Care home "rules"

[Yupthatsit]

One of my relatives is beginning to realise she needs to move into a care home. She's in her mid 80s and she's great mentally but looking after her house is too much for her, she's tired now and she needs more care. She has said she's ok with going into a care home but has refused if she can't go for a walk daily and can't get an occasional online shop delivered (she's dreading the food but knows she'll only be able to get salads and snack things delivered - things that don't need cooking).

We've spoken to two care homes so far who have said these things wouldn't be possible. They allow walks with family members/visitors but not alone and she won't get visitors daily to do this. She only wants to go for a very slow walk for about an hour and she's capable of this if she goes slowly with her walker. She does it daily at the moment. They don't allow online shops. There are other homes we haven't spoken to yet but they'd be a bit further away to visit which makes things a bit more complicated.

I've not had anyone in a home before so I don't know if these requests are reasonable/unreasonable? Any thoughts or experiences welcome.

It sounds like sheltered housing might work better for her. It's more like a small community of individual units with staff who check in on and help residents with things, rather than full-time care. Sometimes they have communal spaces too for socialising and organised events.

Good to know

Care home I have worked in allows walking out. Some even have cars. Residents do get deliveries. Think a food shop might be a bit awkward. Not for the delivery itself. More for where to store it. But then some rooms are extra large (you pay extra). Just not sure if they would allow an own fridge. But I don’t see why not except potential fire risk?

My mum is in an extra care sheltered accommodation flat. They have carers on site so her needs are covered. She pays for a cleaner who does most of the flats and there is a hairdresser there once a week. There's a communal lounge and a lovely garden. No restrictions at all. Plus there are lots of activities if you want to take part but no pressure if you don't. Mum rents hers and it's very reasonable

@Yupthatsit

if she could manage longer at home with extra support I would try that. My grandmother went downhill rapidly when she went into a home, and to be brutally honest sitting in a lounge full of people with varying stages of dementia wasn’t a whole heap of fun.
As well as carers in the home you could look out for any lunch or social clubs which could give her that bit of company she needs.
Also see if you have any Good Neighbour schemes in your area. I visit someone who is mostly housebound once a week for a cup of tea and a natter. If he’s feeling up to it I’ll go for a walk with him. We’ve become quite good friends- my commitment is once a week but I pop in on other occassions like Christmas and Easter, send a postcard from holidays, text him during the football - just small things which take very little of my time but helps him feel not so isolated

Sheltered accommodation with separate apartments and communal rooms would suit her much better than a care home. I work in this environment and patients in care homes are usually very limited with mobility and wouldn't necessarily provide much social interaction, where as the first option is very sociable and they often have games night, afternoon tea, people come in for bingo, they are free to go outdoors and be independent.
People going into care homes can decondition very quickly, I wouldn't recommend this if she is healthy.

I think she probably isn’t aware of her options ..

I agree with others she doesn’t sound ready .

most have mobility issues . Sheltered housing , moving more urban may well help .. lots more options in terms of clubs , support .

she also needs to be aware maybe get her to visit a few care homes . Lots are very high care needs - due to funding changes many don’t go into care homes till needs are much higher .

yupthatisit , you want to be looking for something like this www.compleatcare.co.uk/residential/tannery-lane-apartments/, its apartments next to a residential home , so they can have their meals in the main home , join in the activities etc etc , but have their independence as well .

That kind of place must be rare but I agree it would suit.

I think sheltered accom would be better suited to her needs. They are usually small complexes so will have the opportunity to be social. The one where I used to live had a communal lounge where they'd hold bingo, card nights etc or just sit with others watching TV.

I think there are different types of homes..residential and nursing. My mums friend went into a home for similar reasons are your relative is considering. Shes been so disappointed to discover 90% of the residents have quite advanced dementia and a high num er sleep all day so not really company. Anotherady i know is more able and she goes out most days but only with visitors- not allowed out alone.

@yupthatisit , just seen she is in Lincolnshire- so is the place I just linked to , sunny south Lincs , in a small village , where you can even get s bus to pick up from the residential home and drop off in Bourne/Grantham.

I've probably over egged her abilities. Her mobility is poor, she uses a walker and her walks are incredibly slow and she goes from bench to bench for a rest. She can't do any housework or cooking anymore as it's too much.
I'll look into some other options. Thank you. It's early days for thinking things through.

I was going to suggest this. My grandfather lives in one and although he can't get out now (he's 95...), up until now he's always gone out for a walk or pottered to the shops. They have communal activities which he doesn't join in with because he's a misanthrope but they're available and someone also checks on him a couple of times a day. When he had a fall recently, they came very quickly and sorted ambulances and the like.

My dad moved into an assisted living flat (McCarthy Stone) at 89 when he was still pretty independent and could go out on his own and do his own cooking etc. It was the best move for him and as his needs increased, more care was brought in. He could have lunch every day if he wished and he enjoyed the communal sitting room and the activities provided.

I have mixed feelings about McCarthy Stone as it took us 18 months to sell his flat after he died and we were still responsible for the maintenance fees but as a model of care it is pretty perfect for those who are not quite ready for a care home. As others have said, many homes are now full of very frail, elderly people which might not be the best company for your relative. And they are also ruinously expensive!

There are intermediate level places where you have your own small flat with kitchen but also have a shared recreational area, onsite restaurant, building manager etc, you can rent or buy usually

You can get, from lowest to highest need:

Sheltered Accommodation, which is individual flat, with bedroom, kitchen, living room etc. No carers on site, just a warden. There will be a communal lounge or two.

Extra Care, which is individual flat, with bedroom, kitchen, living room etc. There will be care staff on site 24/7. People will have care needs but lower level. There will be communal lounges/dining.

Care Homes (either Residential only or Nursing) Nursing has a nurse on site 24/7. Both have 24/7 care staff on site. You only get a room probably with a toilet and sink too. There will be communal lounges/dining.

If going for option 3 I would urge you to look into any of the more unique offerings locally. If she saw what most were like she'd probably be horrified.

Im assuming she doesnt need help with personal care at present? Toileting/bathing?

Find the right home for her.
if she’s fully mentally ok then they can’t stop her going for a walk alone and should be supporting her to maintain that sort of thing - possibly with a sign in / out board or what ever do if there is a fire alarm thru know where she is.

ditto food deliveries / fridge in room etc.

this is her home. It works for her or it’s not right. I’ve had 3/4 parents / in lawx in care homes and they’ve worked well. I’ve also working in / with homes which have been good. Including a superficially a bit “ under par “ e tiredly council funded one where the food may have been school dinners but even the guy with the alcohol issues was allowed to go buy his beer and drink it ! ( if he came back with vodka as “ a treat “ they keep the bottle and gave it when he asked - never an issue , just
so he was prevented from necking the lot) that’s proper care and respect imho.

Unfortunately care homes dont have enough staff to accommodate supervised 1hour walk (20min in local are maybe, depending of the care home)
Is it possible for her to fund the care home and paid for 1 hour visit of additional carer??

Also some bigger developments have self contained flats but also a nursing wing where you can move to if the need arises. The facilities near me are right in the town centre so would be ideal, we can't be the only town like this!

@ToniGreen

Most homes cater to people with at least some degree of memory loss these days, they are locked in for good reason, a full care home is not the right setting for people who want to prepare themselves food or go for a walk

My dad was in a Signature care home. Several residents regularly went walking and as pp said some even had cars. This sounds like the sort of place she would like. He had a fridge and his own kettle in his room. The food was actually very nice there imo. There are some companies who ,(for a price) do the research for you if you give them a list of your requirements they will find care homes that meets those. My dad was adamant he had to have sky TV in his room for the football so that was number one on our list. Dad had become quite disabled so we needed a walk-in shower so that was another requirement of ours. I think she will be able to find what she wants. But it is expensive. She might want to look at getting a care home annuity to fund it then there are no worries about the money running out.

You can only lock a resident in if they have a Dols assessment by the social workers. Anyone else is free to leave. I agree that most care homes now are full of people with some memory loss however some are more at the lower end of the needs spectrum and this is where the OP should look. It sounds like OPs relative isnt wanting to prepare food so seems pointless having a full on kitchen unless family are visiting every day.

Some care homes are really nice but they are the exception.

Oh and sorry OP, I meant to say have a look on CQC website for official inspections.

Would you be better off looking at supported living rather than a care home? My gran had what was essentially a ground floor flat, there were staff and a communal lounge/bar area, the flats were all accessible and carers could come in when you needed them, they had the red pull cords and a laundry service if you wanted to use it. She used to get on the bus once a week (London) with a friend from across the hall and get a sneaky milkshake or ice cream or cake in a café! We told her she was an adult and it didn't have to be sneaky but she thought it was fun, they could go out whenever they pleased, it had lovely gardens and she was there until she died. They used to do things like quiz nights , films etc in the communal lounge area too and there was a knit and natter group but my gran said they were terrible gossips 😂 (so was she)

Oh it also had a small kitchen but she would largely get prepared food from m&S my mum would shop for her once a week, others had the meals delivered for older people I can't remember the name , but having her own kitchenette meant she could make tea, toast, breakfast etc