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Dementia & Alzheimer's

Alzheimer's care home, London area, recommendations please

44 replies

OkapiWoman · 22/07/2018 16:42

My mother has quite advanced dementia - doesn't really know where she is, can't remember if she has just eaten, seen a doctor, had a visit, thinks I am her sister... she has several carers but has no idea that she is getting any help or that all her meals have been provided for the last year. She is terribly anxious and depressed, and keeps having the miserable revelation that she is going senile. I don't think I can cope any more and I think it is time to try and get her into residential care. Can anybody recommend any friendly, kind, happy, not too fancy (the expensive homes look like they are all about hair salons and pampering), not too ugly (my mother is an artist and a snob), homes in or near London? I am completely overwhelmed.
Thank you

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Rockyrockcake · 22/07/2018 21:08

The best thing is to get the LA list for your area and then research the QCQ report. Visit them and you will soon get a feel for the right one. My mum was placed as an emergency and I would never has chosen that home. It was two houses. knocked together and really old fashioned looking. My heart sunk. She spent 5 really happy years there. The staff had all worked for the care homev years and it had a maximum of 20 residents. She thought she was In her own house.

After six weeks when it was clear that she would be permanent we were given the opportunity to look at other homes. We looked at two that were very modern and clean in appearance. They offered entertainment and outings,The first one was in a converted cottage hospital and had lots of corridors. My mum spent a lot of time in hospital as a child and she had an absolute fear of them. She had a phobia about corridors and I knew she would have hated it. The second one stunk of urine despite its clinical sterile appearance.

I think asking for recommendations is a great idea but you have to visit a few times to get the feel. What impressed me about my mum’s home was that the manger made a home visit to meet her before her admittance. He and the assistant manager shared a desk in the residents main lounge so he could see what was happening at all times. They were both very hands on with care and very welcoming to visitors.

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OkapiWoman · 22/07/2018 21:47

Thank you Rockyrockcake, yes, I guess I will have to visit a few, but I hope there are people out there who know which are the nice ones. Some places seem so awful.
My mother would prefer dishevelled grandeur, wouldn't mind it a bit scruffy, run down or even dirty, but she would hate clinical, bright light artificial jolliness, modern jazzy colours or acres of pastels.
I don't know how I am going to do it, she has made me promiss not to let her go into a home, even though she put both her parents in to them. People keep telling me she will be happier in residential care and she is not safe in her own home, she has been going out to the local park and inviting people home with her to tea and to be given money, she is obviously lonely although she sends away her visiting carers and is surprised and horrified to find she has a new live-in carer every time she sees her. I think I am waiting for some kind of disaster to precipitate the move.

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Juststopit · 22/07/2018 21:52

I don’t know where abouts in London you are looking. Spring view in Enfield is nice, my man was there and she had advanced dementia. A bit outside London but my Aunt was in Chesham Bois Manor and seemed very content there when I visited recently.

It’s worth checking out their. Cqc rating and inspection report.

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HoleyCoMoley · 22/07/2018 22:04

Whereabouts will you be looking, do you need a residential home or a nursing home, a nursing home has qualified nurses 24hrs a day, a residential home has carers, senior carers and district nurses come in. First thing to do is for her to see a g.p. and have a capacity assessment, this will help with your choice. Do you have power of attorney for her finances and her health. I would also ask for a care needs assessment from social sercices or ask the carers if they have an up to date detailed care plan. You need to decide how it will be paid for and how much you can afford, she should have a financial assessment. Google homes in your chosen area, look up their c.q.c. report although these are sometimes a bit out of date then pick a few to go and visit a few. You need to take a list of questions with you, ask to speak to the manager to show you round. Is there a society for retired artists who have homes.

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OkapiWoman · 22/07/2018 23:15

Thank you HoleyCoMoley
She is 88 and fit, but needs a specialist dementia care home, would that be a nursing home? The GP and memory clinic have advised full time 24 hour care. I have power of attorney for both. My mother owns a house in London so she will be self funding. At present she gets a carers allowance but it is only about £57 a week, the new live-in carer costs £1000 a week and homes seem to cost more like £1400.
Somewhere in central or South London, or Kent or Sussex would be easiest.
I haven't found any homes for artists, they all seem to be for actors...

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OkapiWoman · 22/07/2018 23:21

Thank you too Juststopit
I am in South London, Enfield might be a bit far.

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HoleyCoMoley · 23/07/2018 11:38

I'd go for a nursing home, my mum's friend is in Ashcroft in Bromley, there are some very nice homes in that area, roughly 1200 to 1500 p.w. but if she has a care needs assessment carried out she may qualify for funded nursing care contribution which gets paid to the home but is deducted from her fee. One thing to remember is to tell the benefits people if she does move, we didn't know and ended up paying thousands back in attendance allowance. I'd also go for one that is non profit, it will say on their website. If you see one you like, look at the c.q.c. report, ring them, they should come and see mum at home to meet her and see if they can meet her needs. Go and visit, she doesn't have to go with you, have a long list of questions. Staffing levels day and night, call alarm system, food prep is it made on the premises, are snacks available all day, special diets, home routine, activities, any complimentary therapies, can residents walk around, stay in their room, go in the garden, visiting hours, taking own furniture, laundry services, registering with a g.p. and what's the cost and what's included, some include laundry, continence products, television in their room. She will need a capacity assessment done, either by her Dr before she moves or they can do it at the home.

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OkapiWoman · 23/07/2018 17:52

Thank you HoleyCoMoley, that is very helpful, I think we are on a waiting list for a care needs assessment, I should chase that up. Is a capacity assessment different? She is under the care of a 'memory clinic', that might be what they do. They have offered a place in their home, local authority run I think, but it is really grim, and she would still have to pay as she can afford it, however municipal it looks. I'd better start searching, I can see there are no short cuts...
Thanks again.

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HoleyCoMoley · 23/07/2018 18:15

A care needs assessment, also called c.h.c. Is a list of activities that she will be scored on, depending on how she manages at the moment, you can Google it. Each section is scored, the highest scores means a higher need and can help get her any funding. A capacity assessment is a very simple face to face informal little test to determine how much insight she has, her understanding of how much help she needs, moving into a home, the memory clinic may do it, it can also be her g.p. You will need it for a carehome and also to make p.o.a. decisions. Some l.a. homes offer better care than the big corporate run homes, I.m.e. the staffing levels, staff knowledge around dementia, cleanliness and kindness are mor3 important than lavish surroundings.

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Poudrenez · 25/07/2018 13:04

Hi OP, we're in a similar situation, looking for a care home for my Dad. Although now very much at the end stage of dementia, I still had it in ind that he wouldn't like somewhere that
looked too much like a care home, and I thought that this one in Wimbledon looked more like a grand hotel and might fit the bill.

Unfortunately he isn't going there for various reasons.

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OkapiWoman · 27/07/2018 13:11

Thank you Poudrenez
That does look elegant. I'm now bogged down trying to sort out care from nursing homes, dementia specialist homes, whether or not we need local authority or not-for profit homes, care assessments, capacity assessments - chc reports - so complex!
I can't even work out if dementia is an illness or just an expensive way to grow old, for some reason mental illness in the form of Alzheimer's isn't covered by the NHS as needing specialist care...

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malovitt · 27/07/2018 13:21

When you say she gets carers allowance - do you mean attendance allowance?
If so and she's only getting £57 that means that she is only getting the lower rate so she most probably won't be entitled to any funding.
She will need a EMI home (elderly mentally impaired) which is secure and specialises in dementia care.

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malovitt · 27/07/2018 13:22

If she is otherwise physically fit then she won't need nursing care just residential care.

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Poudrenez · 27/07/2018 14:14

OkapiWoman good luck with it all. The underprovision for Alzheimers is shocking, isn't it? It seems (touch wood) that CHC is going to come through for my Dad so hang in there.

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OkapiWoman · 28/07/2018 12:52

Yes, she is otherwise fit, but can’t really be left safely alone, wouldn’t eat nor wash, it is a disease, not just getting old. I'll look out for EMI, that’s something I hadn’t noticed in amongst all the codes...
And yes, sorry, Malovitt, Attendance Allowance.

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OkapiWoman · 28/07/2018 15:03

Thanks Poudrenez, I have been reading, feel I'm almost getting to grips with all these different Care Needs Assessments, CHCs, CQCs, EMIs, FNC, .. it's a minefield!
That CHC check list would seem easy to qualify for, my mother certainly can't use the kitchen, woudn't dress adequately, hasn't had an unprompted bath for 6 months, certainly never would change her clothes or wash her hair, is at risk of depression and plenty of bizarre unsafe behaviour, but it seems that even people paralysed from the neck down don't qualify. Good luck for your Dad. I'll request the CHC when I finally get the Social Services over for the Care Needs Assessment (or is it Capacity? getting confused again...) that I think they are meant to be arranging.

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OkapiWoman · 28/07/2018 15:09

Malovitt it looks like the Alzheimer's Society recommend going for a nursing home even if you don't need nursing, as you might need it later and wouldn't want to move twice, and you might get some of the fees paid as an NHS contribution. Do you have experience of that? Will we be turned down for a nursing home if physically fit? I still don't really know where to start looking.

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chrissie28 · 30/07/2018 15:28

Have you thought about a live in carer?

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OkapiWoman · 30/07/2018 16:41

We have just started with a live-in carer. I think it makes her feel more lonely and mad, she can't understand what the strange woman is doing in her house and the explanation upsets or doesn't convince her - "she is here to look after you" - "I don't need looking after so she'd better go", or "she is a friend staying for a few days" "No she isn't, I don't know her". She says if she'd known she was going to have to have someone live with her then she would have found someone she likes herself. And because she has lost almost all her memory we have to go through all that several times a day, every day. I think it might be time to get her somewhere with more people so that she can adopt some sort of useful helping role, which might cheer her up a bit. She is very bored, and disoriented, even at home, and bored and lonely with her carer there. And in her flat here is not a very satisfactory way of fitting everyone in. But yes, the live-in carer is where we are now.

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chrissie28 · 30/07/2018 19:42

I would think about several things - if you go for a nursing and you don't need it the people around you may not be easy to socialise with - might be an idea to go for a mix of residential and nursing - some homes have dual registration. Check out the Care Quality Commission reports and don't go for anything that is less than 'good' in all 5 sections. Then begin the search. ....... Age UK have a good checklist google age uk care home checklist. Then visit unannounced - speak to residents, speak to relatives, go more than once and then ask if mum can go for a lunch visit. Don't necessarily go for the ones that look like amazing hotels - it's the carers you want to be really great. Find out what the activities are, how often they happen and check that with the residents who will soon tell you if there's not much going on. Ask what happens when the money runs out - some homes have started to move people out when the money runs out. just a few starter points which i hope will help a bit x

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OkapiWoman · 31/07/2018 18:44

Thanks Chrissie28, Yes, that's true about the nursing home, it might be a bit depressing if everyone else is very ill. What she would really like would be people who she would think need her help, particularly downs syndrome people, as she lost her downs son. I haven't found a way of looking for that home, although I'm sure it must be out there, as Alzheimer's does come to people with downs.
If anyone has any ideas...?

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malovitt · 31/07/2018 21:44

Sorry - was away.
Yes, I do have some experience - an elderly relative, very physically fit but with Alzheimers. I cared for her in her own home as long as I could but she eventually became a danger to herself - leaving the gas on, flooding the place, opening the door to strangers, wandering off and getting lost.

I looked at 35 homes until I found one I liked and that would suit her.

It's an EMI home for dementia/Alzheimers sufferers.
I found that in homes with a mix - the people who didn't have dementia became really irritated by those that did.

She was assessed by the NHS for continuing care but didn't come anywhere near getting enough points even though she displayed the same behaviour as your mother.
She settled in really well and I'm convinced I made a good choice.
Everyone there has dementia in varying stages and they all seem to rub along quite well.

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OkapiWoman · 01/08/2018 08:44

Thanks malovitt, that does sound right, even though it is obviously an illness I can see we are going to have to pay, and I do think she will probably be happier with lots of things going on, so an EMI home would be good. I do fear condemning her to an institution full of potentially agresssive people. Her safety at home is an issue but can be controlled by just insisting on a full time carer. Eventually she must get used to it and I could re-organise her house to fit someone in. I just wish she could be a bit happier and enjoy this (extremely expensive) phase of her life. Perhaps this is just a bad stage of semi-awareness of the horror of her condition, and it will pass, it certainly is very upsetting.

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MyYoniFromHull · 01/08/2018 09:01

I'm not in the right area geographically but I work in an EMI setting. It sounds like she doesn't currently have any nursing needs so residential or dual registered may be a good option. Dual registered can mean that if she needs nursing care in the future she wouldn't have to move to a new place.

There's some good info on the Age UK site about choosing a home and how funding etc works.

You've had some great pointers already. I'd definitely recommend making unplanned visits to potential places and watch how the carers interact with the residents. Are the food options suitable, are alternatives available? Are bells left ringing for ages? Will they encourage her to join in activities? Many places will offer an initial respite stay that can become permanent if everyone is happy. If she runs out of money then how much is the top up fee that family would need to pay?

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OkapiWoman · 01/08/2018 13:42

Thanks MYFH
You are right I’m going to have to bite the bullet and start visiting.
My mother would never ring a bell - she had one of those alarm services with a pendant for a couple of years before she was nearly this bad and never got the idea of how it would work. There are all sorts of things I haven’t even thought about!
Do you know if it matters which local authority home she goes into? I mean I live in a different LA to her, does she need to be in her own borough or will mine work the same? I think it will take her a long time to spend her house, so presume we are paying all the way...

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