Care at home for someone who has lost most mobility - any experiences of making this work?

Sorry you're going through this. If she had a care home I wondered if she could have her riser chair in the room? It might help bridge it a little.

Talk to the OT, as long as there is space it should be feasible to aim home with the Sara steady or whatever the appropriate equipment is. They can be used singlehandedly if appropriate for that patient which would help with the care. Consider if mum has any overnight needs (generally toileting/pad change/agitation overnight) as that can make returning home difficult.

Check she doesn’t have a UTI that can present as confusion.

@DinahCat if your mum is realising that "it's a mess", then she probably has in some way recognised that she's not likely to be going home to her recliner or how it was "before the hospital". I think you've realised that too, especially since you and your sibling really don't have the capacity to fill in all the gaps. I wish you well in finding a suitable place for your DM.

Oh the call button …. Mum always complains that the staff ignore her. Then when I have been at the home the button seems to have slipped too far away for her to reach. BUT when I have given her the call button to use she has put it to her ear like a phone. Then when staff ask her if she wants the bathroom she refuses. 30 minutes later when they are in the middle of serving a meal she needs the bathroom (takes two people) and complains that no one answers the call button that she surely didn’t use anyway.

No one’s fault. Staff need to give out meals. Mum doesn’t know how to plan when staff do their tasks.

Being in her own home would not have helped because she would have been alone between visits. Her dementia is so hard.

My late mum was discharged with very limited mobility, it was a nightmare even with 4 care calls a day, if she needed the commode I had to ring either my brother or my ds & dsil to get her on & off, luckily the district nurse & carers arrived at lunchtime & declared it unsustainable, she went back to hospital in under 36 hours after being discharged.

This is good… and I’m sure it gives you more peace of mind.

I understand the dilemma.

My DS and I are not local - she is a couple of hours away and I am a flight away. We managed to make it work that DPs and latterly DM alone stayed in their own home. We stayed for a week every other month so kept food stocked up and did little jobs around the home. Cameras helped. When we could not get her to understand that she could not wander around the house when carers were not there and she was hospitalized after several falls we agreed that she was unsafe and had to make the difficult decision to move her to a home.

Care fees are now about £1500 a week. That is about the same cost as two carers four times a day which is what the Care Team assessed her as needing. It did not include overnight care.

Mum did not want to go into a care home but even if I had gone to the extreme and left my family to move in with her I would not have coped with the nights.

There is a point at which it is not only about what she wants but also what is safe and reasonable for all concerned.

I can’t give much help but I’m so sorry the original poster and her family are facing this.
Unfortunately it’s a situation more and more of us will find ourselves in as parents ..and ourselves…age and medical conditions become more prevalent.
We should all be making adjustments as we and our family age…it’s a very sobering thought.

My mother was discharged and sent home totally immobile. We were provided with a Sara stedy, a special chair, a hospital bed. She had two carers four times a day - to get her washed and dressed in the morning and give her breakfast; to heat up and serve lunch; to give her a cup of tea in the afternoon and to change her and put her to bed. On each visit they would use the Sara steady to change her incontinence pad and clean her. She only spent three weeks like this but it was totally unmanageable. I was there with her from 9.00 till 6.00 every day and my DD went to spend every evening with her, when she was already in bed. I would go home for lunch and she would phone me saying the carers had forgotten to make her a cup of tea or hadn’t left her with the remote control for the tv and I would have to go back. She had attendance allowance but we had to pay the shortfall. Our local council will not pay for a nursing home unless the person has dementia.

sometimes what we need and what we want don't co-incide.....

Nursing home can indeed be a positive move.

I was an adult services SW and family often felt guilty about a home, but I used to tell them that there were lots of ways to discharge one's perceived responsibilities to an elderly parent and nursing home is one of them. It is not a cop out. Sometimes it is the right choice.

My late OH had PD and he came to see what caring for him at home was doing to me, even with lots of outside input. He suggested nursing home and I moved heaven and earth - and sold our home - to make sure he went to an excellent one.

My parents always said they didn't want to go to a care home.
They had carers visits 5 times a day but they really needed somebody 24 hours a day.
Dad booked himself into a nursing home but wouldn't leave mum at home on her own. She ended up falling , in hospital for 6 weeks so they are both in nursing home now.
I asked dad the other day if he was happy there, he said if he needs to be changed during the night staff come in.
If he's hungry during the night they give him food. None of that was possible at home. Mum is much better too.
She was exhausted minding Dad, wasn't eating properly and living on cappuccinos.

They are much happier and healthier in the nursing home

It sounds as though she might qualify for NHS Continuing Care funding (for care at home or in a nursing home). Take a look at: www.beaconchc.co.uk

They are subsidized by the government to provide information on this funding stream whereby the NHS pays for the care under certain strict criteria - it does sound as though she might qualify - my late OH did.

This isn’t practical they can’t do personal care in a chair
she’ll need pads and they can change her on a hospital bed as the can raise and lower it
she needs a ripple mattress

My wife has virtually no mobility. The OT at the hospital arranged for a Sara stedy to be delivered to our flat.

She started with two carers four times a day. We requested this to be reduced to two visits as we like the freedom to go out with her in a wheelchair.
A recent OT and physio assessment reduced it to one carer as my DW is now used to the Sara stedy

If money was effectively no object, and she was very keen to stay at home, and was settled overnight so that a carer could mostly get an uninterrupted nights sleep, then I would explore live in care plus a second carer coming in at fixed times, or even 2 full time carers (but that would be a few thousand a week I expect). My own grandma had that for a while, and even though she ultimately went to a care home (when she started waking up the sleep in cared too much) it kept at her home for quite a while

It’s totally possible if she’s safe to be left between visits (max is usually 4 calls a day) and doesn’t need pad changing/repositioning over night. But if she has delirium that might not be the case.

in my experience (ex LA social worker) once someone is at the point of needing “double up care” (hoist requires 2 carers) and care overnight/cannot be left, then care at home becomes not feasible.

it is possible to have a live in carer plus a second carer visiting 4 times a day for transfers but that generally then becomes more expensive than a care home so wouldn’t be funded.

if she can transfer with the assistance of one cater who could sleep at night and wouldn’t be required regularly overnight, and she has a spare room, then 24 hour live in care is an option,

or if she could last from an evening call to a morning call with no visits and be ok in between calls ie. Not attempt to get up, be able to call for help in an emergency - then 4 x daily double calls could be possible at home.