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.

I totally agree.

I think a lot of older people don't want to go into a nursing home. They seem to think that the world revolves around them and what they would like. Along with this they can refuse to accept that their is anything wrong with them. They can't manage at home and meanwhile they have family, friends and relatives worrying about them.
I have seen several different scenarios with elderly and not so elderly parents.

One of my friends had a job getting her mother to a doctor's when she started to notice her mother had a few problems. Her mother was very much I am fine when she clearly was not. She was diagnosed with x after a doctor's visit and some tests. As time went by she needed more help and careers came. Fil also did a lot but my friend was getting calls to go help them. My friend had a full time job and 3 primary school children back then and her husband had to work long hours at times. Eventually her mother ended up in care. I could see the relief in my friend because she was no longer getting phone calls about the next crisis ect and she could make plans.

Another friend of mine ended up out of work for a while because there mother had Altizmers.
They noticed that their mother was acting odd and forgetting things. They lucky got a diagnosis early on for Altizmers and could make plans re money and care. They tried to keep her at home but it was no longer possible because of all her issues. My friend had not got a full nights sleep in years and was both physically and mentally exhausted by the time their mother went into care. She lived for a few years after this in a good home where she was safe and looked after well.

Another friend of mine is currently dealing with her stubborn and headstrong mother who is in her late 80's. Her mother body is failing but her mind is still well. My friend had a big problem getting her mother to use a walker rather than a stick so she would not fall. My friend is working full time and then dealing with her mothers wants and needs. Along with this she has a sister who is quite happy leaving her to deal with their mother.

Then it trying to get elderly parents to accept that they need some extra help to stay at home and that help can't always come from adult children. It can be hard to get careers in some parts of the country and then what happens during holiday time like Xmas?
Adult children can have their own kids and jobs and can't put their own lives on hold to keep parents out of a nursing home.

I think a lot of older people don't want to go into a nursing home. They seem to think that the world revolves around them and what they would like. Along with this they can refuse to accept that their is anything wrong with them. They can't manage at home and meanwhile they have family, friends and relatives worrying about them.
I have seen several different scenarios with elderly and not so elderly parents.

One of my friends had a job getting her mother to a doctor's when she started to notice her mother had a few problems. Her mother was very much I am fine when she clearly was not. She was diagnosed with x after a doctor's visit and some tests. As time went by she needed more help and careers came. Fil also did a lot but my friend was getting calls to go help them. My friend had a full time job and 3 primary school children back then and her husband had to work long hours at times. Eventually her mother ended up in care. I could see the relief in my friend because she was no longer getting phone calls about the next crisis ect and she could make plans.

Another friend of mine ended up out of work for a while because there mother had Altizmers.
They noticed that their mother was acting odd and forgetting things. They lucky got a diagnosis early on for Altizmers and could make plans re money and care. They tried to keep her at home but it was no longer possible because of all her issues. My friend had not got a full nights sleep in years and was both physically and mentally exhausted by the time their mother went into care. She lived for a few years after this in a good home where she was safe and looked after well.

Another friend of mine is currently dealing with her stubborn and headstrong mother who is in her late 80's. Her mother body is failing but her mind is still well. My friend had a big problem getting her mother to use a walker rather than a stick so she would not fall. My friend is working full time and then dealing with her mothers wants and needs. Along with this she has a sister who is quite happy leaving her to deal with their mother.

Then it trying to get elderly parents to accept that they need some extra help to stay at home and that help can't always come from adult children. It can be hard to get careers in some parts of the country and then what happens during holiday time like Xmas?
Adult children can have their own kids and jobs and can't put their own lives on hold to keep parents out of a nursing home.

I dont think you can put a blanket judgement on all relatives some are trying there very very best but are probably not getting it right. We have just had my Dad in hospital after a fall and then released to a care home whilst a care package was put in place. 2 weeks later and no package and we took him home. He was confused upset and wanted to come home. By doing this we now cant get him any help and have been told we go to the bottom of the list. We were providing 24 hour support for my Mum anyway with him in hospital as she is blind and he cares for her. When I called and said we needed help when he went in hospital I was asked if we were going to leave her on her own. I said no we would stay with her until we could get some care. Wrong answer she is now not an emergency and no one will help she is on a list and someone will be in touch that was 6 weeks ago they said it will be 4 to 6 months.

Sad stories on this thread. Ultimately it is of course very sad when a person becomes unable to care for themselves. But, no, not all elderly people are safe at home with 4 visits a day from carers. This is where care homes take over.

My own mother's health has improved since she moved to a care home two months ago. She has had at least 3 GP appointments, which she just could not get when living at home and trying to ring and ask for a home visit. She has had her hearing aids updated. She is now able to walk maybe 20m to lunch in the lounge, when in her own home there was no straight walk of more than 2m to be had. She has had her diurectic medication adjusted so she no longer has urinary incontinence. She sleeps well because she's not scared in the night. She has 3 cooked meals a day (if she wants them) plus tea and cake and a sherry at lunch time. She sees probably 20 different people in a week and is forming relationships with them.

She would prefer to have independence, yes. But she didn't have it. She was passively asking for help all the time while living alone at home. The difference now is that help is immediately at hand.

@MajorCarolDanvers , what evidence have you for saying that life expectancy begins to drop after someone enters a care home? People who move to care homes are in any case either physically or mentally frail, or both, and if they’re already very elderly, their life expectancy is not usually going to be particularly long, anyway.

My Dm was very nearly 89, already with pretty bad dementia, when she moved to a care home. She was there until she died at 97. IMO this was testament to the excellent care she received. Despite what people often like to think, there are some very good care homes, and they’re not necessarily the most expensive, either - my DM’s certainly wasn’t.

This sums it up nicely

I work in a care home at the weekend and you get a wide range of reasons why people are there. There’s a lovely lady who has lost use of her legs who chose to move in as she didn’t want her husband to be her carer and give up everything. They self fund and he visits daily. Multiple people don’t want to be there but were “forced by family” normally due to being a falls risk. They’d rather be home but that’s been sold to pay for care fees. Forced is a strong word, pressurised by family and medical professionals that it would be for the best and then it’s too late to change your mind.

There are council funded residents but they tend to be suffering more with dementia than the self funders and aren’t as chatty.

I left my career in adult social care temporarily due to personal reasons but my last case prevented me from going back.
A piece of furniture was so important the elderly person could not return home...
I advocated as best I could. It broke my heart

That sounds heartbreaking but I suspect it wasn't really about the furniture. It can be so hard to say what is really going on even internally that silly reasons are easier to articulate.

The problem with frequent visits from carers are manifold:

1. The visits are too short. They sound like a normal visit by a human being but in reality it's virtually someone walking through your house with a face cloth and a plate of toast. They don't have time to cook nutritious, tasty meals - they're not even insured to turn the oven on and they don't have time to do it.
2. Carers can't manage difficult situations because they don't have time or the remit. Half the time they cannot even lift someone up of they fall because they're not allowed. If your relative is unwell they can notify a social worker but they cannot step up their care. They're very likely to just phone a relative if anything comes up. Which brings me to my next point.
3. If you need four or three visits a day you probably are teetering on the edge of chaos, mentally or physically. You can cope with that level of help on a good day but that level of support was probably instigated because you've had some spectacular bad days. In order to try and prevent more bad days. But they don't prevent more bad days as unfortunately older people tend to deteriorate.

4. Four flying visits a day are not enough to toilet an elderly person or meet their emotional needs. As a result, people living at home under these conditions hardly ever drink and pee as much as they need to ideally. This has a huge impact on well being and retaining function for elderly people.

1. Care packages are made with usually private companies that will regularly threaten to withdraw from the contract as care needs increase and a nursing home would be more appropriate. So any decision in a crisis where a care package is already in place is often make in the knowledge that the care package is hanging by a thread, leaving family members in line for an impossible job. That tends to focus the panic for family members and they are understandably likely to beg their relative to see reason.

Bloody hell, are you me? Exact same thing happened to me (a year younger and with a 6 month old). It was a wretched time.

My 93 yr old father just went into a care home. He had carers going in twice a day but he was having 2-3 falls a week and they couldn't lift him - I was getting the call and it was near impossible for his carer and I to get him up as dead weight. He was lucky he didn't get more badly hurt but it was only a matter of time - so many broken items of furniture and wall fittings crushed by his crashing falls. So distressing to get the call at 7am from his carer and get there and find that he'd been lying on the bathroom floor for 2 hours in the cold - he was so upset and miserable. Swearing (not my Dad). I work long hours 5 days a week and was spending both days at the weekend going to visit or rescue him.

He was confused and struggling with anxiety about managing on his own. He didn't want to have carers living with him 24/7.

Its not an easy decision. He was miserable before and he's miserable now. He wishes he would just die in his sleep and it seems like a rational view. He is healthier now - clean and well fed. He looks loads better. The staff are caring and kind but he's not made any friends - most people are there because they are losing their faculties and unable to be independent anymore. I just try to see him every week and keep him cheerful. My sisters too.

Don't judge. Its bloody awful getting old on your own. Famillies do their best. At some point an older person is now longer safe to live independently and having full time care (2 people on shifts) is expensive and doesn't work for everyone. Most families don't just put people in a home. Its bloody hard. And honestly I've not seen this sentiment on Mumsnet at all?

And I say all that as someone who used to manage a care homes group run by amazing and caring people. Who absolutely knew it was every residents' home and full of care. And an extraordinary privilege to give someone their last home on earth.

"Life expectancy begins to drop as soon as someone enters a home."

Isn't that just an example of the post hoc ergo propter hoc fallacy? People generally only go into care homes when they're already very debilitated.

My mum has been in a care facility for 12 years. My MIL was in one for nine. Neither could possibly manage at home, one due to dementia (I mentioned her being found wandering at 5am by a passing police control, before she had to go into care) and one due to a massive stroke which left her helpless, with only the use of one arm.

I don't know anyone who went into a home and died quickly. I imagine that they live longer than they would at home, because they're fed well and their health monitored by people who actually know them, rather than a parade of different carers who come into their home for a few minutes and then leave, and never really know what's normal and what's not, for them.

Stats show that people go into homes as late as possible now. The average life expectancy is 9 months. Thats not because being in a home kills them - they are at a much higher level of dependency than they were in the past. I ran a care homes group and our care assessments got higher and higher over the years. M most people avoid it for as long as possible but have many more events and episodes at home unable to cope before they go in to a care home.

Many older people get trapped in a home that is not adapted to their needs or becomes medicalised with hospital beds in living rooms, unable to get upstairs to a bathroom. Staying in your own home if its adapted for frailty may be fine but many more people stop having any facility in their unadapted home that they can no longer maintain.

There are far too few homes that are adapted for the whole life. Add dementia into the mix - and its becomes unsafe if people start wandering and being unable to connect with their home and carers.

I know too many people who have had the worst time supporting elderly parents or partners with dementia. They work so hard to care for them at massive detriment to their own health. But in the end a care home may be the only option.

Do not judge.

Many elderly people are far better off in a home.
Their worn-out relatives do not do this lightly.

Whether they are better off in a home or not is not the point. You can not put someone in a home if they have capacity without a court order.

I mean unless they agree to it.

My Mum and Dad looked after my Gran who had dementia for several years in her own home then when she needed more care they persuaded her to move into their home. My Mum looked after my Gran with Dad's help in lifting/moving her for almost 8 years. After my Dad died my Mum tried to look after my Gran alone but hurt her back trying to get her up and after struggling on for another 18 months eventually had to put her Mum into a care home. Mum went to see my Gran every single day for 2 years until my Gran died, in the end of pneumonia. My Mum still felt guilty for putting her Mum in a home. No matter what we said made no difference to Mum she just felt she'd failed her Mum. I think you are dammed if you do and dammed if you don't. No one could have tried harder than my Mum to care for her own Mother but even with me and my sister's often helping washing sheets, shopping and helping change Grans bedding etc and with carers coming morning and evening to help get her up and to bed it was just too much as the dementia got worse and Gran would shout and swear and fight against Mum and carers.

It wasn't all that long ago when the standard line on here was 'they looked after you when you were a baby and now it's your turn' it seems to me that as a society we have now done a volte-face and there is widespread acknowledgement that the two are different by orders of magnitude?

@Soothsayer1 thankfully for that, you absolutely cannot equate looking after someone who needs 24/7 care, support and supervision for what could be decades witb a parent taking their child through baby/toddler/childhood.

I know but it wasn't that long ago when uttering the words 'but they looked after you it's your turn now' to whom ever in the family was the softest touch instantly made that person feel very guilty and unable to come up with a counter argument.
Many people were railroaded into giving up their life, health sanity freedom and time to do an impossible task

I think this is a really relevant discussion.

People are living much longer and the generation before are expected to retire later and often have a family later.

Some have elderly parents who need care and young dc, all while trying to work full time.

I think it is one of the least liberating times to be a woman.

I am exonerated from caring for my poor excuse for Mother but she still has one of my sisters running after her. My Mother could live for another 20 years by which time my sister will be nearing 70.

Talking of DOLs, they never got around to this officially for my mother until she’d been in her (excellent) care home for coming up to 8 years. (It had been obvious when she moved in at 89 that her dementia was fairly advanced.)

So many years on I had a call from a SW to say that she and a psychologist (or psychiatrist, can’t remember) were going to interview her, to ensure that she did actually need to be there.

Well, good luck with that, I said - by then she was incapable of any sort of conversation and had no clue about anything. Still, boxes had to be ticked.

The SW rang me some weeks later to say that she and the psychologist were satisfied.
’Thanks for letting me know, but she died 3 weeks ago.’

I almost felt sorry for the SW on the other end, she sounded aghast. But by then, of course, my poor old DM’s death had been much more of a merciful release, than any cause for sadness.