How to explain to MIL she’s in a care home

Op, you say no alzeimers or dementia. ..but that she has paranoia and delusions. And behaving erratically.

has anyone talked to family about Lewy body dementia ? That doesn’t really affect memory usually, but manifests in delusions, visual hallucinations (which aren’t sometimes obvious ), depression, and paranoia. Also loss of inhibitions. Characterised with REM sleep disturbances

there are also other dementias - rarer ones….

have they investigated all possibilities?

id also say if they rule that out, and she has other mental health issues that are present and she worsens, then push for full mental assessment and if it ever presents , push for sectioning under mental health act. That sounds extreme, but it ensure they then have a 117 order that stipulates higher level of care and that care costs are covered to a higher level.

This. Even with LPOA you can’t take control away form someone to make decison on their behalf if they’re not formally recognised as having lost mental capacity. Not unless she’s previously released some powers like this to her attorneys- which would be unusual…

experience with my dad, it takes a fair bit for someone to be declared mentally incapacitated and sometimes not for everything at once

This. He, or someone you all agree on can only apply for deputyship now, unless she is considered mentally competent enough to sign a LPOA now. If she is able to do that, do it now. Do not let just one of you siblings be Attorney, ensure there is at Least two of you acting severally and jointly

selling house may be a IHT impact. Not sure what rules are, but she would have 325k IHT relief without priority, and 500k with property. Or if she inherited form your dad double that. Theylll be a time limit I think when you claim this relief from when you sold to date she dies. If that’s many years yet, it’s unlikely they’d take into account.

if she is forced to sell her house by council to cover care costs I think that’s allowed on IHT …someone can advise on here I’m sure

many bills can be reduced once someone is in care..council tax, energy and water goes down massively. Depends if there’s money in her estate to pay for it or not. If she has cash then council will have to take that into account when they calculate her payments for care. Without house more of her income/sav8ngs will go straight into care anyway. So, not sure they’ll be lots of savings to sell now. Need to sit down and do Full financial analysis .

but if she is not mental incapacitated, your BIL can whistle in wind. No one but the deed title owner can sell the property. He should be very careful about undue influencing her.

property may be a better investment in longer term than cash sitting in bank. It would be silly to put into investments as you need 5-10 years and you may not have that amount of time in her lifetime

My mum has completely forgotten that her brothers are dead. If they come up in conversation, I just tell her they are 'in nursing homes' (as she is) and she seems surprised and says, 'oh, that's awful, I'll have to go and visit them.' And five seconds later she has forgotten what I've said. And I think this is easier than reminding her again and again that they have died, which would certainly trouble her on some level. Brutal honesty isn't the best policy, I've found.

I have no idea what logic was involved in your post.

No, I'm saying that if the cost of both people's care is £5,000 then my mum and the council should both have paid £5,000.

My mum should have been paying HER costs, not subsidising the council to help pay another person's costs on addition to get own.

My FIL thinks he is at a hotel, nobody contradicts him. Luckily he thinks it is a nice hotel and is happy there.

He often thinks MIL has gone to the hairdresser and will be back soon. She died three years ago. It's heartbreaking.

Having experience of this I think what’s key is to get rid of the tendency we all have to correct someone when they are talking “rubbish” or to have to tell them everything that’s going on.

so an assertion from someone with dementia that they are waiting for Bert to get home when one knows Bert died ten years ago can provoke a need in us to say Bert’s dead mum. But the right answer may be to nod and smile. It’s hard and awful.

My mum was just the same when she went into a care home after a long hospital stay, although she did have dementia and so was very confused. I told her that she was in a convalescent home, rather than hospital, which she seemed very happy to accept. I think this might have been because she had really good memories of going to a convalescent home in the 1970s after her hysterectomy. Whenever she said that she wanted to go home, I just reminded her that she had been quite ill in hospital and needed to convalesce for a bit longer.

My Gran was fiercely independent until her early 90s. After a stay in hospital and undiagnosed dementia she was moved to a care home. She'd have fought tooth and nail if she'd realised it. She thought it was a hotel and we went with that.

She was happy being looked after in a hotel and thrived on the activities. She regularly commented about going home but we were non committal and it would be forgotten about.

If she's happy in a private hospital let her be. There's nothing to be gained by telling her the truth

So are you saying that people with less money should have a poorer quality of care ??

If you're confident you're acting in her best interests, just do it and keep quiet

The level of ignorance in this area never fails to shock me.

You cannot just sell someone's house without their permission. If you could, then none of us would be secure in our own homes.

Nothing can be done with the house without her say so, unless she's been assessed as not having capacity in this area.

My mum had capacity until the end. My brother and I had POA to conduct her financial affairs, but only with her permission (she was paralysed so unable to carry out her own banking, bill paying, shopping etc). So we managed her bank account, paid for things and filled in forms for her. What we did not do was make decisions for her. She was very erratic and poor at making decisions, but that did not give us the right to take over her life, any more than we'd have been able to if she wasn't paralysed. And that's how it should be.

OP needs to get her assessed first of all.

And once again it’s worth repeating to those saying just sell. You cannot just quietly sell someone’s house without assessing capacity and doing a best interest meeting. This means it has to be discussed with them.

How do you know any of this? She has no formal diagnosis of any cognitive impairment and even if she did you’d have no idea how this would affect her.

Reading threads like this is really frustrating with anyone over a certain age with any element of memory issue being deemed as incapable and people saying just to make all decisions for them, what do they know, they’re old and can’t control their lives.

Every single person is different, presents differently. She might not have capacity to make a decision regarding whether she has a flu jab but she may have capacity to decide whether to move home. Only a professional doing these assessments would know this. Making blanket assumptions just on one description of someone is really unhelpful.

As a former nurse who worked in discharge planning as a few posters have said its a little more complicated than just selling. Ased on you saying she has no nursing needs in that she is qell, she would be self funding. It gets complicated when cognition is questioned. Apologies if I'm repeating too much, you said she has no formal diagnosis, is she confused, you will need to involve social care and she will need a formal capacity assessment. Power of attorney is no use at all unless the person lacks capacity. Capacity assessments are also usually decision specific so it could just be around her understanding of issues involved in going home. Also she is allowed to make an unwise decision if she is thought to understand the risks behind it. Subject to her not having capacity then yes a best interest decision can be employed. Make sure that you involve social services as you don't want to be accused of any wrongdoing or depriving her of assets in the future when you are trying to do your best and keep her safe.

It's not what everyone would do but we decided to tell our relative that her house had to be knocked down so she couldn't go back home...she accepted that fine tbh. Before we said that she was pretty much packing her bags to go home every day

Don't tell her

Her brain doesn't work the way it used to work, there will be executive dysfunction. She can't process the information, can't weigh it up, can't see the consequences of any actions and can't judge your motivations

She will forget the actual information you have given her pretty quickly, but will probably remember the feelings she experienced on hearing what you had to say (distress, anger, etc) and will associate them with her situation and with the people who told her. This will lead to a vague feeling of distrust and unhappiness that she can't pin to anything so may start to affect her relationships and the way she sees her current situation. This won't be good for anyone, least of all MIL.

I can't emphasise enough, not only would it be unwise and unhelpful to tell her you're selling her house, it would be outright harmful. Please don't do it. The only people it will help is you, to assuage your guilt. If you're confident you're acting in her best interests, just do it and keep quiet

I would do that.

Call it a convalescent or nursing home, because whilst she doesn't need full-blown hospital care the doctors felt it best that she continue to be monitored.

Genius!

Don't get me started. I had no issue with mum paying her own fees. What I resent is that she was subsidising other residents. When she ran out of money and the council took over, magically the fees went from £6k to £4k. Same room, same care, same food. So basically a large chunk of her original fees were to help pay for others.

I work in a care home and it has a tell them once rule. In other words residents are generally told once about major things, after which staff will brush off questions how they see fit. Usually it is used when their spouse dies. I suspect she either has dementia or doesn't want to back down on the care home opinion. Frankly can you imagine your kids making these decisions for you ? I assume she isn't paying council tax as she is exempt.

Why does she need to be told?

I have an aunt who firmly believes her situation is temporary until her own house can be equipped with various adaptations (wink wink). She calls her daughter when something comes up like a stomach upset or other ailment, and D relays the info to the staff. She keeps busy and chats with the other residents. She's perfectly happy, safe, and well fed while she waits to 'go home'.

BIL needs to talk to a solicitor about whether he has the right to sell the house, even if he has financial PoA.

I live in the north of England too. I’d probably get enough rent on my mother’s 2/3 bed property to pay for one week’s residential care. Perhaps I’d achieve that if I did airB&B with constant occupancy, but I haven’t time to do that.

If the council are funding it as the elderly person has no assets or has spent it already, they can usually negotiate cheaper rates of around £700 a week, maybe less. Something like 80% of the average persons council tax goes to private companies providing elderly care nowadays.

I live in the north of England. How expensive is this house to bring in above £4000 a month in rent?!

A bit unrelated but if you can, see if she has some photo albums at home. She might be up to looking through obe when you visit and it can be a nice focus.