What kind of care is available in the UK?

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My parents moved abroad many years ago. They are now in their 80s and my dad recently had a fall resulting in a brain hemorrhage. He was in hospital for 2 weeks but is at home now again. However, he needs round the clock care. He's become extremely irritable and aggressive. Refuses care or assistance. He's not meant to walk alone as another head injury might be fatal and his balance is terrible yet he insists on walking unaided.

The health care in the country they live in is very good, extremely accessible and reasonably affordable (even if private). When you need a doctor (of any speciality) you can just book an appointment and will be seen often on the same day. Also they can go to the hospital anytime and be admitted with very little waiting time involved. Diagnostic tests and their results are available immediately and on the same day.

Carers are also easily available and affordable and they've got a 24h carer. If necessary a gone nurse could be afforded as well. Further, they have got a cleaner who comes every day and could easily hire a cook.

Still, because of my dad's aggressiveness and to help with organising and decision making my sister has flown there as paid help isn't enough.

Once my sister leaves I don't know how my mum will cope unless my dad fully recovers. Ideally, I'd like them to return to the UK (as soon as he can fly) so I can help out but I don't think dh will be thrilled if they live with us. Either way we will need 24 assistance.

Sorry this is getting so late. Basically my questions are:

Are there any options for inpatient rehabilitation in your dad's country? Sounds like he needs specialist neurological rehab however finding somewhere that can deal with aggression could be tricky. Would he be able to access to a neurologist or a psychiatrist for advice on treatment?

For 24hr care in the uk you would be looking at thousands per month, the nhs has never provided that (unless you reach the savings cap) and is more stretched than ever. Perhaps the plane journey would be too much for him anyway.

Its a very tough position to be in op. It does sound like the care and help they can obtain over there will be far above what they can get here but having them so far away will be hard. Having them here will still be very hard even if close by.

It's very rare for the NHS to fund care on a long term basis but it does happen at home and in care homes. Very specific care needs criteria have to be met. NHS does not look at ability to pay or contribute.

If you contact Adult Social Care they will do an assessment of his needs and can do an assessment of your mums needs as a carer. If they assess as needing care they will assess dads means to pay/contribute to it. If dad is self funding you can seek and arrange your own care or you can ask social services who will likely charge to arrange it. Quality of care varies widely.

My mother paid about 2.5k a month for four double handed care visits a day when she was bed bound. This was pretty much for bathing in the morning and changing as doubly incontinent. Prior to this she was mobile and much more difficult to look after. My sister was her 24hr carer. I had work and kids so did what I could and my other sister was there as much as possible around work. It was still incredibly hard for all emotionally and physically. In our case we did end up fully NHS funded as her needs were deemed so complex to meet. The sleep deprivation for us was awful.

You do need to wait for ambulances and wait in A&E for many hours. If admitted you can't stay with them they way you can in other countries. My sister making hundreds of calls in an attempt to speak to someone at the GP surgery was not uncommon. Trying to transport mum to appointments before she was bed-bound was very challenging.

Even getting him to the UK would cost 10000+. If they have been away years they are unlikely to be entitled to any NHS care. Private care 24/7 at home would be tens of thousands year I imagine

When my Grandad became ill here he was expected to travel 30 miles to his cancer hospital for treatment in his mid 80’s. He always said he never wanted carers or to go into a home so his wishes were respected for as long as possible, when he was on end of life care he was in a hospice but left so he had one a few times a day for pain management.
It’s so hard to know what’s best especially in another country but sounds a lot better than the situation here.
Also have they said the fall was caused by a stroke or just a fall, as when my OH nan had a stroke she became aggressive because she had memory problems and after a few falls the last one was unfortunately fatal but was also caused by a stroke

As an expat, he won’t receive any care free on the nhs unless he has somehow been paying full tax in both the country he lives in as well as in the uk. This would be very unlikely as usually you have to pay tax in the country your a full time resident.

They would be better off hiring full time care where they live. This would probably be someone 12hrs for day shift, then someone else swap 12hrs for night shift.

OP

You are lucky if carers stay for one hour, you will not get anyone to stay for 12. And carers are only allowed to do what they have been timed to do so if they are timetabled to be with you at 7.00 am to get you up and dressed that is what will happen, you can say, "I want a lie in" but the next carer might be due to cook you lunch, they can't get you out of bed as they don't have time.

I can understand your frustration, would it be possible for your parents, well your mother, to employ someone as a kind of manager to deal with the carers?

I'm disabled, I wasn't always and it took a while for my brain to 'click' that my body didn't do what I wanted it to do, I imagine your father is going through something similar.

Would your parents even qualify for NHS? Sorry not clear from your post.

If you are looking at having private 24 hour care in the home your best bet would be to contact some care agencies in your area directly and have a chat about how it works. Ask for recommendations in your local Facebook community groups. Hospitals and LA's may have details they can pass on as well.

my dad isn't accepting the carers assistance

would he accept care if his wife & children were only ones providing it? Because it sounds like he'd highly resist that, too.

The best quality care means a regular relationship, this actually ends up working alright in care homes because most of the staff are there a lot of the time.

Are there no care homes where they live, now? Presumably your mum has lots of friends there, she needs that support network.

Hi. Thanks everyone for your inputs!! I think it might be impossible to get here the kind of care that my dad is getting now. My hope is that he will recover enough to be able to fly. And if he gets to that stage he would not need 24h supervision. My worry however is that if he falls again, which is likely, we will then have to make arrangements here. And if he doesn't get well enough to fly then both him and my mum will be stuck abroad and my mum will probably spend the last years of her life doing nothing but caring. I don't want that for her.😔

Yes, I did. Sorry, I'll reply properly later. Just to the poster who asked if it was a stroke, no it wasn't. He fell on his head, which resulted in a bleed in the brain. The doctors said that all his symptoms are quite typical and they expect the irritability and the aggression and everything else to mostly go away when the blood clot has dissolved, which will happen in 1-2 months. Initially, he made great progress and they were amazed at how quickly he was able to walk (shakily) again. However, now that has become a problem as he wants to walk 24/7 but isn't meant to without someone holding him as he keeps falling and there should be no further impact to the brain.

When my Mum had carers she was in a wheelchair and couldn’t weight bear at all so reliant on them for most things, she also had severe arthritis in her hands.
They popped in 4 times a day for around 30 minutes which was completely inadequate and we supplemented with carers we paid for and her partner helped a bit too.
Since she passed away her Partner (Alzheimer’s and stroke) gets 2 15 minute visits a day
Carers are in short supply here

It all depends on their money and citizenship/qualification for care.

If they have money they can have anything in the way of social/personal care they want, but they might not get the speed/quality of medical care they are used to.

If they want to self-fund a 24/7 live in carer they will need accommodation in their home for the carer (good sized bedroom and ideally a separate bathroom) and the cost is about £1200/week round my way I think.

Alternatively an “extra care” retirement community might suit them well, with suitable facilities and a steady stream of services available. For example Birtley Manor round my way is a lush care home with “Mews cottages” for the more independent residents (google).

If they can’t self fund then I suspect they would find life here very very hard indeed compared to their current standard of living.

Depending how long they have been expats for they may not be eligible for funded care in the UK. They will now be classed as migrants.

I have a very aggressive and assertive autocorrect🤣
I suspect that because of my job and regular posts on a breast cancer support site it is biased towards medical terms.

Absolutely not.

Care in this country is appalling. I have a friend who is a wheelchair user and has paralysis. Her carer puts her to bed wearing an adult nappy at 9pm then she basically can't do anything, eat, drink or go to the toilet until the carer comes again the next morning. So 10-12 hours of just lying flat on her back every night.

She's a young woman, she's intelligent and energetic. She wants to be out partying and enjoying nightlife. Not forcibly tucked up in bed like some 90 yr old. But the care she receives is just the absolute bare minimum.

You won't get 24/7 care unless you pay for it privately and it would cost an absolute fortune.

NHS access is based on residency not your passport held. If they permanently relocate back to the UK, they would be entitled to NHS care such as it is (means tested in most cases) but it sounds like the system is better where they are.

You would have to recruit and self fund 24 hour care, or use an agency, and there is no guarantee any nhs or social care would be free or any eligibility for benefits such as AA as he is currently non resident. If he is accepted either privately or on nhs by a consultant to oversee his health conditions there should be a route to admission but falls are assessed via A and E. Private hospitals are not always suitable for urgent care admissions.

Assistive living requires a level of independence and is no substitute for residential nursing care.

Also worth considering at this point that moving country and away from his home might make him more confused. Would your mum even want to move countries and have to get used to a new place too?

I totally sympathise OP. We have a similar issue with both my in laws - they are in South Africa. Mil is now in a dementia home there which we partly help pay for. Fil is in his 90s and starting to struggle to cope on his own, Bil lives close by to them both so sadly a lot of the stress falls on him. We do our best from
the UK, phone at least a couple of times a week and visit once a year. We give advice and help make arrangements as best we can. But yes we feel very guilty about what it’s doing to Bil’s life.

My mum's dementia home costs £1800 a week. That seemed to be pretty normal costs around here. All self - funded. It's an "outstanding" home, but not particularly smart and does not have amazing facilities.

The cost of care for the elderly or those with dementia is astonishing.

I have dealt with elderly relatives who lived abroad and needed care:
it sounds like your fathers medical care and support is great where he is but the emotional support and companionship your mother needs is missing?
is hiring a companion or support for her an option? We did this for my grandmother. We hired slightly younger fitter women from her church to bring her places, watch her TV quiz shows with her, help her with appointments and forms.
I don’t think she knew they were paid other than petrol money:

Do you parents live in a country where everyone pays health insurance? If that’s the case maybe there are able to access sending your Dad back to hospital or to a hospital. If he is so aggressive and dangerous. Your Mum should speak to her Gp. Or seem the advice of her local council.
Based on what you are saying there would be less care available in the Uk.
It will also take time to get it all established in the Uk- register with a doctor, get the ball rolling etc etc
It may help to know why country they are in.
Unfortunately if your Dad won’t accept the careers and this doesn’t change then your Mum should go to her Gp and get some help.