To wish my mym would properly consider care home for ailing Grandma

[hippohead]

My Granny is 94. She lives alone and until quite recently has been very independent. She has dementia (properly diagnosed) which is becoming worse and she is becoming more and more withdrawn. She is still herself- warm, optimistic, uncomplaining, kind and fiercely independent but sort of fading mentally. She has no awareness of time, forgets things from one hour to the next and is loosing the capacity to do more and more simple tasks e.g. make a cup of tea.

She sits all day in her kitchen, or lies on her bed. She no longer likes to have the TV or radio on. We take her out regularly or have her over to Mums or ours to eat. She enjoys this in small doses.

She needs a lot of help, but does not like being encouraged to do anything, e.g. left to her own devices she would not wash, take medication or eat but hates being 'encouraged' to do these things. She constantly insists she "will do it later" but its clear that she won't, so we have to gently insist but its a real battle. I think she feels we are taking her independence away, which we are sadly- but she really needs this help.

We (Mum, I and a few weekly visits from carers) visit her at least three times a day to help her get washed, dressed and eat. She hardly eats anything and has lost huge amounts of weight. She has seen a dietician who recommended giving her whatever she wants, whenever she wants it, which we do (carrot soup for breakfast yesterday). She also has some special calorie laden drinks which she will sometimes have.

She had a fall in the night. Luckily she is fine. She cannot remember what happened. She wears a redcare necklace which, once pressed calls an switchboard which calls us and send an ambulance. She didn't think to press the button so had been there for some time.

Anyhow, to cut to the point I feel we should consider moving her to a care home. My mum will not consider it. She becomes furious whenever I suggest it. Mum feels its a selfish option and that Granny should remain at home whatever. I want Granny to be safe and well looked after, and I am also concerned that the strain of caring for her is driving my Mum close to the edge (Mum's partner agrees that she is constantly very very stressed and emotional).

I suggested we discuss it again this morning but Mum lost it with me. She also said that if in the future I decided to move her (Mum)out of her own home to a 'prison' of a care home she would never speak to me again.

I feel that part of this Mum is projecting her own feelings about herself being moved from her own home in the future. A horrible thought for a woman who loves her home and is in good health with full mental capacity. But Granny is not that woman- I feel its time to give this some thought.

We could still visit her several times a day, take her out etc..

Sorry its so long- AIBU?

I think you have to bow to your mum's superior rank on this one. It's her mother. You're not the one looking after her, your mum seems to be overseeing her mother's care, so I think you should support your mother instead of fighting her.

Lots of old people would rather take a few risks in their own home than go into residential homes.

Woops- sorry for the typo in the subject. Mum not Mym!!

Thank for your point VS. I am actually doing a lot of the caring, though not as much as Mum.

She is in charge of the situation though. I am trying to support her and I am very worried about her. Must try harder I guess....

Yes, I agree, you have to let her decied, if she wants to care for here the way she is now you have to let her. I was in this situation a few years ago and I could see how it was affecting my Mum. To cut a long story short she was moved into a care home, what helped was my Mum and other family members visiting a few care homes to see what they were like, and she was reluctantly pleased at how nice the facilities and staff were, it was a BUPA one and very fancy. And when my Gran went in she really enjoyed it. You just have to sit back and be supportive and see how things pan out. Hard but the best plan.

It's not a question of 'must try harder' it's a case of stepping back and trying to see the situation from a another point of view. If you can't cope/are unable to with your share of the care you need to tell your Mum that. It's hard work looking after an elderely realtive, I used to dread it. It is a very hard situation but whatever you do please talk to your Mum.

Mum just called me and I tried to talk to her. I really tried to be supportive but she said I was lecturing her and talking to her like a child. I am gutted that I came across like that, I was trying to be helpful and listen to her.

Mum feels maybe Granny is "shutting down" and that wher refusal to eat is because she wants to fade away. She suggested that fading away is preferable to being drip fed in a hospital. I see her point, but that's not her decision to make surely?

She said she doesn't want to talk to me anymore because of the way I was speaking to her. She was screaming at me so I'm not sure an argument about who talks to who in what way was fair, but I guess she is really really upset.

She doesn't have to be drip fed in hospital, it's not all or nothing..

Keep talking to your mum, gently. Tell her she's too close and you do understand, but Granny fell and was not able to summons help.

That's a deal breaker.

LittleMisshissyfit - you are right now I think about it. Its not that black and white.

So tricky.

If I were you I would assure your Mum that you would do nothing without her full agreement, and that you are only worried about her (your mum), and about Granny falling over and suffering alone because she can't call for help.

Would it be possible to suggest Respite Care - a week or two in a nice Home, where Granny would be looked after, fed, have her hair done, - some care homes are like a 5 star hotel! This might be a way of giving you and your Mum a break and you might find Granny flourishes in that kind of atmosphere which would remove any guilt your Mum feels.

Depends on the finances of course.

No such thing as superior rank when it comes to the care of an elderly lady who is fast becoming unable to look after herself safely.

It is not just your mothers decision to make. The needs of your gran have to come before anyone elses wants and feelings.

IMO a multi disiplinary meeting would be beneficial to assess and look at implementing a care plan tailored to your gran.

I think also that instead of butting heads with your Mum you should be as supportive as possible in her choice.

Your mum may know this, but if you move an elderly, confused person out of their familiar surroundings, they are likely to become far more confused.

I do have a lot of sympathy with you (and your mum), but I think that's important to know.

OP I think if you are helping your grandmother and are able to be objective you have as much right as anyone to be concerned. It is not just your mother's decision. Also if your grandmother needs another 5-10 years of care (which you'd be suprised even when someone seems very frail DOES happen)you have that plus the eventual possibilty of looking after your own mother.

I do think when possible people should care for their family members. But that is only when they can provide the best care, which doesn't sound like you are both able to provide (that isn't meant as a critisizim by the way!)

Maybe start doing some independant research in to facilities near you, when you find something right that your family can afford or that will be provided by the state, speak to your mother then.

Mumonthenet- It would be possible for a short time but not sure whether it we could stretch the 'five star' option permanently. Its a good idea though and something I could suggest to Mum when she has calmed down. Although Little RedPumpkins point is a good one and maybe it would make matters worse.

Geek- I totally agree but its hard to seperate Grannys 'needs' i.e. a lot of care, from her 'wants' i.e. for us to stop interfering and nagging her to eat etc.

ForMash, I find it hard to support her totally because I wish she would at least consider alternative options.

LittleRedPunpkin - I think Mum is really worried about this and its a valid reason for Granny to stay put. I just feel its not safe for her to be alone for much longer.

I really appreciate everyones input, especially this type of situation is not a nice thing contemplate. I realise there is no easy answer but its so helpful to read the opinions of other people.

Does your Mum have alternative carer ideas ie care in the home, comfort care some one like that?
We are going through this in our home also and it is sad and frustrating and very stressful and your Mum is trying to do what she feel is right for her Mum while you are trying to do what is right for your Mum.
Does your Grandmother have respite? even 1 week in a nice care home to give the carers a break every 6 weeks?
We have made the decision to be tough and hire a 2 adult carer au pairs. My Grandmother is adamant she wants to be in her home not a care home as is her right so this is the best alternative/compromise. There are options out there other then care homes, they do cost but could they be considered?

Hippo both myself and my mother have been diagnosed with carers fatigue in the last few weeks [it is a recognised condition even though I laughed at the Dr]
We did not have until now a care plan can your District Nurse arrange one for your Grandmother? TBH We only got one when my Grandmother fell at 2 am and I was phoned to go down I refused to move her and called an ambulance but as on 3 occasions found my other Grandmother on the floor after a fall or stroke I have become very cold towards the help me put me to bed plea I just call the professionals now but it did cause loads of rows with my Mum and Aunt, still if they want me to help with the care it will be done according to my abilities and tbh my Grandmother is always happy to see the ambulance persons, uniforms make her feel safe.

Canyou, sorry to hear you are going through the same thing. Its a difficult situation.

We have some help from carers provided by social services, which we pay for. They are brilliant but are often unable to get Granny to do things e.g. take medication, get dressed because they can only 'encourage'.

I have never heard of carer au-pairs. I will look into this. To be honest I am unsure of what kind of budget we have, Mum is in control of Granny's finances and Mum has an income from which she currently pays for Granny's care but its worth a thought.

My grandma always said she didn't want to be put in a care home. After a number of years looking after her, my mum just couldn't cope any more and she put her into a supposedly very good one nearby where she could visit every day. My grandma was utterly miserable and about 18 months after moving in she developed a UTI. The care home utterly failed to realise the significance of it and she died, in hospital, a few days later.

My mum has always felt incredibly guilty for putting her into the home, but I don't know what other option there was really. Not sure of the point of this, other than to say that it has to be your mum's decision as primary carer as to whether she can cope or not, because she will be the one who has to live with the decision for the rest of her life.

have you thought about contacting your local area Age concern ? they are very knowledgable about what is available in regards to help .It doesnt sound as though your grandmother has reached the nursing care home stage just yet ,so i think im right in saying she would be liable for all costs , around £800 a week . I think as others have said that there are other options that might be better at present .
As far as your mum is concerned ,how about writing her letter ?

Hippo they are not much more expensive then an Childrens au-pair but tbh we sold a 'family holiday home' and that will finance the cost but yes my Mum did look at selling her home to finance it at one point as she will inherit my Grandmothers home, The au-pair is only a supplement to the care we already have

Hippohead - I agree with those few saying that your Mum doesn't get to 'pull rank' on this. The only thing that matters is, what's best for your Granny. How to decide that is another matter. There are benefits (to her) of both keeping her at home and of moving her to a great 'care home'.

Finding a 'great' care home is a big challenge though :(

In your situation, I would stop trying to discuss it with your Mum for the minute. I would go to all of the care homes (even ask on here if anyone knows a good one local to your postcode) and see what the options are. See if any of them will consider doing a 'respite' week, to give you all 'a taste' of what it would be like. Then if you find one you think is great and they can do a respite week, then go and talk to your Mum, in person & make her at least listen to what you have to say and how you feel. In the end, one of you may come to understand the other one enough to accept it's the best for Granny, for now, anyway.

I can understand both your point of view and your Mums :(

AGE CONCERN! Of course!, great call! and Social Services too!

Does your Gran have the faculties to take part in the decision herself? Could you get your mum to agree to take her to visit a decent local home (or go for respite care there) so your Gran can see what she thinks? It might be a whole lot nicer than she imagines.

My grandma made the call herself after falling at home in the night (she left her call button hanging on the bedstead when she went to the loo) and getting stuck for 8 hours until her daughter got worried when she didn't call her to check-in in the morning. She was so frightened after that she decided herself she couldn't live alone any more. She had no dementia though, she was sharp as a pin until she was 100!

I agree that forcing her into a home could be damaging, but a good home (especially a residential home as opposed to a nursing home) could help her to keep a bit of independence. I would imagine losing the ability to do your usual things in your own home could be pretty psychologically difficult too. She might feel more capable with a little support.

Hi, I work as a care assistant in a care home.

We have a great selection of staff and all 60 of our residents have dementia. The problem with this is that when they come in, we quickly see them go downhill. It's not the care home itself, but a mixture of staff to service users ratio and the abuse rules. We would not be able to feed her if she refuses.

The thing with dementia is you can get a lady who has been placid all of her life turn into someone who is violent and swearing constantly. I often walk in and break up arguments between residents and often get abuse myself.

At nights you have many wanderers or people calling out which wakes the other residents up. This sends them downhill faster.

Residents go in other rooms stealing things etc.

"There is however a huge difference between the residents who get visitors and those who dont. (you would be surprised how many do not because the families can't cope seeing them)"

I feel care homes, whilst neccessary, should be the last resort. If you do chose one, aim for a small unit where staff to resident ratio is high. Check how many night staff work as there are only 3 a night at my place and thats when there are the most falls.

I have also worked as a home carer for dementia patients and I understand that this is just as hard aswell.

I do not want to turn you off the idea and with research you could find a great one. But, I can completely understand your mums concerns.