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

My mum's care home was £6000 a month. So I'm amazed that anyone's getting residential care for half of that.

Really? A care home round here is approx £750 a week - £3250 per calendar month whilst the average rent for a 3 bed house is around £1200 a month. So thats a shortfall of £2000 a month. The rental income is taxable, so leaves even less money.

One of the most helpful things my aunt's care home key worker ever said to me was that it is ok to lie if it will make her happy. Explaining things as they were was frequently impossible, but referring back to things in her past worked. For example, she would be upset when I needed to leave so I would say I needed to collect the children from school. She had no concept of day, time or their ages, but the need to be at the school gate was in her memory still. She would then send me off, telling me not to be late.

It is so hard to decide about a house but when we sold my aunt's we didn't tell her. One day she asked about it and I told her a lovely couple with three children were looking after it for her. She was pleased about that, she had no idea they were the buyers.

That. My mum had regular capacity assessments after her stroke and need for 24 hour care. She passed them all with flying colours, despite choosing to make some terrible decisions.

I chose not to do anything without her permission. We desperately wanted to clear the storage unit that had stored the entire contents of her former home for ten years, but I felt strongly that if I were in her position I'd be furious if my belongings were disposed of without my knowledge. No way would I sell someone's house if they had capacity and refused permission.

You don’t need a DOLs assessment to assess capacity. Any professional can do this, although for accommodation it is usually best being a social worker. You can call adult social care and say she is requesting to go home and they can come and assess her capacity.

You can’t make such huge financial decisions like selling someone’s house just by getting views from the care home.

With an LPA for property and affairs you are obliged to act in the donor's best interests where you believe, on balance, that she cannot make a specific financial decision.

Given that she doesn't understand her care needs you are on pretty solid ground in terms of the donor not being able to make a decision about whether to sell the house she is no longer able to live in.

If you want to be absolutely certain if your position you can ask the home for their views about mental capacity to decide on care/residence.

If the care home is looking after her on the basis that she cannot positively consent to the care (which is not the same as objecting), and it's being provided as necessary in her best interests, the care home should have applied to the local social services authority for a Deprivation of Liberty Safeguards (DOLS) authorisation.

Checking out her "DOLS status" may give you some peace of mind although most LA have multi year waiting lists for actual assessment of mental capacity and best interests so it's more about seeing how the CH perceives her.

I doubt that legally you can sell her home without her knowing. Even with a LPA that will only come into effect if she doesn't have capacity to.l make decisions herself or if she has given her permission for you to act for her and doesn't seem to be the case here.
I think you just have to be honest with her. It's extremely hard and if she goes home I suspect she may end up back in hospital but if she has capacity and if she fully understands the implications of her actions and she refuses to stay in the care home I don't think you have any choice.
She may suprise you though and decide she wants to stay

After a bumpy start my late DM settled in to her care home and quickly became institutionalised, she enjoyed the company, the food and the routine. She felt safe.
She did sometimes ask about when she would be going home and we said she was in a convalescent home for now. She accepted that well but used to ask how her house was, she worried about it. We said her neighbour was looking after it, and we checked on it regularly too. All true. That reassured her.
My DB and I had POA that she signed when she realised she needed help managing her finances (lots of forgotten and hence unpaid bills!) so we were able to sell her house later on, when it became necessary. She had forgotten all about it by then.
She had medium dementia when she first went into care but of course it worsened.

If she is asking to go home then legally this needs to be explored. A capacity assessment needs to be carried out and then a best interest meeting arranged with family, social work, the care home etc. The decision needs to be the least restrictive for her, with all the pros and cons considered.

If she’s deemed to have capacity then it is her choice, even if this is thought of as ‘unwise’.

Going into a care home literally saved my mums life. She was severely neglected by her husband. Once in the home she thrived. It was council run but was set up like an old fashioned house. No sterile corridors or ultra modern bedrooms. She thought it was her own home, but never questioned why she had other people there.

The fact that she gave you POA meant she trusted you to make the right decisions for her. You have no alternative but to sell, to ensure her future.
i told my mum she was in a convalescence home.

By the time you take off state pension, possibly private pension and sometimes othee benefit what actually neexs paid from a houde sale is less.

Actually it does work. A house the same as DM’s 3 bed currently brings in rent £300 more than care home fees. North of England

Would like to point out that most care homes are now £1,200 a week so that won't work these days unless you charge astronomical rent and have a house in London.

I should add I had Power of Attorney - hence I could rent out her home.
“I had a similar problem with DM. She was diagnosed with Lewy Body dementia (which is like you described). I let her house and used the income to pay for her care home.”

I also had a family member with Lewy Body dementia, I let her house to help pay for care and didn't mention anything to her as I had PoA, I was acting in her best interests and it would've just distressed her.
I don't think it's common for people to tell people in care homes what's really happening unless they are definitely "all there" mentally and involved in their own care decisions. You just let them think whatever they think, say things like 'you need to stay here for a while where you're looked after' and let time pass

With both my parents we've found the phrase convalescent home useful as its a concept they understand from their youth.

I had a similar problem with DM. She was diagnosed with Lewy Body dementia (which is like you described). I let her house and used the income to pay for her care home. The income was enough and saw her through until just after she passed away. She never had her home sold from under her

@BunnyRuddington, I do so agree about (not) telling the truth when dementia is involved. We were new to dementia when FiL first asked where MiL (dead 10 years) was. We explained as gently as possible that she’d died years ago, but he was terribly upset and cried - only to forget and ask again half an hour later. So we soon learned to say that she’d gone to the shops, or to visit Auntie So and So, which would keep him quite happy.

Some years later, when DM also had dementia (😰) there was a stage when she’d often say she ought to go and visit her parents (dead some 30 and 50 odd years) ‘…because they must be getting old and could do with some help.’

I’d just tell her that I couldn’t take her today, because my car was in for a service/any other plausible sounding excuse - ‘but maybe we could go tomorrow?’
Her short time memory was practically zero by then, so this always kept her happy (or as happy as she was ever going to be.)

I used to be a regular user of the Alz. Soc. Talking Point forum (a lifeline for ages) where such fibs were known as ‘love lies’.

Dementia is more than likely to be present considering she doesn't seem to be able to recognise where she is and the past history of bizarre behaviour.

Id like to clarify we explicitly had the support of family members to say what would keep them happy and calm, even if it was a lie. Some we had specific care plans for what to say which would work better. One lady had a son who routinely travelled for work so we would tell her his flight was delayed, for example.

I honestly wouldn’t bother telling her, not if it’s going to upset or distress her. If she asks about ‘going home’ a standard answer is ‘when the doctor thinks you’re a bit better’, or ‘when the heating/plumbing/any other imaginary problem, is fixed.’

Probably a different scenario, since dementia was involved, but one resident of DM’s care home thought she was running a boarding house! She once told me in very miffed tones that another resident, ‘….still owes me nine quid for last week!’

Absolutely this. Legally she must be assumed to have capacity. Although any Home Manager should have done this already before admitting her, especially considering her history. You don't need a formal diagnosis to be ruled to lack capacity.

The questions change over time. MIL went into CH fairly willingly (FIL died and we couldn't care for her long term in our house) but kept asking when she was going home. Except it wasn't her most recent home she was asking for, it was a previous one. So we knew what she was really missing was a sense of home and familiarity. She did settle but never really liked living with lots of people around her.
Tbh tell her what will make her feel happy and secure.

We used to do this with my mil who was in a dementia home. And I used to tell her I was popping out for a DRs appointment but would be back soon when I had to leave (otherwise she got stressed about being left).
But it sounds like this lady doesn’t have dementia so this wouldn’t work,

Why do you need to tell her. Let her think it’s a private hospital if that’s what makes her happy.

This is the best way to go about it for sure.

DMIL would often ask for her own DM. I used to say that she had popped to the shops to get something for tea and she would be back soon.

This kept her happy as it was a scenario that seemed familiar from her childhood.

DFIL saw (who has always been a bit of an arse) was dead against what he saw as lying to her and caused her so much distress over the years. Truly heartbreaking to watch and so frustrating as he would just not take advice from anyone on how to pacify her and keep her happy.