Many care homes are very depressing environments

Unskilled is the wrong word. Unqualified. A lot of them are school leavers.

My Dad had respite in a lovely care home but he didn't like living with 32 others that he hadn't chosen to live with and the general hubledeebub noise of a busy environment.

One day, we may not be able to cope, and he will.have to move to one. However, while we can, we will look after him here at home. We are in year 3 of increasing care now.

I cant imagine how hard the work must be - looking after 32 dads who wake at night, need bed changes regularly, try and dress with clothes upside down, pull out catheters as a distraction, struggle to eat, have Jekyll and Hyde personalities, and want to go wandering despite being a falls risk - and assessing medical need - all whilst being unable to communicate. 1 is hard enough and I love the menace to bits!

The staff aren't unskilled. They work under very difficult conditions. Many homes are understaffed with heavy reliance on agency workers. And yes they're poorly paid particularly in private homes.

My Mum is very fortunate to be in her care home . They are really excellent there . She is very happy and they all love her . I think what has made the difference is that it's the local care home to where she lived her whole life and she knows a lot of her fellow residents and staff since they were babies . It makes a huge difference. They have church every week there. A beautiful garden to sit in . A resident cat and Guinea pigs and the food is excellent 😁
I know how lucky we are .

I’m not sure what people expect to be honest. Unskilled staff, minimum wage, in a job that I can only imagine is pretty thankless at the best of times. Many people go into care because it’s a last resort. And it absolutely shouldn’t be like that. I think it needs a massive overhaul.

Yep. I never want to end up in a care home. I'd happily agree a take it or leave it deal to die on my 80th if the deal in return was I would never end up in a care home.

My mum’s care home was better than a lot and the staff were kind. But there was only the capacity for my mum to have a bath and hair wash once a week. My sister and I were allowed to go in and do it but other residents weren’t so lucky. Until they start recognising how hard being a carer is and paying a decent wage things won’t change.

I have had a relative in a care home...an incredibly expensive private one...even though it was objectively 'good' yes it was still very depressing....it's the nature of it I think.

I think generally hospital staff won't do it.

As a first aider whose attended many calls requiring CPR I’m aware and I’ve said, medical staff at the hospital have said but the denial is what it is, our hope is that medical staff would step in. She is far too frail.

I think if they knew the impact of CPR on an old frail person they might change their mind. It's pretty horrific.

My mum’s care home was a bit scruffy but they really looked after residents. It was run by Methodist Housing Association. The staff were amazing. 4700 per month in the NW

This is more or less our situation. Add in an acute hospital stay which was what saved her for this kind of life and a relative in complete denial about the decline it is very eye opening.

You would have to ask them. A family member in denial who cannot cope with the decline has definitely played a part.

@GnomeDePlume Plus fewer women worked (for money) and families were prepared to be poor. Now we don’t want that but there’s another cost. We cannot look after our own elderly unless we are rich or don’t need to work. Many retired people now look after their parents which doesn’t feel like a great retirement.

Dementia care is more expensive than standard care. My DMs care home was £5,500 a month. Here, dementia care at a good standard would be more. So who pays? The rich can but others? The state: but the state doesn’t have the money. We won’t take out insurance (remember Teresa May tried) so we have sub standard care. It’s actually our fault.

Yes, people died younger and we didn’t see dementia as much 60 years ago. DNR is vital. Many relatives cannot cope with death and we need to get tougher. Pete Townsend got it right.

I think nursing homes are a last resort myself, having worked in one. The one I worked in was profit making though, so they were always trying to cut corners.

Have you reported all of these things you have seen? Most of them not the norm in most homes at all.

It does amaze me the number of families who refuse to allow DNR certificates when their frail elderly relatives go into hospital or nursing homes with severe dementia.
Despite what we see on tv resuscitation is not often successful out the hospital setting.
When the care home suggested DMIL needed hospital admission we were upfront and said yes to DNR which surprised the young doctor on duty as most families had insisted the the elderly person by kept alive no matter what.

Incontinence, double or not, does not preclude the capacity to have psychological needs, e.g. for safety, and for positive sensory stimulation.

I work in adult social care, and people with dementia can still be happy, provided there are sufficient staff present who care about achieving that.

People shouldn't be left to sit in armchairs without social or cognitive stimulation, and it matters. As for carelessness regarding oral care, it drives me mad. It's neglect.

For patients like him - who would rather die than live like this - as long as they aren't suffering actual abuse, does it matter?

Yes it does. That he isn't who he used to be, or is divorced from his lifetime of previous social understanding, is no reason to further punish him by allowing the lowering of his quality of life, when it doesn't have to be that way.

The majority of people in his position can be given mainly good experiences in the 'now' regardless. These aren't related to who they where necessarily, just where they are at now, and what soothes, connects, both with bits of the past, and the present, and makes life more pleasant, less anxiety inducing, and into a 'good day.'
I've spent a lot of time providing meaningful living to people who where 'no longer themselves' and 'very far gone.' Very few cannot be helped to have overall quality of life no matter how scattered and fractured their minds are, but it mainly requires a lot of one to one work, and then training busy care staff to use the tools developed for them as best they can in between, and mainly we don't value them (or the care staff) enough to pay even NMW for it, or anything beyond 'housing' them..

I've also been a resident in a care home as a disabled person, when I couldn't get into a proper rehab unit and there was no where else to put me post operation.
I found myself treated as if I was subject to a DOL's order, visitors turned away, including the hospital OT, and kept in bed with my wheelchair confiscated, refused (simple) vegetarian food, even a non shared towel, with no good reason other than it was 'easier' for the running of the place.
Some of what goes on in the name of cost cutting and 'do they really matter' is unbelievably cruel and parsimonious, and often entirely unnecessary.

It sounds bleak, but my grandad didn't know who he was in his final few years. He hit his wife for the first time, didn't know his own kids, made sexually suggestive comments towards us grandchildren (he thought he was a young man and not related to us) and was doubly incontinent.
For patients like him - who would rather die than live like this - as long as they aren't suffering actual abuse, does it matter?

@Decisionsdecisions1 But what is the alternative?

I agree. If my DM wasn't in a care home she would have to live with me plus carers. DM can no longer walk. She requires a two person transfer plus equipment between bed/chair/wheelchair. The whole of the ground floor of my home would be taken up by hospital style bed plus storage for MoLift, electric stander and hoist.

Back in the 'good old days' an elderly and infirm person would at some point take to their bed. They would then be carried off by pneumonia which used to be known as 'The widow's friend'.

Of course the caring responsibilities would fall to the women of the household.

DM is in a care home and TBH it's fine. She has a good sized room, which is kept clean. No major issues with laundry. I make sure her clothes are labelled plus I make a lot of her tops so they are unique.

DM is now in the nursing care section. There is a qualified nurse on duty 24/7. On the whole staff are friendly and competent.

It is a purpose built home. When choosing somewhere for DM I avoided the converted edwardian vicarage type homes as often the fabric of the building isn't suitable: narrow corridors and dodgy plumbing.

DM's place is bright, sunny, clean. The food is institutional as you would expect when catering for so many people with so varied tastes.

Cost is £1400/week (Midlands).

But what is the alternative?

Live in carers for those that can afford (and where carers are available)? My aunt has dementia and this is working for now but only because her adult son (no wife or kids) also lives with her and her adult daughter (divorced and children left home) travels 150 miles to visit every other weekend. It wouldn't be enough otherwise and she would be in a home. And of course its expensive.

How achievable is the above for many in reality?

There is a bit of a nostalgic view of how elderly were cared for by their families before care homes - the reality is women transitioned from caring for children to caring for parents/in laws. And then faced poverty in their own old age (one of the biggest groups living in poverty currently is women who took long periods off paid work for caring responsibilities). Is that what we want to return to?

With people moving away for work, having children later, working longer etc, its not realistic anymore. Neither would I personally want my child to give up their income, life etc to care for me.

So the alternative is paid care. The big problem is it isn't valued as a career choice and is massively underpaid, under resourced and under trained.

Years gone by I worked in a fair few homes both council run and ‘posh’ private and what your describing is true for I’d say 95% of homes.
ive learnt many things in my time but I stand by saying never fully trust what a Care home manager is telling you, they spend half their time covering their arses and jazzing up what actually goes on.
Daily entertainment is poor at best but made to look good for photos, food isn’t great apart from lunch, everything is like a military operation and residents don’t get a say in what time they go to bed/ get up/ have food/ shower.
some staff are great but they usually burn out and leave hoping another home will be different or end up making themselves Ill but the majority are working there because they have to and it shows.
I don’t know what the solution is but I really hope I don’t end up in one