Care homes make me think people never die

My elderly relative has spent years looking after their physical health but none looking after their mental health. Think extra screening, obsessive with exercise, statins, blood pressure medication etc etc.
The problem is that years of untreated severe anxiety have undoubtedly contributed to cognitive decline.
They express a wish to die suddenly of a heart attack rather than end up in a home, but have done everything in their power to prevent that happening.
It’s a bizarre mismatch.

@NewspaperTaxis Yes, falls are the thing!

I used to work in a hospital and didn't understand why there was a Working Group on fall prevention in the elderly. Well, now I do...

It's such a chicken-and-egg situation though. Sometimes there can be mini strokes that contribute to the fall and are never detected. But falls seem to precipitate mental decline, often dramatically.

Now in my 60s, I'm pursuing functional fitness in a way that I never did when younger! The motivation is strong 🫣

It's far from inevitable that you will end up that way though, only a small percentage of people go into care homes and an even smaller percentage last for many years in them. Plus many can have quite a good quality of life or at least be getting some enjoyment from life when they get good care. As people have said, if you are gifted with good health to start with then trying to look after yourself so you have as long as possible healthy is a good idea.

My dad only ended up in a home for end of life care as they could provide the round the clock care he needed and make sure he was peaceful and as pain free as possible. My mum died peacefully at home having been pretty healthy up to the age of 85 and only unwell for a few months. I'm not scared of old age, I'm scared of not getting there as one's 50s are like sniper alley. PIL are 82 and doing very well. I release from my own parents who were slightly older that it can change quickly so we will appreciate them while we can.

I'm not unsympathetic to this thread with all its different views but I take it some would have been quite happy to be with Boris Johnson's 'let the bodies pile high' strategy during lockdown. It's almost like it's building a narrative.

I am absolutely terrified of old age and the idea that I might spend years in a care home is horrifying to me. What makes it worse is that I will have absolutely nobody to keep an eye out for me as I am an only child and can't have children. I used to take some comfort in the fact that safe guarding bodies like the CQC existed, but now people are saying they aren't for for purpose? What a tragic way to end my life. Completely alone and probably neglected and abused.

Exactly what my stepfather is going through.
Now 94 and 'benefitting' from all the physical activity he engaged in over the decades. He used to 'jog' before the word was invented 😂.
But his brain started to deteriorate when he was in his mid 70's and he's been 'away with the fairies' for many years (I don't mean that rudely just how he is) and it just got worse and worse.

He has taken a cocktail of drugs for years to keep his blood thin and has had several stents so the body is ticking over nicely.
After aged 80 he had a hip replacement but now struggles to walk any distance as the mini strokes he keeps having affect his balance.
He has plenty of muscle on his legs and was always a tall slim man (still is) but it's his brain that's f**d so he's prone to falls.

He's been in a care home 3 years now and he'll go on for years. Despite his children not wanting life extending treatment, the care home sent him to A&E after another TIA. Afterwards he couldn't eat or drink so they were spoon feeding him and doing the thickened liquid. So he's still there (@8k pcm private funding so cross subsidises others) and just exists.

Sadly my mother died from a rare illness at 76 and she was super fit for her age. But she developed a rare disease affecting the liver and was dead after a year. We were devastated at the time but looking at them both now I wonder if she actually had the 'better death' .

Falls are an accelerator, one way or another. There have been a number of celebrity deaths in the last few years that came quickly after a fall - Des O'Conner, Barry Humphries, Nicolas Parsons I think, Christopher Plummer, Bobby Robson, very possibly the Queen I would have thought, and Jilly Cooper.

Most of these were mentally lively until that time, some actually still working.

Some were quite tall and I have a theory they're more likely to stumble and hit the ground hard in that case. As most were still active, that is a factor - the brain wants to do a certain thing but the body doesn't follow suit and - bang! My mother was in a wheelchair and used a hoist for her last few years; it is unlikely she would have had a fall (but don't rule it out; make sure the seat belt is fixed on the wheelchair or going along at speed, you can hit a dive and they can go flying as the wheelchair stays where it is...)

But both did had falls of a kind; my mother had early Parkinson's and was walking and stumbled a bit. It broke her hip but it didn't show for a while, she had brittle bones and it doesn't hurt immediately, she wound up with a hip replacement while the pain killers interfered with her drugs and drove her mad, she thought people had entered the house.

Dad had a fall because he went nuts - this can happen with a urinary tract infection, easily cured with antibiotics, or low sodium levels, which may well require an overnight stint in hospital. He tried to get to the loo and fell, so my advice is to have a piss pot by the bed - an empty beetroot jar will do it - to avoid unnecessary nocturnal trips to the loo.

Dad broke a leg but it was near the top of it, on the pivot, so didn't require plaster and it healed by itself, this was around lockdown lifting. He didn't really walk again however - in a way I regret that, but he had a touch of dementia and I could just see him haring off and falling again.

I more regret not getting Mum walking again on a wheelie zimmer, it would have made all the difference, the act of walking keeps the mind going. But once the care home had her leg contracted, stiffened up from its use in bed, that was the end of that.

My point is that it's the fall that gets you, though it may not be immediate, there's no way of telling. Have to say in the documentary showing Jilly Cooper inching her way up the stairs of her house, plus 80, I would also advise relocating the bed to the ground floor if possible.

I agree. How a young fit person die suddenly and an elderly person has to suffer sometimes decades in a care home?

My aunt took a cup of tea up to my grandad and found him dead in bed. A heart attack in his sleep at 78. A bit young these days but the best way to go.

My dad is 92, and has forgotten most of his life before the last few days. But recalls bits of childhood, he thinks his wife is his daughter. But actually, I think in a very odd way, this might be the happiest he has ever been. He has mellowed and softened, he is in his happy place with a great view to enjoy over a harbour with boats moving, and his wife still adores him and spoils him. He enjoys his food, requires no medication, and while he has periodic crises after which she has to wrestle him back to decent health (because the NHS doesn't really care for very old people well, in Dorset) they rub along. I think it comes at a high price for her health though.

My Mum spent three months in a care home in the final stages of Alzheimer’s following a protracted admission to a mental health ward. In hospital she was wrapped in cotton wool and even placed on 1-1 observations because she kept wandering. She died very suddenly in the care home although I suspect this was due to poor care. I didn’t pursue it as I was thankful she was no longer suffering. Dad was living independently at home and suffered a major stroke. The doctors agreed there was little hope of a meaningful recovery I requested palliative care only. He died in a hospice a couple of weeks later. I miss my parents but I’m relieved they didn’t linger for years in care homes.

Maybe. But if not I won't just sit there day after day and let my body waste away when I can do something about it.

CQC are a joke. Care homes are told when they're going to be inspected and pull out all the stops - extra cleaning, painting, paperwork completed, extra staff, fancy activities and nicer food. The inspections that are unannounced are usually the ones that catch them at it.

What you can't legislate for is intelligence and genuine kindness. Emotional intelligence is a particularly rare thing amongst staff and most just aren't switched on or bright enough to know that it's inappropriate to patronise the elderly, have blaring radios, put on toddler games as activities, not talk about their relationship problems with another staff member whilst resident is having a bath, forget to put someone's glasses on, not close the door when they're having a pad change, be slow with pain relief and not give them choices about how they want to be cared for. Mil never came to terms with the fact that the staff looking after her weren't naice young ladies and she couldn't interact with them at all or ask for things she needed doing.

I'm not sure, some are, some aren't. Some are closing because they can't make it work - this puts the onus on to richer care homes to pick up the flak, with the local authority having to make up the money difference.

With this in mind, you could argue the CQC and Council's Social Services don't care to look to closely, to regulate much, for fear of care homes closing.

Please ignore the yess that was meant for somewhere else.

Are care homes raking it in as you say? from what I’ve heard many are closing down regulations make it impossible to keep afloat

My Nan went into a care home at 96 after living independently until then.
She died at 102. It was no fun for her, she was never happy there but needed to be looked after to be safe.
She just died of old age really. She didn’t have any serious illness in her whole life, no heart problems, no high blood pressure, took no medication and only had surgery once for a knee replacement at the age of 80.
I used to think how amazing, but now I know I wouldn’t want to live as she did for her last couple of years.

After being transferred to the Vic in Fife, following his open heart surgery, my late husband had a nurse asking "Who tucks you in at night?"

Yess

The so-called Care Quality Commission isn't fit for purpose, hasn't been for a decade - that was the words of current Health Secretary Wes Streeting and the reason its last leader stood down. In my view it is corrupt.

Its role under the Tories was to turn a blind eye to bad care homes so the austerity programme would be deemed a success. Leave the care homes alone to coin it in; they are in league often enough with local authorities who are the ones who actually run the country on a day to day basis and have real power.

Its awful to be faced with that reality and on top of that you'd have stupid nurses and healthcare staff calling you sweetheart and generally infantilizing you.

Years ago an old couple l know and kept themselves to themselves, started behaving strangely in the street. One day I had to take them some wrongly delivered mail, and got a shock. Their previously pristine home was wrecked by their dogs which they could no longer control, Their clothes were dirty , and neither seemed to know what was going on. I phoned their relatives who obviously had not been keeping in touch. They both had dementia- tragic.

Nearly everyone vows they won’t go into a care home. Trouble is things can happen fast, a massive stroke , dementia taking over etc. Unless they can afford carers coming in several times a day, can people cope with someone physically and possibly mentally disabled , double incontinence? Decisions have to be made quickly. An acquaintance was just about coping with his wife who had dementia, but one day she was plastered with faeces , and he knew he had to face what he had been dreading for some time.