Taking Dad out of nursing home for day trips

pog it

Hope personal issues is the right place for this! The carers forum is very quiet sadly.

My Dad is in a dementia unit in a nursing home having moved there a few months ago. They are doing a great job of looking after him- we had no choice but to go with the nursing home as his dementia advanced very quickly over a few short years and we, and carers, were no longer able to manage.

He has settled in well now but I would like to bring him for day trips and take him to see the sea, the mountains, and possibly an event where he might be stimulated but it is so difficult to come up with suitable events.
Where we live is not near the coast and so anything coastal will involve a drive of a couple of hours.. I'm wary of taking him on such a long drive but what else can I do?

I haven't asked the nursing home their advice yet but before I do I'd love to hear from others who have experience of this- is it wise to do something like this at all, and will I run the risk of ruining his experience of the nursing home for the sake of these day trips? They are going to be once a month at the most.

Diane Selwyn

Hi pog it
I don't have personal experience of this but my aunt is in in a nursing home now with dementia that seemed to come on really very quickly - sadly my uncle passed away not so long after she had to go into the home but my cousin lives quite near her and does bring her out for special occasions such as mother's day but never very far as I think she gets very tired easily - I'm not sure if this is related to trying to make sense of things which could be mentally exhausting or just because of her physical condition/age (she is pretty much confined to a wheelchair now). It sounds like her moods can be unpredictable and she might become stressed if she is having a bad day. Maybe it would be better to start just with something nearby and see how that goes but the nursing staff should know your dad pretty well and have a good idea of what he would be up for so see what they recommend. I'd say he will be happy just to spend some time with you whatever you end up doing.

baby and crumble

If I were you I'd talk to the nursing staff who are looking after your Dad- sometimes trips are a great idea since they can stimulate long term memories which is proven to help calm a person with dementia. Did you Dad have a particular love of the sea, or the mountains? Going somewhere new can be really scary for someone with dementia, and can backfire if it's not managed well.

pog it

baby and crumble wrote: »

If I were you I'd talk to the nursing staff who are looking after your Dad- sometimes trips are a great idea since they can stimulate long term memories which is proven to help calm a person with dementia. Did you Dad have a particular love of the sea, or the mountains? Going somewhere new can be really scary for someone with dementia, and can backfire if it's not managed well.

That's a very good point re somewhere new being potentially scary. I will definitely ask the nursing home staff for their advice but I just wanted to get as much ideas around this as possible. I visit him every 2 or 3 weeks but just in the home. Shortly before the dementia set in he had expressed a wish to go to Achill island when the weather improved but we didn't get to do that- I brought him on several trips before he got dementia but they were more nearby than further afield.
Achill is out of the question now but that made me think of sea and mountains- just something to refresh him completely.

What would you suggest I can do given his dementia? What would stimulate him without being potentially overbearing to him?

StevieNicksFan

pog it wrote: »

That's a very good point re somewhere new being potentially scary. I will definitely ask the nursing home staff for their advice but I just wanted to get as much ideas around this as possible. I visit him every 2 or 3 weeks but just in the home. Shortly before the dementia set in he had expressed a wish to go to Achill island when the weather improved but we didn't get to do that- I brought him on several trips before he got dementia but they were more nearby than further afield.
Achill is out of the question now but that made me think of sea and mountains- just something to refresh him completely.

What would you suggest I can do given his dementia? What would stimulate him without being potentially overbearing to him?

How about taking him to a local park or lake that he might have visited in days gone by? He will be outdoors in the fresh air with various sounds and sights stimulating him - but at the same time it won't be too overbearing. If it's local enough, he won't be too far away from the nursing home either if he does get anxious. Maybe somewhere that you both used to go also, as it would be nice for you to to have the opportunity to reconnect with your father. Dementia can most certainly be difficult for close family members so it is important for you to grab opportunities like this too. I would imagine that anything that can contribute somewhat to your fathers social, emotional and mental health would be wholeheartedly encouraged by nursing staff. I know of far too many family members who leave their loved ones in nursing homes for months at a time with no visits. I'd say your father above anyone else would be delighted to get out and about and hopefully that will take priority.

LegacyUser

My mother has dementia and is living in a nursing home. She loves when we take her out to places during the day but as it gets dark she wants to go back to the nursing home. She must associate darkness with sleep. Last Christmas I brought her to my house for Christmas dinner, we live an hour away, and after a few hours she was anxious to get back to the nursing home. She found the day too long. When I bring her for a walk on the beach and lunch somewhere she loves it.

Try taking your father out for short periods and see how you get on. A change of scenery can do a lot of good for their spirits.

Best of luck with it

Pawwed Rig

Hi pog it

First off I would commend you on trying to keep your Dad active and I would say even just a walk outside will be great for him.
For longer trips it really depends on your fathers health. Does he wear adult nappies for example and are you willing to change them for him.
My Dad was in a similar situation. I used to take him out for nights away to see his sisters or just upto my own house for the evening to watch TV. It was really difficult as his balance was shot so he couldn't walk far, he had difficulty swallowing so would often choke on his food, had to be heped to the bathroom, cleaned up after, remember his tablets, dress him etc etc. It was similar to looking after a 16 stone baby.
If it is just dementia your Dad has and can still walk, eat etc then there should be no problem bringing him out.

In a nursing home I found that they do not cater for the hobbies of the men too much. For example I went in on All Ireland Sunday one time (as my Dad was a big hurling fan) but the common room TV had Eastenders on. There were similar situations when the 6 nations might have been on the TV. This is not out of badness but often the staff would not be aware an event was taking place. If you know what he likes to do (or watch as TV and music was all my Dad had in the end) try and incorporate that into your visits.

pog it

Thanks again for the terrific advice. I think the suggestion of going to a lake or somewhere familiar to him is really the way to go, and I'll just make it as enjoyable a trip as possible for him, and stay close by to his own home and the nursing home.
Yep he needs adult pullups and also is restricted mobility wise- he isn't able for long walks and has to be assisted at all times. That's why I was putting the emphasis on the scenery of the trip to make it stimulating during the drive as well.

The nursing home are great but I'm not sure what activities they do. I have asked and they mentioned things like reading the newspaper and talking about the news, etc., but every time I've called in so far my father has been either sitting in the dining room for meals - which is a huge part of his day - or in their sitting room, and he is often alone there- probably by choice.

Pawwed Rig

pog it wrote: »

The nursing home are great but I'm not sure what activities they do. I have asked and they mentioned things like reading the newspaper and talking about the news, etc., but every time I've called in so far my father has been either sitting in the dining room for meals - which is a huge part of his day - or in their sitting room, and he is often alone there- probably by choice.

Nursing homes cannot really cater to everybody. They cater to the residents that join in and like to chat (which tends to be the women) but the quieter ones or the dementia residents tend just to be moved around.
Up in morning washed and breakfast, day room until lunch, eat lunch, day room until dinner, eat dinner, bed. The one my Dad was in did bingo (which he had no interest in), some ball catch games (which he wasn't able to participate in), TV (usually soaps or daytime gossip TV). They do their best and were all lovely and pleasant but as you know even this level of service is astronomically expensive (probably €1,000 per week in a private nursing home). Human nature being what it is when the staff end up looking after the loudest and most troublesome whereas the quieter ones tend to get marginalised. I was lucky as I lived close by and usually managed to get in everyday and had brothers and sisters who (some better than others) used to call over.

pog it

Pawwed Rig wrote: »

Nursing homes cannot really cater to everybody. They cater to the residents that join in and like to chat (which tends to be the women) but the quieter ones or the dementia residents tend just to be moved around.
Up in morning washed and breakfast, day room until lunch, eat lunch, day room until dinner, eat dinner, bed. The one my Dad was in did bingo (which he had no interest in), some ball catch games (which he wasn't able to participate in), TV (usually soaps or daytime gossip TV). They do their best and were all lovely and pleasant but as you know even this level of service is astronomically expensive (probably €1,000 per week in a private nursing home). Human nature being what it is when the staff end up looking after the loudest and most troublesome whereas the quieter ones tend to get marginalised. I was lucky as I lived close by and usually managed to get in everyday and had brothers and sisters who (some better than others) used to call over.

Yep, you were lucky for sure. I sadly can't do that- none of us in the family live nearby to be able to call in every day.
Definitely is expensive but Dad is a maximum dependency resident there so there is a huge amount of monitoring and care involved. I do wish things in Ireland were better in terms of quality of consultants and nursing homes. We were lucky to get the home we got for Dad but there was really nothing else on a par with it around. It's depressing when you compare services with more mature societies- the low standards we have, relatively, just trickles down into everything. Has been a huge blow to me to discover this is the case even in supposed top level health care.

Semele

Is there a version of Age Concern or Help the Aged in Ireland? I used to work as an activity co-ordinatior in a nursing home in the UK and found both of these really good. They do befriending work, so I often made referrals for clients with no family nearby and a volunteer would come in weekly to spend individual time with them doing whatever it was they enjoyed.

Can you look for similar in your area?

I have some other ideas based on my experience and will write again later when I have more time:)

tenifan

Hi op. If you're able to take him out, I'd definitely recommend giving it a go.
Don't go too far the first time, and if it goes well you can try longer trips.

LegacyUser

Got to agree with the advice not to take him too far at first. I'd also warn against you getting your hopes up too high. My mum has dementia and I tried everything in my power to stimulate her. I brought her on trips to nice places, played her music that she'd liked, bought her her favourite food etc. Now I wonder did I do it more for me than for her if that makes sense? I don't think she enjoyed these trips as much as I hoped she would. One of the sad things about dementia is that it gradually sucks the joy of life out of people.

I found bringing my mum to a local park to look at the nice flowers did as much for her as a longer trip. I'm not sure she really enjoyed the car journey. If you or I were a passenger in a car going through a nice area we'd be looking out the window and enjoying the scenery. My mum might as well have been looking at a dingy back yard somewhere for all it did for her.

Another thing to warn you about is possibly unsettling your dad. Sometimes when people take a parent out of a home for the day they don't want to go back or they think they're going home. Be prepared for that

tenifan

shadysback wrote: »

Got to agree with the advice not to take him too far at first. I'd also warn against you getting your hopes up too high. My mum has dementia and I tried everything in my power to stimulate her. I brought her on trips to nice places, played her music that she'd liked, bought her her favourite food etc. Now I wonder did I do it more for me than for her if that makes sense?

+1
But I don't think there's anything wrong with that.

My poor granny, when she was in earlier stages of dementia she hated being stuck at home. My mam would bring her places, and she'd just get so restless and just want to go home again.

The things we found that helped my granny when she went into the nursing home were to take her to a quiet area in the home (she generally hated noise and her nursing home was ridiculously noisy) that had a table and a few vending machines and I think she thought she was in a cafe because that's the only place she could relax. My sister had a baby so we used to bring him to visit, my granny thought it was her grandson so enjoyed watching him.

It's really sad the way things go, op. At this stage, anything you can do to improve his life will be a win.

pog it

Semele wrote: »

Is there a version of Age Concern or Help the Aged in Ireland? I used to work as an activity co-ordinatior in a nursing home in the UK and found both of these really good. They do befriending work, so I often made referrals for clients with no family nearby and a volunteer would come in weekly to spend individual time with them doing whatever it was they enjoyed.

Can you look for similar in your area?

I have some other ideas based on my experience and will write again later when I have more time:)

My dad does see us every week but it's weekends for the most part.. Would be great to have someone to go in on a weekday for sure to add to it!

Maura74

tenifan wrote: »

+1
But I don't think there's anything wrong with that.

My poor granny, when she was in earlier stages of dementia she hated being stuck at home. My mam would bring her places, and she'd just get so restless and just want to go home again.

The things we found that helped my granny when she went into the nursing home were to take her to a quiet area in the home (she generally hated noise and her nursing home was ridiculously noisy) that had a table and a few vending machines and I think she thought she was in a cafe because that's the only place she could relax. My sister had a baby so we used to bring him to visit, my granny thought it was her grandson so enjoyed watching him.

It's really sad the way things go, op. At this stage, anything you can do to improve his life will be a win.

+1
Terifan ,my love one was so ill the person in charge told me that they moved her into high dependency part of the home as she got pneumonia. I was amazed to find this was next to the kitchen very noisy with trolley full of cutlery back and forth into the room next to her then washing machines noise as well lots of chattering going on. My love was too ill to be transferred to hospital. The only small plus was the room was a bit warmer than the one she was taken from the other end of the building.

OP, I expect there is not much ‘secure’ outside space for residents to roam around in. Have a word with the person in charge of the home as that person should be able to give you advice on taking your Dad’s out for trips. If he has not been in the care home too long then he will certainly enjoy it. If he has been there for a while he may have gotten used to the routine and may miss it a bit. It appears from your post the home is like most of them not much entertainment save for TV. Resident do not get to see what they want to see on TV as most of the time it is just on by carers and then leaves room whether residents want to watch it or not.

Semele

Hi again OP

Sorry for the delay in posting again! Unfortuntely voluntary agencies don't seem as common in Ireland as in the UK, but I did find this one

http://www.friendsoftheelderly.ie/services-2/visiting-programme/

They might be able to help, might know of other organisations or be able to advise you on how to advertise for a volunteer yourself (in the care home I used to work in a number of families got me to recruit dedicated volunteers for their relative, which I did via Gumtree....obviously you have to vet people carefully!).

On the topic of activities, I think the real challenge for families is to break away from pre-conceived ideas of what a meaningful activity is. Long trips may indeed be a lovely idea but as others have said, if your father is in an advanced stage of dementia he may not get much more from this than a local trip with less disruption/fatigue/confusion etc.

A lot of the time we don't hink of activities as being appropraite for people with dementia because they can't do them "properly". We have a natural focus on completing tasks and working towards results, but just because a person with dementia can't do this it doesn't mean that the process of the activity isn't enjoyable or beneficial.

Just a couple of examples of what I mean from my experience:

A lady in the home had quite severe dementia, wasn't very mobile, had little speech left and as a result didn't do much apart from sit in a chair all day. She had always been a real homemaker and was very houseproud. We started popping a table in front of her after mealtimes and giving her a basin of soapy water with some cups, saucers etc (could be plastic if there is a breakage concern). She loved this! Although all she did was swish them around, take them in and out of the water, play with them etc, she took to the activity immediately and always seemed very focussed and BUSY throughout (in a big contrast to her presentation otherwise)...it seemed to feel familiar and meaningful to her, as well as providing sensory stimulation that she wasn't getting otherwise. This became a daily routine. Now, you might think that seems like a patronising or childlike activity, or that it is so pointless it barely counts as an activity in any real sense of the word, but that isn't the point. We found something that was meaningful for her and that occupied her in a satisfying way. It is her activity and it doesn't matter if you or I wouldn't find it fun!

Similarly, another older man in the home used to always polish his shoes daily when he was younger (he was a real dandy!). When his family told us this it became part of his routine in the home and again he took to in a way he hadn't to anything else. It was familiar and meaningful enough to him to spark a sense of normaility and purpose, even through his dementia. Although he couldn't remotely actually polish the shoes that doesn't matter- it's about the process rather than the goal. He didn't know he wasn't doing it properly and he would happily busy himself for ages with the brushes and cloths.

Another lady loved sorting through things, even if she wasn't quite sure what they were or what they were for. I got her a big handbag and filled it with a variety of things I thought might catch her interest- everything from a little photo in a frame, a comb, a soft toy, some little party games with moving parts (the sort of thing you get in a cracker). She loved this, carried the bag with her everywhere and could occupy herself for ages taking everything out, sorting them whatever way, showing them to people, and packing them all up again. Again- I wouldn't find it entertaining all day, but its not for me! We used a similar idea with a man who used to work in construction except he had a box full of items, some personal like photos, some related to activities he would have found familiar (tools, giant screws with nuts that he could screw off and back on, etc!) and a selection of sensory toys like stress balls and musical instruments (like shakers or whistles). Again it kept him busy and occupied for ages- the trick is finding items that capture a persons interest, unexciting though they may seem to you.

Another older man's son used to visit at weekends and take him out to sit in the garden, where they would play cards and chess. The man was well beyond the stage where he could play either, but there was enough familiarity in the games for him to pick pieces up, move them, put cards on top of other, or just examine them. All the while his son would act as though they were playing perfectly normally and chatter away, never correcting anything. At times they were just taking turns to put cards on top of each other! The man really enjoyed it and again, it doesn't have to matter at all whether an activity is being done "right". It would have been very easy to think "Oh, he can't play games like that" and so not bother, but I always admired the son for how patient he was and how normally he acted through an activity that I'm sure was fairly dull for him. He really saw the point though- that his dad enjoyed it and it was meaningful quality time together that continued something they both valued. Apparently his dad always enjoyed beer with cards, so he used to bring some and make weak shandies for them both as they sat outside, in another lovely example of maintaining the spirit of an activity despite the fact it can't be exactly what it used to be or "should" be.

Sorry for the massive post- it is something close to my heart and I have seen so many times how hard it is for family members to know how to support heir loved one.

If I can be of any more help then feel free to ask any questions, all the best otherwise:)

pog it

Hi Semele, thanks for taking so much time to respond. You have made me rethink the weekday visits thing and am taking yours and the overall advice here on not going too far with my Dad. The problem with my father is that he didn't have any one thing like that based at home apart from reading the paper- he loved going to lectures, seminars, or talks, or political things, but we could never talk him into getting a 'hobby'. He had hobbies like gardening (horticulture more so) when he was younger but he had lost interest in that years ago anyway. Is there anything around this you can think of that could be done in the nursing home? A local history or some such talk?

He loves Irish music and we were told the home has music every week but I'm not sure if that is the case and I'm wary of asking them again in case they find it confrontational.

If you don't mind there is one other thing I'd like your opinion on.
I had suggested to my siblings that we could pay one of our former carers to call in once a week during the week and my siblings- all but one- turned it down, with one of my brothers saying that my father's brother who lives nearby would be calling me every day. I didn't believe that for one second, and sure enough, after about 2 months of Dad being in the home I asked the head nurse there if she sees my uncle calling in, and she shook her head.
I thought it would have been great to have had this carer call in every week as she is really bubbly, in her 60s herself, but really 'young' for her years at the same time, and she was very fond of Dad too.
Maybe I should revisit that again as she is familiar to Dad. What do you think of that?

StevieNicksFan

You mentioned that your father loves music, particularly Irish Music. Have you ever considered Music Therapy? It has been proven to be very effective for people with dementia - reduces agitation, promotes relaxation, reminiscence, provides familiarity etc. This can occur on a one-to-one basis so it will be individualised. The goals are specifically related to the person's needs i.e. it's just not 'singing a few tunes' but more clincially based with regards to their overall wellbeing. There are no demands on the client either as it's taken completely at their own pace. Here is a link to the Music Therapy Ireland page:

http://www.musictherapyireland.com/#!dementia-care/c1eyp

Also, IACAT (Irish Association of Creative Arts Therapists) provide information on Music Therapy in addition to a list of all registered and qualified Music Therapists in Ireland - you can find one just by clicking on your county. (They also have Art Therapists, Drama Therapists & Dance Therapists just for your or any other readers information). www.iacat.ie

I have experience with Music Therapy and I would definately recommend it

GreeBo

Hi OP.

I would agree with not going on long trips, even trips at all can be a big big effort for all involved and not work out too well.
Its very easy to want to do something for your dad, I went through the same, but it takes a bit of thought.


As Semele said, try to find something that will occupy your dad, even if it means nothing to you or him (in your opinion)
I found it very hard to visit my dad and every day he would be sitting in the same chair, doing nothing.
If he can and will interact with it thats all you can want or hope for tbh.

Try not to get your hopes up, in some ways its like an autistic child, you can try and try and it just doesnt get through and yet sometimes the weirdest thing will hit a nerve or trigger an old memory in them and you might even get a smile.

best of luck.

Maura74

pog it wrote: »

Hi Semele, thanks for taking so much time to respond. You have made me rethink the weekday visits thing and am taking yours and the overall advice here on not going too far with my Dad. The problem with my father is that he didn't have any one thing like that based at home apart from reading the paper- he loved going to lectures, seminars, or talks, or political things, but we could never talk him into getting a 'hobby'. He had hobbies like gardening (horticulture more so) when he was younger but he had lost interest in that years ago anyway. Is there anything around this you can think of that could be done in the nursing home? A local history or some such talk?

He loves Irish music and we were told the home has music every week but I'm not sure if that is the case and I'm wary of asking them again in case they find it confrontational.

If you don't mind there is one other thing I'd like your opinion on.
I had suggested to my siblings that we could pay one of our former carers to call in once a week during the week and my siblings- all but one- turned it down, with one of my brothers saying that my father's brother who lives nearby would be calling me every day. I didn't believe that for one second, and sure enough, after about 2 months of Dad being in the home I asked the head nurse there if she sees my uncle calling in, and she shook her head.
I thought it would have been great to have had this carer call in every week as she is really bubbly, in her 60s herself, but really 'young' for her years at the same time, and she was very fond of Dad too.
Maybe I should revisit that again as she is familiar to Dad. What do you think of that?

Do not be afraid asking question about what music is available for residents most homes have this for their residents and as mentioned it's beneficial for their well-being. Perhaps the local church may have choir he could join, I know it will not be Irish music but any kind of signing will be good for him.

There will always be a shortage of staff in these homes. I always found talking to other residents very helpful as they obverse what going on during the daytime. You can find out so much from them regarding how the home operates. Also some may be grateful for you taking time to talk to them as well. They always like talking to different people.


Find out from the person in charge about secure outside area for residents so he can wonder outside when he feel like it. Doors will be locked but access to secure outside area should be open. It's vital that they home knows that you are interested in your day care by asking them questions about his care and medication he is on.

GP's are very busy and sometimes takes at face value what the person charge tells s/he therefore it is important that you know what medication he is taking, when you know this you can check it up on the internet for reference.

pog it

Maura74 wrote: »

Do not be afraid asking question about what music is available for residents most homes have this for their residents and as mentioned it's beneficial for their well-being. Perhaps the local church may have choir he could join, I know it will not be Irish music but any kind of signing will be good for him.

There will always be a shortage of staff in these homes. I always found talking to other residents very helpful as they obverse what going on during the daytime. You can find out so much from them regarding how the home operates. Also some may be grateful for you taking time to talk to them as well. They always like talking to different people.


Find out from the person in charge about secure outside area for residents so he can wonder outside when he feel like it. Doors will be locked but access to secure outside area should be open. It's vital that they home knows that you are interested in your day care by asking them questions about his care and medication he is on.

GP's are very busy and sometimes takes at face value what the person charge tells s/he therefore it is important that you know what medication he is taking, when you know this you can check it up on the internet for reference.

Hi Maura, I'm watching the medication side of things closely. We got a new GP when he moved into the home and that has been a really positive thing for everyone. Long (surely obvious anyway!) story!

Yep they have a nice and secure outside garden for residents so that's grand.

I'm going to be there during the week and will ask again re music and activities as I've been easy going about that since I initially asked.

Goldenlady

Hi Op,


Im not sure if I can add much to the great advice you have already received, but my mom is in a nursing home for the last 14 years, she doesn't have dementia though so my father takes her out every week end, but I know a lot of the residents do go out & love the break away. Most people in long term care do become institutionalised so don't be concerned if he wants to go back to the nursing home within a few hours.
you mentioned that the home had said they had music, I certainly would ask them again, believe me its best to show them that you are interested in how they are running the home & what they are doing to stimulate your father during the day. I have a path worn to the matrons office as I am expecting them to care fully for my mom, don't get me wrong, I do it in the nicest possible sense.
it will be nice for you also to be out of the surrounds of the nursing home & bring a bit of normality back to your visits.
best of luck with every thing
x

Maura74

Also, if you can, go into the home at different times morning, midday, afternoon and evenings, I found it best to go in the morning times and leave at lunch time for an hour to get something to eat, went back in the afternoon and that meant 2 visit for my relative. If possible do not get into a routine of visiting the same days and times. I know, as the homes knows, people families have to work and time is limited, but if you can try and get there morning times that would be good for your Dad. I was shocked at what I found in the morning times.