Many care homes are very depressing environments

I have worked in a few care homes when doing my nurse training and they are pretty much all bleak places with not enough staff to provide more then basic care. Things have to be rushed and they often take the easiest option just because they dont have time for anything else.
Its very sad but I dont really see things changing, not with an ageing population and very few interested in going into caring roles.

I think I only ever found one care home I actually liked. It was tiny, just 7 residents. The owner and her family lived on site and treated them like family. Everybody would eat dinner together, her kids would sit and watch telly with them in the evening and the family cat would visit all the rooms.
It felt very much like one big family. I doubt it would be financially viable these days and I imagine it would of failed various care standards but if I had to go anywhere.....

Auto correct changed that to bells but glad you know what I mean. I have a feeling they’ll be playing the same music when I’m in a care home when dementia me would probably want Spice Girls 😂

@TeenLifeMum There will be blue birds etc! Too many people seem to think older folk were all around during the war! Many now were very young or not born at all! It’s somewhat lazy to think everyone likes the same music anyway.

My grandparents didn’t have drugs pumped into them when very old to stay alive. Family doctors just presided over decline and there was greater acceptance of inevitable death.

This is the crux of the issue, as a community nurse we see it all the time, we need to start being more realistic about death and good deaths

You're suffering is prolonged in care. Prompted with fluids using ice lollies, yoghurt etc. Poor diet no problem ... cake, chocolate, high calorie drinks. If that fails hospital admission and ivf drip. This is on instruction from the care commission. If this isn't adhered to heads roll.

My grandmother’s was as nice as it could be but she used to complain they played music her mum would have listened to. There’ll be blue bells over the white cliffs of Dover was not what current 90yos were listening to. Their parents yes, but not them!

With an ageing population and people living longer, a redesign to the care system definitely needs changing.

When my relative had to be admitted to a home as there was no other choice, it was hard enough to get a home to accept him. After one eventually did the 'dementia home' couldn't cope with him, despite being specialists in dementia, due to his aggressiveness and 'wandering in the night'. It then took months to find an 'EMI' home that had spaces. We had to go on waiting lists. This was with the 'luxury' of being self-funded. Many homes we spoke to wouldn't accept gov funded and some wouldn't accept CHC, as their costs wouldn't be met.

Surely damand is only going to get higher, there is not enough places as it is.

i wish we could …

@CloudPop Umless you have a lot of money, care at home is expensive. £35 an hour privately. Not much different if you employ directly. Plus you have night issues and costs for some people. The state care is 4 visits a day. Around 15 mins per visit.

I’ve no idea how we pop ourselves off. It’s appealing I have to say!

I feel exactly the same ! But how do we avoid it?

Well firstly they estimate 45% of dementia cases are preventable (or at least delay-able) through lifestyle changes so that's one thing we should all be doing.

Secondly you should put in place a Living Will which enables you to say in advance that you will refuse certain types of medical intervention if you don't have the capacity to do so at the time.

You should also set up a Lasting Power of Attorney which means someone can make decisions about your care and medical treatment for you if you're unable. The Alzheimer's Society is good on all this stuff and I've done this with my parents.

However, if you're sliding into dementia but otherwise healthy then none of this applies. As above, I'd advise stating really clearly (and getting signed off by a solicitor) what your ideal wishes would be in this situation as who knows what the law will be in future.

Personally I've said to my partner that if I have dementia I want him to continually explain to me what's happening (not hide it from me) so I can be empowered to make decisions.

Sorry this is morbid but I've seen this stuff happen with close family members (as have many of us) and so have thought about it a lot.

as would have said just about anyone who is currently sitting in a care home with dementia. I feel exactly the same ! But how do we avoid it ?

Sad but true. I know some women are happy to take on full time care of their elderly parents, but for those of us who can’t/frankly don’t want to, residential care is the only sensible and safe alternative. Carers in the home is great on paper but is a huge admin / organisational burden.

Yeah if I get dementia I want to die not live on and on in a bloody care home

I think there should be a way to make an advanced directive to say I don’t want to live any longer when I get to a certain point in dementia

I think it's worth putting as much of this information in writing as possible. There may well be changes to laws in future that enable this kind of thing. I'm still in my thirties so hopefully don't need to worry about it just yet but I certainly will in a couple of decades (assuming I get there).

When people say they are adamant they will care for their own parents rather than a care home they do not know what they are committed themselves. Loosing your job, wage and independence. Moving in with your parents or taking them into your family home. People with dementia can be aggressive, suspicious and even violent. No one knows what dementia will do to a person. You are effectively caring for toddler in reverse, but with an adult size an strength. The very early stages of my Mums dementia turned her into a vicious bully, drove my stepdad to suicide, and when she lived with us briefly it was so relentless, my family was under such stress even my very chill DS (9) at the time lost it and told her to leave. She is now in her 2nd care home as she was told to leave by the first one because her behaviour was “upsetting the other clients”. The care home she is in now is excellent, has a 1 staff to 3 resident ratio and have no problem managing her behaviour. There are activities but she is not interested and sometimes they actually make her more confused and distressed. It’s over £8K a month. Care home aren’t really designed for what they are, they are still being imagined as retirement homes for elderly people with physical disabilities. What they actually are - the privately funded dementia wing of the NHS, funded by the people who are unfortunate enough to have a terminal disease. I know many professional carers who weren’t unable to care for their own parents, the added emotional toll of caring for a loved one on top of the physical and mental load was impossible. And statistically people in care homes survive longer than those cared for at home, while on average carers loose roughly 6 of their own life expectancy. I would not ever want to put that pressure on my children. I think there should be a way to make an advanced directive to say I don’t want to live any longer when I get to a certain point in dementia (for example when you become aggressive, or when you no longer recognise family). I know my Mum thought that’s keeping someone alive with dementia to the point where she is now is cruel, and I feel ultimately responsible and guilty most of the time.

Say 30 beds at 1.5k a week … that’s more than £2.3m a year. If they didn’t make profits they wouldn’t be being opened!
once the staff costs and mortgage (assuming it’s got one) and bills are covered.
Care home investors rake in billions from ‘cash cow’ pensioners - you should be able to read this…

https://www.telegraph.co.uk/gift/d5baab254b29dcb3

There are many threads on https://www.mumsnet.com/talk/elderly_parents

Unfortunate as it is some people, not all, do walk into old age with their heads buried in the sand about what they may NEED to remain in their own home. A lot of talk about what they do and don’t WANT.

Living in a large family home that has not been maintained, has unsuitable bathroom facilities etc becomes problematic especially if the elderly people in question refuse to get in carers, cleaners, gardeners, food deliveries etc.

The upshot of all this tends to be a crisis and then perhaps a DoLs where the person and the family no longer have choice. Certainly in my case our parents ‘wasted’ years ignoring our please to move to more suitable accommodation-their home was completely unsuitable for our DFs diagnosis 15 years ago but they knew better. Buried their heads in the sand, stupid cliches such as a previous poster said about ‘put a cushion over me’. No regard for the stress on the wider family.

The home we found is not fancy to look at but it is excellent. None of the comments regarding clothing, showering etc are my experience. They have a policy of visiting being at any time - not after bedtime obviously. Entertaining activities but often no one is interested in joining in.

@Fupoffyagrasshole a small minority only need this kind of care, and most of those won’t be cognitively able to consent to any form of medically assisted dying. It’s incredibly rare for governments to have laws allowing people who can’t consent at the time to be killed, for obvious reasons. If you want to die before you become impaired in the same way, then that’s medically assisted suicide, which is even rarer. And tbh you have to consider what the alternative is to a specific form of care. If you do need 24 hour care, who are you expecting to do it, if not a nursing home? If you literally can’t move, can’t make decisions, can’t manage your own catheter?

id recommend an Advanced Refusal of Treatment- I have one in my GP notes, refusing life-prolonging care of any type once I lose mental capacity to decide on my own care, and I have applied to give Lasting Power of Attorney to people I trust, having explained my views.

Sounds very much like the care home my friend was in a few months ago, but they did do entertainment. There were a lot of patients with dementia and we could always hear people crying out which was hard to hear. My friend was only 57, and admitted for end of life care due to advanced cancer that had spread to her brain and meant she needed 24-7 care. The staff were lovely, and treated my friend with a lot of care and compassion, but they worked so hard and were clearly short staffed at times, as these patients all had substantial care needs.

My friend often had PJ’s on that weren’t hers and when she died was wearing someone else’s PJ top so we had them find a nice Pj set i’d bought her so she was wearing something nice on her final journey. Her clothes were named, but even the personalised blanket ended up in someone else’s wardrobe. We had them find that also when she died as we wanted that to go with her. The staff saw the dog on the blanket every day as I took him in to see my friend (was her dog) but still somehow the blanket was missing for 2wks. Overall it was a nice place in that the staff were lovely and welcoming and treated my friend with care and dignity, but it made me realise I don’t want to live to a grand old age if that’s what awaits me. £1500 a week for the privilege too.

Exactly why assisted dying should be allowed! I can’t bare the thoughts of actually ending up in one of those places

I would much rather be dead than even have to spend a day in a home. It’s no life.

I'd guess the money is spent on the building, much like maintenance and sinking fund charges like a block of flats, so the building doesn't depreciate in value. That would be much guess.

When I was in hospital there was a lady being moved to another care home. Think her daughter was saying how it was different.

The lady from the new care home came in to have a chat and was saying how they had all these activities and she wouldn't get depressed and spend all her time in her room on her own like the old place.

It was a real eye opener.

Staffing costs are huge though. I don’t think people quite appreciate that even on minimum wage to have one carer on site 24 hours a day costs in excess of £100k per year.

I worked in a small home with less than twenty residents. There were about 20 carers, two nurses, half a dozen domestics, two physios, a chef, admin bod, two maintenance and a manager. Admittedly some were part timers but the wage costs were nearly a million quid despite no one being paid particularly well ( we did get over min wage)

My friend is in a good care home. They get him up when he wants. But he’s been there five years and only just been seen by a dentist, and his teeth now look awful and are broken. The home doesn’t have a dentist visit them, which I was horrified about. My friend is the only resident there who doesn’t have dementia. It is very depressing seeing all the other residents like that.

I agree. I wish something would change.

I had a relative self funded in a home. They rarely gave him a shower. He was never taken out on day trips, none of those with dementia were, as were seen as too much of a risk. The home smelled of wee, we visited many and they all did.

Glasses, hearing aids, false teeth constantly missing. Wearing clothes that were not his.

Costing over a thousand a week too. When he had to go to a new specialist home that cost even more, and as he was self funding it was up to us finding one and arranging a private ambulance to take him. Apparently if you're state funded you get help with that.

So where is all the money going. It's not on the staff, I know they're not well paid and are under staffed. But spending hard earned life savings on sub-optimal care and poor quality of life in your final years, it's sad. I believe some countries have better models of care but don't know much about it.