Choosing a Care Home Dilemma

[NaToth]

I have had another thread running about MIL, who is still in hospital, now bedblocking, waiting for a reablement bed. However, although that would be for a six week period, we doubt that she will co-operate with attempts to overcome her refusal to walk and we suspect that the placement may come a sudden end before the six weeks is up.

Realistically, as she is virtually immobile, with mid-stage dementia and has shown that she is unable to look after herself, we now need to look for a care home.

For the record, I have looked at the CHC Checklist and the Decision Support Tool and I don’t think we’re there yet, so her care will have to be paid for.

At current rates, MIL has funds available for about a year and for about three years if/when we sell her house. Apart from the dementia, she appears to be perfectly healthy. Her BP is lower than mine!

We started off looking at homes close to where we live, but found that they don’t take people with dementia. Those that do are further away and often prohibitively expensive.

We now have a list from the LA of the homes that they are contracted with, of which there are only six in our city of 350,000 people that take people with dementia. Once the money runs out, all but two will require a top up of anything up to £850 a week. MIL’s DC are all retired and I cannot see any of them, including DH wanting to attempt to pay a top-up from their pensions. We couldn’t rely on everybody making a contribution.

What do we do? Do we choose the expensive place with the great facilities and hope that she doesn’t live until the money runs out so we don’t have to move her, or do we go for one of the cheap places and, hopefully, continuity? What an awful decision to have to make!

Does anyone who’s been through this have any advice?

Thank you

[FinallyHere]

I'm very sorry to read this NaToth it does sound like a terrible dilemma.

My DM is now in a LA nursing home which deals with dementia and all nursing needs, so that we can be sure of her continued care there.

They do run several 'enrichment' programs but to date, she has not engaged with any.

How much do you think your DMiL would actually use the additional facilities?

When we were looking, we focused on the kindness and friendliness of the staff. We absolutely 'followed our noses' to rule out any which did not smell fresh and clean.

I hope that helps. We know now that DM is now safe and well cared for, even though she appears to sleep round the clock.

[HappyHammy]

sorry about your mil. Her needs may well change over the coming years so she could end up being moved to a different home that looks after people with dementia. I would look for a suitable home now, has she had a care needs assessment, if so the hospital may be able to recommend what level of care she needs now and you should ask the home if they will be able to look after her in the future. I'm surprised more local homes don't think they can look after her dementia, I would google local homes websites, see what care they offer, go and visit any you think look suitable and ask what level of care they offer.
If she's fully self funding she may well get attendance allowance and funded nursing care contributions which help towards the costs. When her money runs out I don't see why you would be expected to top up, surely the LA re-assess her financial situation and pay for her care. No one knows how the govt. will fund longterm care. What area in the country are you looking at, I'd be happy to look up a few for you if that helps.

[NecklessMumster]

I would be inclined to go for the more expensive home, altho as a social worker I'm not supposed to say that. We do sometimes have to move people to cheaper homes when their money runs out but thats a fight for another day and as you say, anything could happen in the next few years. Some homes agree to lower rates when this happens, she might become eligible for CHC later etc. But £850 top up is huge. Most care homes cope with a certain level of dementia, does she really need a specialist person with dementia (PWD) home? Has she had a local authority assessment?

[NaToth]

Thanks for your responses. No assessment so far other than looking at her mobility, which is virtually non-existent.

We have heard this morning that she will be moved tomorrow to a dementia care home that is not contracted to the Local Authority, for reablement and that they will do a needs assessment. I had asked DH to push the hospital for an MCA assessment and a CHC assessment, but he hasn't. I think he is simply overwhelmed.

Would she engage with activities etc? I honestly don't know. She might once she'd settled in, but I couldn't guarantee it.

Whether she will need a specialist home I don't know. We don't know. While at home with the care package she had, she was not washing, eating properly etc and she has ongoing bowel problems. I guess that's what the assessment will tell us when it finally happens.

First job now I think is to let her settle in over the weekend and see if she will engage with mobility rehab.

Thanks again

[HappyHammy]

Ask the care home to do a chc and MCA assessment. Good luck with it all

[stucknoue]

Been through this in the last year. When it comes to choosing try to look past the hotel style finish and fancy activity programmes - they woo you with fresh coffee on arrival, tell you about the belly dancing classes and that they have a nutritionist on staff but they are businesses and very expensive.

Instead see if you can find an independent home where the manager and carers actually care, foid can be basic but what your loved one actually likes, and any activities are things they enjoy. Make sure they have an open door policy (you can come at any time) and be suspicious if not. The cqc ratings do matter but look at the details, why they didn't have a perfect score - perhaps they were too busy caring to fill in useless paperwork!

We found an amazing home but it's not flashy, no co pay over the chc rate!

[loopykay]

I am in a very similar situation to you OP. My Dad is able to self fund for almost a year. His fees are £850 a month. I really don't want to have to move him but I can't afford to pay anything towards the home myself. It's horrible to be in a situation like this. My LA won't give me any idea of how much they will contribute until the time comes. I will follow this post.

[FinallyHere]

@loopykay

It's a horrible situation, isn't it

Have you tried asking the hones themselves whether their LA funded places require a top up over the LA amount.

The home we went for were very open about this aspect of things.

[loopykay]

It sounds like they will accept a top up. It was a question of which LA would pay because of the area move and who would be responsible for the top up.