myself or brother and sister as we all work full time.

I was at least familiar with what to look for in good care provision. We had been recommended a ‘really nice’ place, that was expensive but it would be worth paying the extra for. We knew a ‘top up fee’ would apply to get the standard of accommodation and care we would all want.

My mother and I drove out to find the highly recommended place which was further than expected. We needed to be mindful that whilst Mum can drive at the moment, there might come a time when she won’t be able to so it needed to be convenient for her and equally importantly for friends of my father.

This first place was tricky to find and it took us further out of our locality than we were familiar with. We arrived feeling somewhat ‘harassed’ from trying to find it. Whilst it looked ‘amazing’ it also struck me as a large holiday resort – great for a two week holiday but totally impersonable. It felt like a sky scraper looming above. Flash, big, swishing, glass sliding doors and two smart receptionists behind a large desk – it all simply felt ‘too much’. I didn’t want ‘big and flash’. Working in a small home for 35 people this really was too big, too perfect, too institutional – a wonderful glossy cover to what I knew would be a service that could not possibly be able to provide truly personal care from the top down. It was not ‘homely’ or welcoming - it was perfect in a sterile kind of way and it was not right for our family.

Mother and I looked at each and decided against it. I kindly explained to the receptionist that it was too far away from us and we dashed off pleased to leave it behind us.

The next place we knew wasn’t going to be as flash as the first place but even so, we were back in our locality, this in itself gave us comfort. However, when we explained to the receptionist we had been told we didn’t need an appointment she looked rather blankly, raised an eyebrow and said there were no vacancies. We asked to look around anyway which she obliged with. I found it what might be seen as a ‘typical’ care setting, somewhat empty of soul without much warmth or homeliness in the lounge. Chairs lined up and the type of place you might stay on a school holiday. The bedrooms all had lino on the floors, albeit all rooms did have direct access to (at least) a shared bathroom. There were a few larger bedrooms (requiring a top up) and then we were shown a larger room but with four beds in it! Well to me this is not a bedroom – it is a ward.

It didn’t fill us with much hope but here were no vacancies and a waiting list of people who already lived on site in the supported living facilities. So, we drew a blank, came back out to the car feeling quite concerned. There was one more option that we had not wanted to consider as my father had known a few people be cared there for their end of life care…..

We now realised that we would have to consider it on the basis that Dad understood it was for a period of rehabilitation – until Dad could regain some independence and their house sold so they could live in a single story dwelling.

Easier said than done! When we got there they were closed to admissions due to building a new suite of upmarket care apartments.

I started to feel anxiety creep in – would we find somewhere?

There were only two more places to consider other than two large consortiums building multi-occupancy facilities for hundreds of people in one setting. These type of organisations were large multi million (or billion) dollar, shareholder, public listed companies still under construction.

Looking at the two remaining options, we visited the home closest to Mum - just two and a half miles away.

My first impression was a kind of familiarity. With only a ground and first floor it felt so much cosier than then imposing feel of multi-story. The outside of the building was tidy and offered a good level of parking.

The reception was bright and clean, with new looking armchairs. It was a little ‘busy’ – in terms of paperwork and things happening (which I could relate to) but these ladies were ‘nice and normal’. I just felt like I could relate to them and the surrounding.

Sure – there were things that I thought could look a little better ‘if’…., and would be more ‘perfect’ if ….. but what it was not, was that (almost false), sterile, institutionalised perfection of a (faceless) Hilton Hotel. It was real people, doing a real job with real smiles who I felt I could relate to.

We asked if they had vacancies? Which they had; three rooms available. My initial instinct was to wonder why? But actually – it turned out to be a simple twist of luck…. We felt hopeful. As we were shown around, my heart did sink at first.

Before you read further, we must all bear in mind that care homes, receive tough press. Not many people are thinking to themselves – ‘oh I can’t wait to move into a care home’. But, what absolutely must be remembered and appreciated, is that the people who are being cared for require 24 hour care to enable them to be safe and well.

We can’t imagine that one of the people using the service would choose to share their days in the company of other people, strangers at first, who are also in need of a high level of care. But please remember – they are people. Amazing people, who have lived amazing lives and who now, as a minimum, deserve respect and recognition for who they are. They don’t want to be like this any more than you do.

We are able to live longer but with that often comes complex care as well. Without services such as care homes, people would live in neglect, discomfort, dehydration, under nourished and at risk of all sorts of abuse and harm, living in the most dreadful of conditions.

All the same, my heart did sink, as I just could not imagine my father, with his cognition still intact, feeling inspired in the company of others with very high physical and / or cognitive health care needs. Would my father be asking himself if he is really this poorly?

I was disheartened by the rows of people in arm chairs in the main lounge – it felt so institutional - however it was good to see that there was activities and interaction going on with a truly lovely Activities Co-ordinator – who continued to inspire me each time I met her. More importantly – people were out, with others – not hidden away in their bedrooms. There was plenty of light and things were going on around them.

We viewed the dining area and whilst everywhere was perfectly clean with some nice touches it felt large and soul less. People here required a high level of assistance with their meals which I thought might be depressing for my father.

And then I felt a sense of calmand total relaxation as we walked into another wing. My entire body softened as my attention perked up passing a lovely outdoor decked area which my father would enjoy. He is an outdoors man and needs to be outside pretty much every day and certainly at this time during a very warm Auckland summer. The corridors widened and people were sat in smaller groups surrounded by large windows letting lots of light in.

These more intimate groups of people inspired me. People looked content and I could relate to them. They clearly were in need of complex care but it felt so much better in the smaller groups. This would be a pleasant enough setting for me, so that makes it good enough for my father.

The first room we saw was acceptable with a shared bathroom.

The next room required a top up of just over £100 per week. This room really struck me, it had a long view (only across a street) with plenty of light and a large en-suite that I hoped would inspire my father to try and get up to use that bathroom for himself which would provide the foundations for and every hope of returning to his own home. (Incidentally – this room also had an auspicious number on it – so I was rather ‘hooked’).

We looked at one last room bumping into another lady viewing the home. She must have arrived just after us.

This third room did not grab me in the same way the previous room had.

I knew I wanted to reserve the 2nd room. On our way back through the main lounge – something caught my eye. A lady resident with freshly applied bright pink lipstick that she clearly could not have applied herself. Yes, I felt good about this place. They care enough to know that her lipstick is really important to her and they have applied it for her. Yes – this is the right place.

I confirmed to the Manager that we wished to reserve the 2nd room we had seen. Her response was positive as she replied they now only had one room left! Within the fifteen minutes or so of being there, from three vacant rooms there was now only one. That was the twist of luck that we arrived at the time we had. Maybe there would not have been any room for my father had we been even an hour later.

My father has now been there three weeks or so. Yes, there have been a couple of matters such as response time to Dad’s call bell but for certain the Care Manager has responded to everything we have asked of them. My father reports how nice they all are and how good ‘the boys’ (the male nurses) are to him. I can sleep at night knowing we chose the right room in the right home for my father.

Working in the same setting I can balance perspective when well meaning family and friends report concerns. The team at Forrest Hill are lovely, I feel confident that they put Dad’s care at the forefront. They have listened to us and between them and the new GP we have made good progress. Dad regularly goes outside in the morning. He is fortunate to have friends and family visit him daily. His life has changed but there are windows of new opportunity, new relationships with the people who work at the care home, he now uses a smart phone and an i-pad. He enjoys watching a lot of documentaries on Netflix. He receives good quality food and is encouraged to drink more fluids (than he would do if at home…..). His medication is taken as prescribed (unlike when he self administered from home…..). I feel he is safe.

It was only after we had chosen the setting that I actually read the official Department of Health (equivalent to our Care Quality Commission) report. There were a few matters that had been addressed since the inspection. I was pleased to see that my instinct choice was supported by a good report. My advice – follow your feelings.

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