Convincing parent to move to care home

@Enterthewolves Extra care was suggested to us by SS when DF was not coping in sheltered accommodation with visiting care. I spoke to a few managers of extra care places to explore and each asked about current needs, each then said extra care is still independent living and if sheltered with carers isn’t working then extra care isn’t likely to be enough.

@user16422052 we presented respite as a holiday and a nice place really is like that, good food and everything taken care of.

Sorry, but I wouldn’t involve SS unless you have to. They’re all too liable to ask the person whether they want to go into a home, to which the answer is bound to be no.

TBH since DM was self funded, we saw absolutely need to ask any SW who didn’t know her from next door’s cat, to ‘assess her needs’. We who knew her so well were only too well aware of what her needs were. And by that stage, she absolutely needed 24/7 care and supervision.

She would undoubtedly told any SW that she was absolutely fine, thank you - she didn’t any help. And she’d have thought she was telling the truth.

I didn’t and I wouldn’t. My parents did not want to go into a care home and I didn’t blame them. My brother wanted them to so that he could completely wash his hands of them. 😔
I cared for my parents, did all the stuff you talk about and had my dad living with me after dementia took my mum. He had cancer and it was really hard work. I feel for you but there are alternatives. I had a cleaner come in twice a week for a couple of hours which gave me the chance to get out. You could get a gardener for her too, it’s just someone around. Carers coming in 3 times a day for an hour to get her up and give her breakfast then lunch, her evening meal and get her ready for bed. If you haven’t already please register as a career with your GP I was put in touch with very helpful people when I did this. These things cost money but so does a care home and a care home isn’t your mum’s home too many of them are not nice at all. If you’re going away on holiday many care homes take people for respite care for a couple of weeks. Is there no one who could give you a break from some of the chores?
Having LPA does not give you power to put your mother in a care home while she still has the capacity to decide what she wants. You need to talk to her and explain that you can’t go on as you are and why you need help. The day May come when a care home is where she needs to be but it doesn’t sound to me like that day has arrived just yet.

What about Extra Care? https://www.housing21.org.uk/our-properties/extra-care/

I do wish there was an alternative to being " put in a home". I had this accusation levelled at me, that I wanted to " put them in a home". What I actually did was visit a local place , unannounced and concluded it might be an option.
Then it all unravelled.
You can't make people do anything if they are " deemed to have capacity"

Its awful.

Get social services involved. Even if she's a self funder they can still support with the process

@GETTINGLIKEMYMOTHER I don't want to derail the thread but I think we might have to get my DM into residential care by stealth as well. She thinks everything is fine but she can't be alone for more than half an hour. No capacity.

Please could you DM me if it's not too much trouble as I'm at a loss for what to do. At the moment it's just tantrums and suicide threats 😫

@falstaff1980
You have done the right thing and I'm sure you were worried about having that conversation. I hope it goes well for you both.

Op, my dm refused point blank to consider a care home. We booked her two weeks in a home as 'recuperation' after an operation. She lasted 6 hours and got a taxi home. 😀
So we organised farm foods deliveries, a cleaner, gardener, home hairdresser, weekly taxi booked to an old people's centre lunch, and a neighbour used to take her to the supermarket once a week. One of us visited every weekend. She had something happening most days, and they all had our phone numbers.
It was a bit of a logistical challenge but she was happy and stayed with her garden.
Good luck

She won't see the need to go into a home until it's obvious to her that things are failing.

They won't fail until or if you step back.

Don't bother stepping back on home maintenance, she won't notice that.

Stop having her round for dinner each night (come up with a reason - a previous posters idea about building resilience is good) and see how she copes.

@falstaff1980 we’ve just ‘extended’ a respite stay in a nursing home. It turned out that it is all actually quite nice, although I don’t think we can quite use the term ‘permanent’ yet.

You’re definitely doing too much and it sounds like your DM isn’t able to plan for her future herself any more. So while some posters are saying it sounds like your DM doesn’t need a home yet, you’re propping her up by seeing her every single day and it can be harder to see the level of need when it’s been a slow creep.

The right care home is not a prison, if finances allow your DM to choose then I strongly encourage some respite stays.

We recently learned about the Clinical Frailty Scale and reading through that helped us realised where DF was in terms of his needs.

If you there every single day nothing will change
Step back
Tell her you cannot do Tuesday and Wednesday so you will arrange someone else to come in
Start with domestic help later move to personal care

Do you have lpa for finance

It took a fall for elderly relative to go hospital to care home. Self pay.
Have a look around to see care homes and costs
Maybe start by getting regular home help in to do shopping make dinner so you start stepping back
Eg 2x week someone goes in and does this so you do not

Try age uk for such help

My mums GP was all for mum moving into residential care while she was still compus mentis enough to adjust. The GP said in cases like my mums where the path of her progress is clear then the earlier the better as far as they were concerned.

However, as we all know on this board, making the practicalities fit the good theory is virtually impossible. Mum refused, even though I have two suitable homes within five minutes walk of my house (she is 90 miles away). She has a mindset similar to OP’s mum in that she sees me visit once a week and not the daily phone calls and admin. Therefore in her eyes, moving close to me where I could pop in for 15 mins once a day and be her daughter again instead of her shopper, carer, property manager etc, is more work than staying where she is. Plus she’s lived in that house since the early sixties so I’m wary that any move now is going to make her worse such that she wouldn’t last that long in care anyway, so why not keep her at home as long as possible. She’s just about safe at home with 4x carer visits a day.

i would also say that adult social serves at your local council could assess and advise, but to be perfectly honest the push these days is to keep people in their own home as long as possible so you may not get the outcome you want. I found the social worker helpful in signposting services in the local area though.

Age UK offer handy person services in some areas.

I think it would be really helpful to talk to the Age UK helpline. Having another person to bounce ideas off would be a good support.

I'm not sure that your mum is going to be able to choose a care home if she's in denial that you're supporting her. I also think that tbh a home that is convenient for you and where you get on with the manager, routine and ethos would probably be best.

@falstaff1980 sorry but what in the world possessed you to have your mother for tea every single night????? you should have started as you meant to go on. once a week would have been ample!

Do you have the kind of relationship with your mother where you can have a conversation with her and make her aware of all the extras you are picking up, and that you are struggling? As it sounds like she can afford to spend money on care, why not ask her if you can arrange a gardener? I'm not sure what you mean by "maintenance" on the house - if it is cleaning, then get a cleaner, if it is more general odd job stuff I'm sure one of her friends could also recommend someone local who can be relied on for things like that? And yes perhaps suggest she has supper one or two evenings a week on her own.

Right now, it doesn't sound like she really needs full-time care in a home. However, are you going on holiday this summer? What happens then? Could that be an opportunity for her to have a week in a nice home local to you which at least opens the discussion to it being a more permanent solution later on?

It doesn't sound as if your mum's anywhere near ready for care. From my own experience it's something to be put off as long as possible. I've never been more stressed than when my mother was in a home. If she has capacity you can't just override her wishes. You don't need to have her for dinner every evening either. You can get an alarm system, prepared meals eg Wiltshire Farm, cleaners, carers if necessary. Certainly while meeting up with friends is possible it needs to be encouraged. Have you looked at the cost of care homes? 80k per annum is not unusual. Unless she's very wealthy capital soon runs out.

In terms of carers, you/she should talk to an agency - then they manage the sickness issue. The sacrifice there is that you don't get as much continuity - it's true that if she employs a private carer she can build a relationship with them which could make the situation a lot more stable and even pleasant for her.

Wouldn't it be worth moving to a situation where you are the backup person who covers the occasional missed evening, rather than the default?

It has to be said there's no such thing as a perfect setup but there are a lot of piecemeal bits you can put in place if she will agree to them.

Do you think she would agree to a ring doorbell? That would help if she calls you saying that the carers haven't been when in fact they have?

It may be easier to frame it as building resilience. It's never a good idea for all this stuff to be reliant on one person being available.

If she's got someone else coming in to sort out an evening meal that means she's used to an alternative should you not be available - and you cannot possibly be available every single day, what happens if you get flu, break a leg, the car breaks down or you go on holiday?

Carers are usually arranged via an agency so it's the agency's responsibility to send someone else if the usual one is off sick or otherwise away.

Gardening could a local gardener be organised to come for a couple of hours weekly or fortnightly (depending on size and state of it?). Then you don't have to worry about it. That's someone else around to check up on her.

House maintenance - are you talking the place is falling down, leaky roof and dodgy plumbing? Or cleaning, arranging annual boiler service, gutter cleaning type stuff? Could be worth getting a cleaner for a couple of hours a week (might be more palatable prospect than a carer?) to keep on top of things, then gradually increase hours as needed.

Age U.K. are a useful source of information for a lot of this stuff and should be able to signpost to things like approved handyman for basic maintenance stuff.

She doesn't sound like she's at the stage to need a care home.

Have you told her you're struggling? Does she know how much you are doing? Apologies, I don't know how her dementia might affect her understanding on this.
I'm not suggesting you go straight to "I'm not coping, you need to go in a home" More "I'm finding things difficult, we need to get some more help"

I had said all along that I’d help until there was a crisis of some sort, so when they had a fall and ended up in hospital, that was the catalyst to moving to a home. It helped that their house was entirely unsuitable for having care at home. They wouldn't have wanted me to sacrifice my life for them either, we’d had discussions about this in their late middle age.
Once settled in the home they lived there quite happily for nearly 7 years (at 5k a month…) the dementia fortunately never progressed past being “delightfully dotty” thank god, i know most are not so fortunate.
Good luck OP.