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.

Can the doctors intervene? Absolutely. If the person themselves have mental capacity to make the decision, they do. If they don’t have mental capacity, it’s the consultant and social worker who make the decision in their best interests. If a relative has Power of Attorney, the relative makes the decision in the person’s best interests.

My Dad was cared by my mum 24/7 aside from the last 3 days in a hospice. My mum was cared 24/7 by my sister for 3 weeks before she passed. Exhausting for the carers, and we were fortunate it was possible.

Do the care yourselves

Out of my four grandparents one was in a care home. Out of DH and mine combined parents, 1 out of five (including a step parent here) went into a care home.

@PermanentTemporary sending you ❤️

Would your DH be happy to change an incontinent MIL day in day out to avoid paying for a care home?
No one has an inheritance - until the person has actually died. Your DM might have left everything to the cats home!

Ending up in one means literally no proper care at all.

Yes I don’t mean it like that I mean more that it scares me because there is no getting better or leaving them, and there is really no escaping that fact. It was so sad going to visit DH’s grandmother and seeing her friends pass away one by one then eventually her. I wouldn’t easily send my parents to one or go to one myself.

I don't think it's a large proportion of people who end up in care homes. Noone in my family ever has, but then noone in my family has had dementia, nor do my family tend to be long lived. 3 out of my 4 grandparents died quite suddenly and the remaining one had cancer that killed her before retirement age. Only one of my grandparents lived to retirement age.

If she is sound of mind and doesn’t want to go into a home nobody can make her.
If she needs 24/7 care you’d have to be prepared to either pay for it (it is possible to have a nurse overnight). Or you’d have to do it/ part of it yourself.

Of my six grandparents (I had step grandparents I counted as grandparents) only one went into care, for close to a decade (they had dementia but lived until their late 90s regardless).

I'm an older adult mental health nurse. A lot of people with dementia will end up in a care home. In late stage dementia, the person will be unable to walk or feed themselves, but most die before that point. As for others, it really depends on the risk. Some people with dementia are quite content and will watch TV all day. Others will be distressed, aggressive, and engaging in things that put them at risk. It is not good for anyone with dementia to move home, but the move is often about the carer and their ability to cope.

As someone who goes into care homes regularly, there are very few good ones, particularly if you have dementia. Trust me when I say there is some very poor practice in care homes. From my experience, most care home residents have complex needs (either physical or mental). It's part of some big NHS studies/guidelines that we should support people to live and die at home as much as we can.

Social services cannot make you go in a care home unless you lack capacity. Even if you were falling a lot at home and you were unsafe in that regard, if you could weigh up those risks enough to make an informed decision, you can't be forced into care. If you lack capacity, social services can choose to put you into care, and the decision will be made with family/power of attorney involvement. Social care can however override POA if you're not acting in someone's best interests.

My dad is 81 and thankfully in good health and still going on 4 holidays a year with no care needs. My mum is 12 years younger and doing well.

Will all people with dementia eventually need nursing care? My aunt has 4 x visit and is not mobile she is frail and not violent but lonely . SW got a quote for nursing care from a home she was interested in, is that because she will need it?

it’s dementia in our family that has led to care homes

Out of the elderly people in my family that I am/was close to, only one of 6 died at home. My grandmother, who oddly had lived with a life threatening degenerative illness for many years so objectively was in far worse health than all the others. We nearly lost her so many times in hospital but in the end she passed in her sleep at home.

Her husband, my Grandad passed in hospital from advanced cancer. Other set of Grandparents both went into a nursing home. Her for vascular dementia and then a major stroke, him due to heart and lung disease. Aunt in a care home with Alzheimers until she passed last month. Uncle (other side of the family) in hospital from COPD.

I would fight tooth and nail to avoid my immediate family going anywhere near a care home. Having had recent experiences with visiting an elderly aunt, and an elderly neighbour in a care home, on several occasions, they are awful places run by people who are clearly money focussed, and who employ uneducated, unskilled people who are there because there’s nothing else for them, rather than having a want to care for people.

I have a relative who has been jn a dementia care home for nine years. I have LPA and I can't even guess how many times Ive had calls to say she is close to death and then she rallies again. I find it hard to see her, she is a skeleton with skin, she hasn't known who I am for years, she is unable to walk, doubly incontinent. I can't imagine how long this can go on.

Yes, they'll end up needing to be fed, washed, dressed, and changed because of incontinence.

Some people die of something else before the dementia gets to this stage, though.

My MIL had to go into a care home because she was getting dangerous from her dementia. Wandering off, getting on buses and getting lost, cooking things in the oven that shouldn’t be cooked etc. We found a really lovely one, and she lived several years there. She’d been given three years to live before she moved in, but she put weight on and thrived. Pretty much all her money and house went on paying for it.
Ive recently moved my mother into our house. She’d wanted to stay in her house, a mile away, but I’d been doing all her care there, with one visit a day from carers, and I was exhausted plus she kept falling. She was pretty much bed bound anyway. We created a lovely little “wing” in our house for her with bedroom, wet room and kitchenette. It’s much easier for me. But still very tying and hard work. I set my alarm for 3am to take her to the loo because she kept falling going on her own.

@PermanentTemporary

thinking of you. I was in your position this time last week.

Just to say social workers cannot override POA they would need to refer to court of protection

They can raise a safeguarding concern but they cannot make a decision that is a social care one.

If there is a crisis whereby the elderly person ends up in hospital, that can trigger SS involvement, whereby they won't simply be sent back home. It happened to a friend of mine last year - her GP did a home visit on hearing she was housebound, and promptly called an ambulance. She died in hospital a month later. For much of that time she hadn't been receiving medical treatment (beyond tablets), but until a care package could be arranged, she couldn't go home. She didn't have any cognitive impairment, but was bed bound, so a care package at home would have been sufficient.

Why, they seem ok to me, the ones I've been in.

Apologies if I am repeating anybody.

I think you have said that your mum is 79 years of age and your sibling lives with her. A property should be disregarded for care fee assessment if a relative age 60+ lives there so that might become relevant at some point.

Google "property disregard for care fees"

There are a million different ways that things could play out for your MIL. Some of them will end with her needing a level of care that requires residential / nursing care. But statistically not very many of them.

Incontinence and needing someone else to deal with toileting is often a red line. So is dangerous behaviour - wandering and getting lost, turning the gas on, boiling water etc. So is carer breakdown - when the person who’s doing the most simply cannot do it any more..

This hasn’t been my experience, my DM is in a nursing home, there are 22 residents, with 10 or 11 residents on each floor and nearly as many staff. The staff are the kindest and most caring people I have ever met. They have got to know my DM so well despite her very challenging behaviour.