Put parents in a home

[AllOutofEverything]

This advice is often given on mumsnet and drives me mad. You can not put an adult in a home unless they are assessed as having no capacity to make that decision. It does not matter if you have power of attorney. An adult can decide if they want to go into a home or not. And that includes making decisions that are against their own best interests. They may have a better life in a home and be better cared for, but if they do not want to go, that is their decision.

Similarly family can not just decide the state will pay for a relatives residential home because they think they need to be in one and do not have enough money to pay privately. A care assessment is carried out and a decision made about whether the person needs the level of care given in a home or is fine at home with carers. You can challenge this decision of course. But if your relative is assessed as not needing a care home then the state will not pay for it.

Most people without dementia are at home with carers popping in. If someone needs getting out of bed, washed, dressed, food given and toileting, then carers visiting their home is usually what will be recommended.

Of course many people persuade a reluctant parent to go into a care home. But they still have to agree however reluctantly.

Sometimes it is impossible to care for someone at home though and they have to go into a home. My grandmother had a stroke and afterwards had an extreme change of personality. She was violent and would strip naked.
It was simply not safe to have her at home. We were living with four generations under one roof and we had to say that in no circumstances could she continue living with us. She didn't want to go into a carehome, but what other choice did we have? Throw her out on the street? Dump her somewhere? She had to be in a carehome for her own safety.

I am pretty old 😀

The thing is when my DPs and ILs were my age all of their parents had died. DHs grandparents died in their 60s! They didn't have to look after their parents because they weren't there.

MIL was 85, my DF is going to be 90 this year, although he is utterly amazing and is still fully independent.

We had this with MIL. SW threatened her with a care home if she didn’t have carers, so she reluctantly agreed, but she frequently denied then access and they frequently phoned us about this and that. We had to pull out and let her fail, that’s when she went in a home.

I see. My grandparents lived to an old age, my parents died fairly young.

Of course many people die not long after moving to a care home. They are generally very old and frail! What a strange comment.

I don't think many Mumsnetters don't understand that an adult with capacity makes their own decisions, do they? I can't say I've seen any proof of this anywhere on Mumsnet. I must have missed all of the many threads which prompted you OP.

I see all the time on MN comments about you just need to put her in a home OP.

If I had months to live I would rather die at home even if I die a few months early. People resist care homes for good reasons.

@AllOutofEverything , if someone needs ‘toileting’ as they like to call it, how are carers popping in 3 or 4 times going to be enough? What are they supposed to do if they need to go in between care visits, or during the night?

An old aunt of dh (no dementia) eventually had to move to a care home because she could no longer safely get herself to the loo, especially at night.

I might add re social workers, who are supposed to have had some sort of training in dementia, that from experience, although they think they understand it, some are still clueless about the practical realities of short term memory loss.

E.g. ‘If she can’t remember to take her medication, you could always write it down for her.’
No comprehension that even if she did look at it, she’d have forgotten almost as soon as she turned her eyes away.
Ditto, ‘Well, you could ring to remind her.’

Yes, and she’ll have forgotten whatever I said almost as soon as she’s put the phone down.

Not to mention wanting to thump someone who evidently thought you were too stupid to think of anything so simple!

Some GPs are as bad.

@GETTINGLIKEMYMOTHER If that is not often enough they have to wear incontinence pads. Loads of people get 4 care visits a day at home, it is not unusual. I appreciate my bladder may not be as strong in the future, but 4 toilet visits a day would be fine for me. But most probably wear pads or at minimum can manage to use a commode at other times.

I appreciate the understanding of dementia can be poor.

This is a very good point, but is also the key to improving matters, make care homes better and more humane, and thus more appealing.

In the Netherlands they are trialling a model where students live in the care home free, but they have to spend a certain number of hours socialising with the elderly residents. In this country they had nursery school children visiting an old folks home once a week.

It would cost, but would almost certainly reduce costs elsewhere in the health and care system.

You are partly correct but if someone is incapable of caring for themselves without the assistance of family members then they do not have the capacity to live alone. Whilst everyone wants to be able to come to a compromise, ultimately if an older person cannot live independently, their relatives, typically their children can refuse to provide care. If they cannot care for themselves the court of protection can rule that it is in their best interests to be deprived of their liberty and be placed in a secure home. Nobody wants this to happen but sometimes it does.

Social services do a care assessment, and only pay when appropriate.

So if I understand what you're saying, if your parent is suffering from dementia but is understandably reluctant to move from their home where they feel safe rather than to go into a home, they should just be left at home and carers come 4 times a day maybe at strange times because there are no slots left at the desired time.

Their children shouldn't trot round all the homes trying to find a good one, put the parent on the waiting list, move in and look after them until a vacancy arrives, furnish the room so they feel at home, lie to get them to go there, rely on the skills of the home to make them feel settled enough to stay, and of course be there to take them home if it doesn't work out.

Instead, the children should just call an ambulance, they should get taken into hospital, a SW gets involved, looks on their list and puts them in any home that has a vacancy - even one that requires improvement and is deemed unsafe. And they can't leave there no natter how miserable they are.

There aren't many children who want their parents to go into a rest home if they are capable and happy to stay at home. We're all just trying to do our best and we don't stop worrying about them and their welfare even when they're in the hands of a good care home. Sometimes the law definitely does not know best. And it certainly doesn't care.

It is very rare for the court to over rule people's own views if they have capacity. Yes family do not need to provide care, their decision.
But legally people are allowed to make foolish decisions. And in many cases people can manage after a fashion, just not as well as relatives would like For example they can't manage a shower but can wipe themselves down with wipes. Or can't cook, but can eat snacks. Or are at risk of falls. Or more normally a combination of all these things.
But most people manage with 3 or 4 daily visits for basic needs and the issue is an increased risk of falls if they try and go to the toilet alone. That risk is the individuals choice.

@MarshaMelrose I was specifically talking about carers visiting. We knew a decent carer agency locally and care was quickly organised.

No, if a person reaches the stage of being admitted to hospital they can't just demand to go home. They have to pass an assessment to show they can manage the challenges at home. If they can't they are obliged to choose one of three nursing home places offered. That's how it works in our part of the UK anyway. It may not be legally binding but it might as well be because the elderly person will not be discharged to an inappropriate residence and they're hardly going to be in a position to go to court. That's why we have so many bed blockers.

I had an older friend who was perfectly mentally able and intelligent but who had become quite frail. She had carers going in to help daily. Then she told me, whilst in hospital, that her adult children had decided that she should go into care. Not that they had all discussed the options but that they had decided. It made me sad and mad. She died very soon after going into the home.

"Most people without dementia are at home with carers popping in. If someone needs getting out of bed, washed, dressed, food given and toileting, then carers visiting their home is usually what will be recommended."

Sure.

And when they get to the next stage, when without dementia, they are so confused, frail and unsteady on their legs that they are not safe to be left alone for even short periods?

Who does their shopping? Who does the laundry? Who makes sure they don't run out of incontinence pads? Who pays the bills? Who gets endless phone calls from the neighbours?

How about when they try to use the microwave even when they've been told dozens of times not to, forget how long something needs to cook for and nearly set the house on fire, and you turn up to a house filled with smoke?

When the carer 'pops in' and give them their tea and goes again, and you turn up an hour later to put them to bed and find them on the floor in the dining room because they fell asleep in the middle of their dinner, and keeled over sideways off the chair?

When you have to wait a very long time for an ambulance?

When, during their time in hospital after that fall, they are told over and over again to ask for help in going to the toilet, yet forget to ask and try to get up, falling flat on the floor again?

When you get a phone call at 1.30am from them saying that the carers haven't arrived to give them their breakfast yet, and you have to explain that it is the middle of the night, not the morning, and they need to go back to bed?

When they forget to hang the phone up properly all the bloody time so you can't contact them at all and have to drive 10 miles over there at whatever time of day or night, just in case there has been another disaster?

When you can never, ever, have a drink in case you have an emergency to deal with and have to drive over there?

When you have to spend hours and hours every day speaking to care teams, support people, nurses, doctors, never minding that you are losing money every day because you can't go into work?

Because all of this (and a lot more) has happened to us in the last three weeks, and it is getting impossible. My DH (no spring chicken himself and with a heart condition) is having to move in with her now for a few days, because the hospital in its wisdom has discharged her again today, with no time to rearrange for carers to come in at such short notice.

If you had to deal with that and the sheer exhausting unrelenting stress that goes with it, perhaps you too might think that maybe a nursing home isn't such a bad idea after all.

But hey ho, she insists she wants to be at home, and there we are.

@larchforest , yes, this is the sort of reality that all too many relatives face. 💐
So many people have absolutely no idea, but that doesn’t stop them sanctimoniously pontificating about what other people should or should not do.

I fear we will be facing this at some point.
My Mums partner has dementia. He is fully functional as long as someone tells him to do things, if not he will mostly stay in bed and won’t wash or eat. My Mum was in hospital recently and it showed how much he has deteriorated. We assumed he would die before my Mum because he is a bit older but she’s deteriorating too and I am not sure whether he might outlast her now, which he would hate.
The house belongs to my Mum only and his family are miles away and other than a quick phone call they don’t bother with him. I have tried to tell them but they say “he seems fine” - which he is as he has a task to do, speak to them on the phone.
If anything happens to my Mum he will be very resistant to move and won’t be safe in the house alone but I am not sure how we will get him to move somewhere more appropriate. I do have POA for him but given this post I’m not sure how much it will help

Be careful what you believe. My DM wanted to go into supported living, she was bored, lonely and fed up with living alone. I drove her around to see several places, we interviewed the people in charge, looked at the available rooms.
When she chose one, she had a trial week there, and liked it.

I made all the financial arrangements, my OH and I hired a mini van and loaded her furniture , her bits and pieces, I packed her clothes. We bought and put together the new bed she wanted.

when we got there on moving in day, she marched into the lounge where the other residents were having coffee and announced ‘ They want to get rid of me’.

gee, thanks Mum.

Supported living is very different from a care home. You still have your own flat in supported living.

That is so sad.

@larchforest I am sorry to hear you are dealing with that. I am not pretending it is easy. If you withdrew all care yourselves she would probably end up in a home quite quickly.

But my mum lives in a village. The care agencies in the local towns, can't staff visits for evening times in her village. Latest visit she could get was 7.30.
And my mum was getting scared of being left on her own. She's not unsafe, no danger of falling, no wandering. She was just scared to be on her own. We looked at getting people to stay overnight with her. Cost over £800 a week. Plus carers during the day, plus all her housing and energy costs. It's totally unsustainable. At the same time she didn't want to go into a home.
Something has to give. Better that I find her a good home and make her go into it. Than the SW makes her go into a crappy one.

Since I posted, what, just over half an hour ago, I have had a phone call from DH - there's another crisis. He is there and dealing with it.

Honestly, I could scream.

@MarshaMelrose It is hard. But your mum has a choice. Stay at home alone in the evening or go into a care home.
And liviing in a small village or rural area makes life much harder when you get old unless you have a large involved family close by. I never understand people who retire to the country.