How common is it for old people to end up in a care home?

[Dappy777]

In general, do most old people die at home? Roughly what percentage of us, would you say, end our days in a care or nursing home?

I have a 79-year-old mother. One of my siblings lives with her and I am within walking distance. Also, my husband is a nurse, so he has experience dealing with illness, helping people get in and out of bed, etc. Can people with so much support still end up in a nursing home? If there is enough will and support can you always keep an elderly person in their own home, no matter what? My mother often says she dreads "dying in a strange bed" (as she puts it), and we want to do all we can to prevent that happening.

The priority is her well being, and if that means selling her house to pay for a nursing home, so be it. But I'd be lying if I said I didn't care about the inheritance. No one wants to lose their inheritance unless they have to. How common is it for an elderly person to have to sell their house and go into a nursing home? And who makes that decision? I mean, can a doctor or social worker intervene and insist she go into a nursing home? I suppose what I'm asking is can you usually keep a parent at home if there is enough support, or are there circumstances in which no matter how much support there is the individual simply has to go into care? And how common is that? For example, I have known people whose parents developed dementia and became violent. Presumably such people need 24 hour professional supervision.

If you have enough money you can supply the 24 hour 1:1 care at home. Most people don't.

Well it varies greatly because there are so many things that can be different from person to person.

My parents are in their late 70’s and early 80’s. They live alone and are totally independent I don’t have to do anything for them, nor does my sibling but when they do end up needing help we are all within 5 mins. DH’s grandmother was in a home at their ages, a friends parent has needed full time care since their late 60’s.

My grandmother died in her mid 80’s living alone miles away from all her children just with the odd visit, the other grandmother needed round the clock care for years until she died at 80.

Having been in care homes I would not like to put my parents in unless absolutely necessary and it is my worst nightmare to end up in one.

can a doctor or social worker intervene and insist she go into a nursing home? Can you actually imagine yourself ignoring sound medical advice?

I’m sure I read recently that only about 5% of people end up in a care or nursing home.

Can your husband not find the information you are looking for?

If family are happy to care for a loved one, I don't imagine clinicians or social workers would be champing at the bit to provide high quality state provided even if privately funded care.

My grandmother died in a nursing home after 4.5 years. She was previously cared for at home for many years but her alzheimers became too difficult to manage.

I am at the stage where friends parents are in their late 80s/early 90s. It's half and half. Those who don't go into a nursing home seem to develop an acute illness and get admitted to hospital and die there fairly quickly.

DH's grandad died, aged 92, in the armchair. He's the only one I've heard of personally to die that way.

I think it’s about 3%, it’s pretty low really. If you can all juggle care and pay for some care then they can stay at home. Obviously if sectioned due to violence due to dementia then they have to go in to a home.

I think once an elderly person living at home needs night time care, as was the case with my DF, you are looking at a care home. LAs can provide four care visits a day but not at night. If you can afford live-in carers your loved one can probably live at home but that’s incredibly expensive and usually more so than a care home.

When the morning carers arrived to find DF, who has dementia, on the floor we realised it was time for residential care.

We are selling DF’s house to pay for his care and it is under offer. You can get a deferred payment arrangement with the LA.

If you have POA and your loved one does NOT have capacity to decide and they need care you can decide.

In terms of the stats I’m not sure how many are fortunate to stay at home…. but I’m grateful for DF’s care over the last year. He is now in the last few weeks of his life and palliative.

It really depends on their needs, whether their home is suitable and whether home care is sufficient. Out of my four GPs, three ended up in a nursing home nearby. Two had dementia and one had Parkinson's and a stroke. They could not be cared for at home, nor manage the upkeep of their home/garden - they needed 24/7 care and that was when they went into a nursing home. We probably all want to live at home and then die suddenly while still at home, but IME this is unfortunately quite rare.

Depends a bit. Dementia is almost impossible to handle at home, unless you can literally afford multiple carers round the clock. Otherwise I think the only reason family wouldn’t be allowed to carry on if they wanted to would be if it became clear the carers were not doing a good job of caring — ie abuse, neglect etc. That would lead to a formal process.

This information surely is somewhere in ONS. I only found this www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/socialcare/datasets/carehomesandestimatingtheselffundingpopulationengland

I don’t think it’s a given, if you’re determined to keep her in her house you can. You just don’t know what’s coming down the line.

As you said dementia tends to throw a spanner in the works.

My father became quite aggressive, wouldn’t allow us to bathe him, wouldn’t eat or drink, and became doubly incontinent in the later stages of his dementia - it would have been nearly impossible to keep him at home, although we kept him there as long as possible.

In the end he didn’t know where he was anyway, so was no such thing as a ‘strange bed’.

Even when he was still at home he would wander around the house, demanding to ‘go home’ wherever that was in his head.

Eventually he was admitted to hospital after an infection, and they recommended not sending him home - but my mother had the final say, they wouldn’t have forced us to put him into care. Quite honestly we were relieved, as we were so broken by it all.

In the end he lasted less than a year in the nursing home, and yes it was expensive, but my mum still kept her home thankfully.
I wouldn’t wish it on anyone.

All you can do isyour best for your mother and for yourself.

With enough support you can keep her home, but don’t underestimate the toll it can take caring for someone full time.

can a doctor or social worker intervene and insist she go into a nursing home?

I don't think you're alone in wanting to protect an inheritance op. Anyone that says otherwise is telling fibs.

But can you not imagine a situation where despite everyone's hardest effort, it is NO LONGER SAFE for her to stay at home? You've obviously never had to manage the ever-increasing care, emotional and financial needs of an elderly relative. Is your DH going to want to give up his nursing job to care for your mum (for a pittance)? Are you all happy to provide 24/7/365 round the clock care for someone who may not recognise you or your efforts, or who could become abusive and violent?

If it is deemed unsafe for your mum to remain at home, yes, she can be placed in care, and the cost will be recovered if she has assets.

I find this a sad comment re care homes as you're tarring them all with the same brush. Some are not so great but others are really good. I think overall standards are improving.

I don't know anyone who has gone into a care home. We're in the UK but Asian and most families have older family members come to live with them when they are elderly, even if they need a high level of care. My grandmother lived with us after she became frail following a stroke. She had dementia and was tube-fed and doubly incontinent. We had council carers visit 3 times a day to lift/turn/change her. She lived with us until she needed to go to hospital one day and then died there. One of my grandad's lived in with an uncle and his family, and my other grandad lived with an aunt and her family, all until they died, and they all had some kind of cancer and needed ft care towards the end, provided mostly by family. My other grandma died relatively young, under 70, in a fall but she was fit and healthy.

I remember once watching a documentary about retirement villages and they said the vast majority of elderly people get sick and die within a short period of time e.g. months. Very small percentage require a nursing home.

Thinking of elderly couples I've known. I would say approximately 50% have ended up in a care/nursing home, the rest have died in hospital/hospice/home.

My uncle had to go to a care home. Family couldn't cope with him at home, as much as they tried and it just wasn't viable to get carers around the clock. House had to be sold. Care ranged from 1800 a week for a residential to 3000 per week in a nursing dementia home.

It really is a small %, and the trend over time is it is decreasing rather than increasing.
I believe it is about 2.5% of those people who have reached pension age, only rising to something like 10% of people over 85. Keeping in mind many of us die before we are 85, it is statistically unlikely most of us will end up in a care home.
Of those who do, it will often be for months rather than years, at the end of our lives.

I guess there were people at home to support in between care visits? My mum went into her care home for the last year of her life. She’d been at home battling dementia and I’d arranged care visits but it was becoming impossible to manage outside of those visits due to putting herself in risky situations, falls and continence. She lived alone and I was her only child. I contemplated bringing her to live with us but we both work so it wouldn’t actually solve the problem, and that’s ignoring the fact that there would be no space.

The care home was brilliant with her to be fair, we saw her several times a week, it just cost a fortune.

My dad was discharged from hospital under nhs continuing care, to be cared for at home. He could have gone into a nursing home or remained in hospital. His care was nhs funded due to what was needed. In the event he died the day after he came home, as was probably his plan. He wanted to die at home and the nhs enabled that to happen. Most people in his position would die in hospital though.

The number one reason for people to need care in a nursing home is a dementia diagnosis.

If your mum is just getting older and more frail and has physical impairments, you could very well look after her at home until she dies.

It's when people lose the ability to reason, and start wandering at night, and cannot feed themselves, and are incontinent, that it becomes impossible for home care to be feasible, unless you're able to pay for 24 hour care, which is eye-wateringly expensive. Dementia causes all these outcomes and more besides.

It was the falling, especially if it was as relative tried to get to the toilet, that did us in...relative was at home for many years prior. Much cleaner and better looked after in a home.

It's not always best for someone to stay at home and we were all struggling hugely with care needs for someone who insisted they were fine.

It's not always best for someone to stay at home and we were all struggling hugely with care needs for someone who insisted they were fine.

This is very, very true.
Caring for someone generally becomes an intolerable burden.
Middle-aged women, and women in their 60s are suffering and their own health is deteriorating, due to caring for their own elderly relatives.

It's not just the physical care. It's all the organising, the appointments, the medication, the endless phone calls. The burden becomes too great.

My mam died at home aged 98. We were lucky that we are a big family and most of the older ones were retired by the time she needed full time care, so we were able to take it in turns to stay with her 24/7. Having said that, if necessary I would have moved her into my home if the alternative was a nursing hone. She was fully compos mentis though, if she had had dementia I think a nursing home would probably have been necessary. Not every family will be in a position to care for their elderly parents at home, but if its possible its the best option imo.

My aunt felt like you and insisted on moving in with my grandmother against medical advice after she was released from hospital. I think her motives were partially duty based (she genuinely hated the idea of my grandmother in a home) but also mainly financial (she had her eye on the inheritance). She lasted about 36 hours before she dialled 999 at 4am and told the call handler that if she didn’t send an ambulance immediately to get my gran then she was going to kill her. (Aunt was normally a stalwart of the church choir rather than a budding murderer.)

The thing is though - my grandmother was a working class girl who nearly starved to death as a child in the depression and yet managed to win a scholarship to Cambridge. She deserved more dignity than all her family knowing that she smeared poo all over the wall. Had she been moved into a home when the doctors advised then we would never have known. (The home referred to “some continence issues” which felt a far nicer way of putting it.)

Even 15 years later I am actually quite furious with my aunt for her choices.

I has a similar situation. My DM wouldn’t let the carers in and then she was violent to one so they refused to come any more. My sibling and I managed for another couple of years but it became impossible to keep her at home. My sibling wanted her to live with them but it became apparent it was impossible to keep her safe. My sibling has to sleep at some point and my DM could potentially wander off, fall, set fire to the house etc etc.

There were so many incidences at home, many involved the emergency services, trips to hospitals, blood everywhere where she’d smashed up the house. I wanted her to move to a home about two years before my sibling did. In the end the decision was taken out of our hands and social services and the medical profession made the decision for us.

I had no life for a number of years, it affected my DC, I didn’t realise how ill my DF was and he died during this time. I wouldn’t wish caring for someone with advanced Alzheimer’s on my worst enemy.

She is in a nursing home now with a very high staff to resident ratio but she still needs one to one care at night.

She was like a skeleton at home, it was impossible to wash her and even get out of the bed to change the bedding during the last month of living at home. When she went into the home she put on two stone and was clean. The staff have extra medication for her for when she kicks off so no one has to endure her violence.