Sister and I can't agree regarding Mum's care

It's so sad. We as neighbours did our best with a lady. Eventually we all got compassion fatigue her alarm kept going off because of falls. Both sons lived in London we're in Wales. One neighbour ex NHS contacted son said she has to get carers. They went from twice a day to four times a day. It quickly become not enough she was having falls when they weren't there, losing weight, confused. So we had to answer alarm get her up from the floor, shower her, or call ambulance. Hospitalised twice. The second time with a broken hip. Finally she was long stay started putting on weight. She then refused to go home.

Her sons didn't organise a home. She died in hospital. Which was avoidable if plans had been in place. Her sons had POA

I agree with this sadly. Sorry you're going through this Op as it's horrible.

Has mum had any input from her g.p or district nurses regarding her alcohol intake. If she was drinking a lot she may need extra medication,vitamins and supplement food and drinks if she is not eating much now.

When Mum broke her hip and was in hospital presumably she had zero alcohol. You say that you're weaning her off slowly. How much is she drinking daily now?

You sound like a lovely daughter but I imagine all you're doing for your mum must get pretty tiring. If your mum went into Care, you can let go of some of that responsibility. You no longer have to run her house, oversee carers etc, you just get to visit your mum and be a daughter.

Having said that, one of my relatives has dementia and has some capacity but it's getting increasingly more difficult. She is living at home with daily support from her immediate family and the siblings have installed a camera upstairs and downstairs so they can check in on her if they need to. It's a tough decision whatever you decide! Do you know what your mum would have wanted?

Re the Best Interest meeting. These are part of the Mental Capacity Act legislation and process.
A capacity assessment is carried out by a social worker regarding a specific decision. So the decision here would be where does your Mum need to have her care and support needs met.

The assessment consists of four elements, and the assessor will use the information gathered from your Mum in the assessment to deem that your Mum either does or does not have capacity.

If it is deemed that she lacks capacity, then a Best Interest meeting will be arranged. Here, all options, the risks, benefits of each option will be discussed.

It’s important to note that if the decision is made for your Mum to move to residential care and she refuses to go, the Mental Capacity act does not cover the forceful removal of a person from their home. The only time that would happen is if, during a Mental Health act assessment she is shown to be a serious risk to her own safety.

Sending you lots of strength. It sounds very stressful, overwhelming and emotional.

Also, if there is a conflict between you all, your Mum is entitled to an independent advocate.
Your local authority will probably
have a contact with an advocacy service.

I strongly recommend starting the process by viewing what's available in your area, there's likely a waiting list too. You need to work out funding as well, adult social services and/or nhs continuing care may be useful

I would keep her in her home for as long as possible. Could you increase Carer’s to 4 per day?

I agree with this. Your mum has a deteriorating condition. I wouldn’t let it reach a crisis point before doing anything. It is a very hard decision all round but your mum being safe and cared for is priority. It’s just you and you sister have different views on how to do that. For you, you need to work out if you can visit more as your mum needs more help. 💐

@gandalf456
When we can't agree on Health and care stuff, we have to go through a process called Best Interests meetings.
They have a formal format and are lead by social services, they seek input from mums GP in advance and usually involve mums social worker, a representative of the care team (care manager) and us siblings.
We do them over zoom because we started having to do them in the pandemic and then realised it was the best way to get everyone to the meeting.
Written representation can also be given if somebody can't make it.
Basically everyone discusses the issue, their solutions and then a decision is made taking all of that into account. It's a bit of a process but I also find it makes some of the sibling ranting and raving go away as they have to do it in front of somebody who isn't family.
We've had them for mums care, renewal of her DOLs, access to medication and vaccinations - it's exhausting but there are 4 of us and some have some extreme views. It also gives us perspective and allows us to hear what the professionals think.
One sibling got a private OT assessment done of mum, which was great and very thorough, she spent some real time assessing mums needs and discussed progression although he then decided to ignore it because it didn't agree with him 🙄
However we presented it at the best interests meeting as another independent viewpoint.

Does she have an understanding of residential care? Would she consider going for some day care at a home as a way of introducing her to a placement?

My grandmother didn’t want to either. She was scared we would dump her there and it was like one of those panorama specials. The reality (for us) was very different, it was a lovely place. Mine went in for emergency respite and they assessed her as not fit to go home.
She never asked when she was going home.

Why on Earth have they discharged her? I mean this kindly, it’s not like she’s going to get better? Fair enough file her away from the immediate inbox, but she should be reviewed regularly for more support. Not have to start the whole process again when it’s an emergency.
my experience of adult social services is that they are great but you really have to push and push to get support. Which frankly, a lot of carers haven’t the energy for.

I have been through a very similar situation and I know exactly how difficult and exhausting it is. If your mum still has some capacity, what does she want?

OP, there's a lot of good advice in the posts above. Read the posts carefully and have a good think before deciding how to proceed. Be prepared for things to change. They rarely stay the same for long in someone with dementia.

I completely understand where you are coming from.
My siblings and I don't see eye to eye on mums care and it can be very difficult.
I would say whilst your mum has some capacity try to talk to her about her wishes.
I would also start looking in advance as you don't know what could precipitate an emergency admission.
You say you are currently providing the bulk of the support what happens if something happens to you?
I was the one who pushed for mum to go into a care home. However I'm also the one that does the bulk of supporting her even though I live a long way away and my siblings are closer.
Our decision was somewhat made for us by the disruption of the pandemic. Disruption to her carers and activities made her increasingly confused and she would go out looking for company and getting lost. She was already needing a high level of support at home and the social worker agreed to a respite placement after a week of having to search for her every day.
Luckily I had visited lots of homes prior to this and knew all the local ones so when we were offered a respite and then permanent place in a great local place I jumped at it.
It's been good for her, her dementia has progressed but she's no longer scared and lonely as she has company 24/7.
Her home is lovely, not too fancy but really great staff and even in the worst of the pandemic the staff were good at maintaining as much contact as possible.
Some of my siblings have been ideologically against her being in a care home but they don't offer a viable alternative. Mum is settled and generally happy. I know we have been lucky with her home but not all homes are rubbish.
I think you need to see how your mum feels, work out a plan for what happens over time and if situations change because it's all very well saying she's ok now but thinks often change quickly and without notice and it's much easier if you've thought about it and planned up front.