When to force the issue re residential care?

I know they can be violent, I said about my elderly female relative punching a care home manager in the face.

Obviously if someone hasn't eaten or drunk in days it is a medical emergency but generally if it is just that relatives are worried about memory loss or behaviour do you think many people would want to have their relative removed in the way you describe. I think that is a last ditch thing and of course the medical people have to be confident the person doesn't have capacity to make the decision, like they always say you can have capacity to make bad decisions.

Even if you get them to a home, we did it by deception like a previous post, the home is on dodgy ground until they can get a DOLs done and that can take months, over a year in our case.

It isn't easy to get someone sectioned for dementia, the NHS isn't daft, if they section they pay. They much prefer the family to sort it and it is a nightmare quite apart from sorting out finance which I found the easiest bit.

And yet another man tried to stab one of his carers with a sharp knife from the kitchen of his home, and it took several police officers to get the blade from him.

He had to be sectioned, too.

People do not always realise that there can be a very dangerous, violent side to some people with dementia.

Another gentleman I knew with dementia refused to stay in his home with his wife - he walked out endlessly and went for very, very long walks, and she never knew where he was, and the police were always having to look for him and bring him home. He did not recognise his wife anymore in any case, and was looking for what he thought was "home". Unfortunately he was remarkably fit, physically.

His wife had all the doors and windows reinforced so that he couldn't get out when she wasn't there, but one day she came home to find him methodically removing all the locks on the French doors, and he threatened her very aggressively with a screwdriver when she tried to stop him.

He was sectioned and ended up in a specialist psychiatric dementia unit.

Would you have been prepared to have her removed from her home by force

Sometimes, that has to happen.
I cared for an elderly lady with Lewy Body Dementia who had not eaten or drunk anything for three days; she had been doubly incontinent and would not let anyone near her to change her clothes/wash her; she growled menacingly when the dementia specialist nurse (Community) came out to see her.
Her GP arranged for her to be admitted to hospital, but it took three paramedics and three police officers to get her into the ambulance, and she assaulted each one of them - they had to strap her down for the journey, she screamed unendingly throughout the journey and (unfortunately) there was a little audience of neighbours gathered on the pavement, watching it all.

Once she was at the hospital, and medicated, she became calmer and (just about) accepted help to get clean again. She started to eat and drink.

She ended up going back home with sedation, and 24 hour nursing care, which her husband willingly paid for. He was looking at care homes, but she died before she needed to be moved to one.

Some dementia patients become very, very violent, no matter what you do.

My neighbour with vascular dementia, was only sectioned / put in a home, after becoming very violent and smashing the patio doors with a hammer that was in the shed, his wife was lucky it wasn’t her head.
My other neighbour spent £400k and sold his 3 rental properties to keep his wife with dementia in a care home for 8 years. They would likely have disregarded half the value of the properties but I don’t think he even thought about a financial assessment later on and he definitely didn’t know about annuities.
All he has now is is house, worth maybe £200k and his pension.

Have you looked into Immediate Needs Annuities OP?

If I had a pound for every person who told me to "just put her in a home" I'd be a wealthy woman. If you can't get a DOLs done, it took us over a year, and they physically won't go what do you do? Social worker told me the next step was the men in white coats coming and her being removed by force and that wasn't something I was prepared to sanction. You said your aunt acquiesced but what if she hadn't? Would you have been prepared to have her removed from her home by force. To clarify when my elderly relative needed to go into care she was visited by a care home manager to assess her and she punched him in the face. She was never going to agree.

Get a good IFA, sell the house, invest the money. If her pensions are enough to pay the fees the return on her investments will insure you against costs rising.

she is a danger to herself, and it seems that we might have to overrule her preferences because it isn't in her best interests to follow them. Any advice would be welcomed please. Remember that perspectives change and she may prefer to keep her autonomy even at physical risk to herself (in the same way that people will continue with sports with a high injury risk). “Best interests” isn’t just physical safety.

Being blunt people moved into care homes tend to die more quickly. Those at home tend to have better care and live longer- so it is more expensive. The opposite was stated with equal authority on this board about a week ago.

Don't want to skimp on care by paying for a cheaper option when she could potentially afford better More expensive doesn’t necessarily mean better. Don’t pay for facilities that look good but which she won’t use, and keep an open mind re shabbiness. The quality if manager and staff us really important.

I used this: https://www.carehome.co.uk/ but also checked out the individual homes websites and Google for ones that weren’t featured on it.

Some good providers are Audley, Richmond Villages, Signature, Avery, Cinnamon etc.

You can start online OP. I scoped homes round where she lived and homes near family in London. A big plus side to her moving near you or other relatives is being a able to have visitors.

I went to care home U.K. website and looked through the homes, the reviews and the CQC reports. You get the feel for the different companies that run chains or homes quite quickly. Some of them are excellent, others not so good.

I made shortlists and only went to see the front runners.

Sorry cross posted. It is very time consuming and overwhelming to check out homes. There see to be a couple of online review sites which might possibly help narrow it down before starting?
https://forum.alzheimers.org.uk/threads/reviews-for-care-homes-residential-homes-nursing-homes.134418/

and the cqc ratings of course

When looking at care homes remember it’s not frills eg how posh the place looks that counts. Staffing levels, enough so that people can move around as they wish and not corralled into a lounge, trained staff who understand dementia and that it affects everyone differently, hygienic with no bad smells but not a stink of bleach either, a good atmosphere, natural light - all much more important than if the paintwork is a bit scuffed here and there

This happened with my gran. We tried to persuade her to move to an assisted living apartment but she really didn't want to. We quoted all the same reasons you have.

In the end she had a few falls at home and ended up passing away in hospital after surgery. It may not sound it but it was rather peaceful and quick and in the end I'm glad that she never ended up having to move out of her own house. I'm glad we didn't try to force the issue (though we may have if she had lived longer).

With my aunt I could see the way things were going and I scoped out homes with my cousin well before we got to the point she needed to move - so we were prepared with list of options.

Otherwise something major will happen - a bad fall or she sets fire to something - and you will be in a panic trying to find somewhere quickly.

I agree. I care for my father (along with other carers) and he needed someone with him 24/7 quite early on as he would get up in the night, wander round, start shaving, try and go out on his own etc.

Also - with dementia you can have capacity to make come decisions and not others. My dad’s (who also has dementia) GP has been excellent about supporting what is in his best interest.

She does have dementia if you read the OP.

OP I wouldn't worry in the least about the possibility of her having to move to a different home if the money runs out.
If she gets to that stage, she won't notice where she's living by then.

You can make a decision as a family that it needs to happen. We would have moved my aunt even if she had resisted.

People are allowed to make unwise decisions even if things go wrong it won't automatically mean she won't have capacity.

For there to be a decision that her mental capacity is impaired she would have to have dementia or some other brain based disorder that impaired her cognition to the extent that she wasn't able to understand the choice or decision being offered to her.

I've lived with my mother-in-law who had Alzheimer's. When we started caring for her she could walk around and go into the garden, one day she shut me in the shed 😃. Within a few weeks she couldn't walk very far but would go into the kitchen "to tidy it up" in actuality to move things around and throw decent food in the bin.

This was in August, by November she was basically in a chair staring into nothing. She had a fall or two but one we managed to get her into bed (me and two carers) but she couldn't get up the bed to lie properly, ended up dying in hospital with pneumonia.

So things can go downhill very fast and a dementia patient needs 24 hour care. If you cannot offer her this then a dementia home is the best place. Although she'll probably fight not to leave her home she'll settle soon enough.

I found this forum really helpful as there are plenty of experienced people on there. forum.alzheimers.org.uk/