Is there an alternative ?

Damn - typed a long reply and it’s disappeared !

roughly, “entering into their world is basic dementia care “, all staff should be trained to do it. Things like the urine bottle, you should be able to ask why. In our small home I take all these queries to the manager.

Time for new home?

I’d consider paying someone, not as a care assistant, take them along a few times with you as a “friend”, then they start visiting on their own. Mainly to do the things that aren’t high on carer’s list if priorities, though take him to the loo if needed, just as you would yourself.

Live in carer may be an option if his home was big enough or able to be adapted sufficiently. When you say he needs 2 staff to transfer is this using equipment? There may be a suitable standing aid/hoist that one person could use with him safely. Usually during carer breaks the person would be left resting in bed or armchair with TV/radio/book or a sitting service used. But it would likely just be sitting with them and not facilitating toileting.

And as someone else has said using a urine bottle may help continence if he has the dexterity and understanding to use it.

If his current home is on the market could he downgrade to a smaller home, adapt it and then look to have a live-in carer. He would retain his autonomy but have access to the support he needs?

My dad is in a home and he hates being patronized and having to eat at set times with the other residents. Every 3 months we have an evaluation with carers (and every 6 months with the doctor) and then he can tell about what bothers him. They made arrangements for him to eat in private when he wants to, carers try to maximize his freedom. The evaluation really helps my father to get his frustrations out. Does that happen in your father’s home as well?

About continence: my father uses a urinal which hangs in his room. I always find it an unhygienic sight… but for him it is freedom.

It’s not a conflict of interest to employ your own person to attend to your family member in a home.

I would though be suspicious of why the home don’t want someone watching what’s happening, what don’t they want someone independent seeing?

[sorry]...if you organised it on your dad's behalf and your dad paid for it, then he's the employer. How is that a conflict of interest?

We’ve asked about this and the manager says it’s not possible as there would be a conflict of interest in terms of who the employer is.

This makes no sense. Unless they think you want to pay them extra for one of their staff to do it. If you organised it

Maybe he can buy a 2 bed ground floor flat and have it adapted to suit his needs. He'd need a 24/7 care, so more than one person which he'd either have to pay for through an agency or employ them himself which would be cheaper possibly and might provide more consistency because someone employed by him can't send a replacement but an agency can (although that option isn't going to be great if he's got dementia, he doesn't need to be dealing with National Insurance and Income Tax deductions, holiday pay entitlement etc and what happens if the carer is off sick or on holiday? He'd need a backup plan). Also as his dementia deteriorated he'd maybe need to go into a care home anyway. That could be a long way off though.

Having to ask permission and having to wait is standard. They're not his personal assistant, they're care home staff and will go where the highest need is. If he hasn't yet soiled himself he's probably not the highest need etc.

The being patronised thing is tricky. Maybe comes across that way as there is actually no ideal solution to dealing with a pissed off person who wants something they can't have ie personal assistant services. The staff don't have hours of spare time to listen to him complaining about what is a shit situation and one they personally can do nothing about. So perhaps are brushing it off and trying to jolly him along a bit when he's grumpy. Would you/he feel any better being told "I'm sorry but I don't have time to talk about this right now" as they bustle about doing whatever practical task they're doing before rushing off to the next person, every single time he wants to complain about his situation? Because that's going to be the truth.

Hmm. With that level of need then yes I would look for another home. It does sound as if this current one is not ideal for him. They really do vary.

I do some adhoc admin work for a 92 year old who still lives at home, but recently with a live-in carer. The carer charges £112 per day plus 3 meals a days & coffees etc when out and has a 2 hour break per day, which she occassionally saves up and takes in a longer block. She's self-employed and has her own public liability insurance. This carer requires her own bathroom, which is not used by the client.

The 92 year old doesn't require personal care (yet) but does require a lot of help with household tasks, shopping, all cooking, washing clothes and help taken out and about and driving and is company for her.

Would this be an option for your Dad? It sounds like it'd be cheaper and more suited to him?

I think for some there comes a time where what they really want is to return to their prime and nothing else will do. My mum is still at home and one day she will be complaining that she's lonely (despite several activities a week) and wants to move into a home so she has company. But if you start looking at options she is horrified by the suggestion.
What she wants is to move to the assisted living flats where a friend lives but they won't accept her now she has been diagnosed with alzheimer's.

So the options are a homoe and sell the house to fund it or stay where she is with carers coming in. She doesn't have the money to fund live in care for very long so that isn't an option.
Basically all options are wrong as far as she is concerned apart from turning back time and resurrecting dad.

I would think very seriously about an accessible flat with live in care; it will be eye-wateringly expensive but if there is any chance you have enough money after the house is sold, I would definitely consider it. Given that he's currently paying £8000 a month minimum, you might do. It takes a lot of organising though.

You may have to let go of him being happy. That may not be possible any more. He could, however, have a more congenial environment, and peace, and perhaps as you say better function around continence.

You could hire someone and introduce them as a “family friend”. Most of what @watcherintherye describes is what family would do.

He is likely to hate everywhere bcos he just wants to be home.
My friends nana cried every day, but as her dementia progressed so did her violence she pushed her daughter down the stairs and broke her arm and it was impossible for her to stay at home with carers.

The big problem is that no home is going to give him the quality of life that you and he would want, because the staff/resident ratio operating in most homes just isn’t sufficient for people who are totally reliant in others for everything - personal care, food, mobility, mental stimulation. Most homes can just about do personal care and food. It’s my view that there would be an (completely justifiable) outcry about such ratios in a childcare setting.

However, I volunteer in a home where one of the residents has their own private carer who comes in to the home on a daily basis, employed by the family, so he has 1-1 care during the day which is what most dependent elderly people need, of course. She takes him into the lounge, to activities etc. and engages with other residents, but is basically there for him, to facilitate timely personal care and general well-being. Might this be possible for your father?

My grandad is currently having a live in carer arranged. He already only lives in the downstairs of his house but his needs are less than your father's sound to be. It is significantly cheaper than a care home and the carer takes 2 hours break a day. They have several who work on rotation and swap every 2 weeks I think.
He went into a care home for respite which cost 2k a week and was told that he could join the 'waiting list' to have a shower and he would 'hopefully' be offered one within the week which is what swung the decision to keep him at home really . God knows what they did with residents who were incontinent but I'm sure being washed once a week wasn't exactly beneficial to either their health needs or their remaining dignity.

While he still has lucid moments it may seem as though there is an alternative. Sadly, that period won't last. You say undiagnosed dementia - if he does have dementia then once he is diagnosed a lot of doors are opened to extra services. (something else to bear in mind, if he does get diagnosed, not all homes are able to give dementia patients the care they need)
If you brought him home, then you will ultimately need 24/7 and 1-1 care. And somewhere to do it. Your house?
Also, in a good care home he will be stimulated in ways that a 1-1 carer, or even a family member won't be able to do.
There are wonderful carehomes out there, my mother's was amazing. Trips out, even in the later stages, concerts in the home, a project with the local primary school, pet therapy, the whole kit and kaboodle.
At first, when my mum was also having lucid moments, it seemed worse. She'd tell us she was going home because she didn't need to be there etc.
Ultimately it saved my sanity knowing she was clean, safe, and well looked after.

How much money does he have? Could he afford to stay in his home and have two living in carers. This would be expensive.