Care homes make me think people never die

Sadly that might not be your decision. Say , for example, one of you was in absolute agony and the other called for an ambulance…

Do read the excellent book on this called ‘Being Mortal’ by Atul Gawande. Its context is the US , but much applies to the UK also.

I assume that we would simply die at home

I think medicines which people take are keeping them alive much longer than their body and minds actually can cope with!
whilst you have good health and good mind take the tablets to prolong your life but if that’s stops and you are waiting to die stop taking the medication and let nature take its course. (my medicine I mean like statins etc)

my aunty has dementia and in a care home been in 3 years now and the decline is horrible and she could have many more years of it

I have a friend in his early eighties with dementia. He is doubly incontinent, non verbal, spends 85% of the day with his eyes shut. Has to be spoon fed pureed food. He doesn’t recognise his wife or children.

The doctors say he probably has another ten years…

It's a fair question. First of all she lived in Ireland which has good policies/supports for care home financing, and the money never runs out! In mum's case the "Fair Deal" applied which meant that 80% of her income and 7.5% per annum (for a max of three years only for the family home) of her capital assets ( savings) were used to pay the fee. This would apply no matter what means she had, even just State Pension.

The asset charge on the family home can be deferred until death/house sold etc. In the meantime the house can be let, and the income is not taken into account for the 80% income levy. Income Tax is payable though, but tax credits for NH fees, at the higher rate of tax are available to offset the liability.

So if a person had income of 100k, 80k would be used towards the fee. If the family home was valued at 1million, then a max of 225k would be used for fees no matter how long a person lives. That can be deferred until death also. Other capital assets are charged at 7.5% pa until death.

So when mum died, the value of the family home was reduced by 22.5% and paid to the Government and that was that, more or less. She still had to contribute 80%pa of her income and 7.5% of her savings pa all along though. Quite fair IMV.

You can select any nursing home you wish, private or public and you will qualify provided the nh can meet the needs. There is no distinction made re costs in either home.

It's a long time ago now, and I may have some info wrong but that's the gist of it.

My Mum is in a wonderful care home.
She's gone 94 been there over 3 years.
Despite many illnesses she's carrying on going and l think it's got to be the care given to them that prolonged their live . It's socially good for them , they are in a routine , regular medications , Dr and District nurses on hand . Good food , regular drinks and entertainment.
It's like a hotel with help. I think your person must be in a good care home@rockrollerpud

My FIL is 86 and def not petite - maybe 15 to 16 stone and 5 ft 11 - he also eats well but likes good stuff -salmon twice a week, coupe of veggie meals twice a week, veggie chilli etc, eats veg, limited cakes and sugar - also walks a mile into town and back every day, ( does still drive) - does all his own housework apart from ironing ( which he has done) - no carers. Still fully compus mentis -intelligent guy still keeping up with news and tech - I know it’s luck but it can also be lifestyle for many too .

The care home should not have "forced the issue" by trying to make you feel guilty. They should have just respectfully confirmed with you that they should follow what was written in the notes, especially if that was what the relation requested while of sound mind. They deserve a complaint, but I can see it would be difficult without making you look awful.

Can you share more about an advanced directive please? Ive not Leeds of these before. Do care teams HAVE to comply with them?

The use of metformin, statins etc keep people alive.

Not sure about the overweight bit. I tend to notice the opposite in care homes - most elderly, as in the over 75 group, are slim/petite. Not a lot of obese people make it past 75, and definitely no overweight people past the 80 years mark. Your vital organs just can’t support excess weight past a certain age. And most old people have very small appetites.

The care homes are a business that's probably why? Unless there's a waiting list for the room? It's disgusting.

My MIL is in care with mixed dementia. She is given what I reckon would be $10k to $20k in medication every year. Why? To what purpose? She would be furious about it if she knew.

My ex's gran is 91 this year and in one of these. They have a lot of activities but a lot of them look like the same things nursery age children would do. Ex's gran doesn't have dementia, it's also sheltered accommodation, so (no professional here btw) I wonder why they don't do more appropriate things with them? Colouring in pictures of Elton John and Elvis Presley seem odd. Correct me if I'm wrong.

Years ago, pneumonia was known as 'the old man's friend' as it usually led to a relatively peaceful end of an elderly, infirm, patient's life.

It’s very sad. I think it’s because their bodies are so pumped full of drugs it just keeps them going and I don’t understand why we do it to people. I watched my grandma suffer for years and it was awful

My dad moved to a nursing home 5 months ago with advanced dementia aged 83. He is mobile but cannot communicate any needs and requires help eating etc. I am traumatised to realise he is one of youngest. Most residents are in their 90s and have been there 6 years or more. One lady has been there 17 years...she is 96. It's truly horrific.

I have an advanced directive, and have made it clear to DC, that if I end up in a home with Alzheimer’s, like both DGM and currently DF, I don’t want antibiotics for UTI’s, pneumonia or whatever. You wouldn’t let an animal live for so long suffering the way some poor people do, bed bound, dribbling, doubly incontinent, often frightened or bewildered with no quality of life. It’s appalling.
Unfortunately both DGMs lived until mid 90’s, DF has been in a dementia care home for 5 years already. I’m hoping I have a much shorter lifespan rather than end up with the same fate.

When my mum was admitted to a care home she was 91. She had dementia but it was her mobility issues that took her there really. She was incredibly frail and she had a some episodes where we were all called as she wasn’t expected to last the night. For these, we insisted (and we really had to insist) that she did not go to hospital. The next morning she was having a cup of tea. It was very stressful mentally preparing for her demise only to face another unknown length of time before the next time. She was completely unaware by this stage. She was just a shell, and she would have hated to see herself that way. She lived to 96 so five years in the home - I thought she would never die. Sounds awful but she just seemed determined not to leave. She had not been out of bed (literally) for the last four years of her life and had no medication for underlying health issues - I don’t know how she did it. And yes it terrifies me, I’m adopted so don’t necessarily have these genes but still.

My mother insisted she never wanted to go into one. Luckily she was able to live out her later years with me. Although she had dementia she remained with me (with the help of private carers) until she went in her sleep. My elderly neighbour refuses to put his wife in a care home and looks after her himself (with help from family/carers).

How on Earth can you guarantee that? Unless you have a lot of money in the bank to pay for 24 hour home care if you need it (and sometimes that’s not enough.)

@OldJohn I don’t think anybody wants to go into a nursing home. Sometimes the alternatives are worse, or require things that actually you might not choose. I know a couple of brothers my age who are spending their 50s working very flexible part time jobs to try and keep their 80+ parents in their home (they are also getting 4 care visits a day each), and although I salute the brothers for it, they are impoverishing themselves and exhausting themselves to do it. I would never say never.

My friends’ dad was in a home. He had dementia and didn’t know night from day. He was relentlessly miserable. Everything time he got a cold or a cough, the doctor would see him, usually prescribing something to make him better. She eventually had to put something in place to stop him being prescribed antibiotics and it was a blessed relief to all when a chest infection saw him off.