Nursing homes for elderly people with dementia. A good thread derailed; can we try again please?

[OCSockOrphanage]

I know there were some people adamantly opposed to the idea that they might ever need to place their parents in care. but this was, I felt, a useful thread for all of us wrestling with the decision. Any takers for its continuation?

I work in a nursing home for people with dementia.

In a care home your relatives are given three meals a day, clean clothing, any incontinence issues are quickly dealt with, their meds are all taken care of and they have company all of the time.

In emergencies there's people to hand and generally we'd have more luck getting GP visits sorted (round here getting a GP appointment is a total ball-ache).

My mum and her siblings refused to let my granny go into a care home. She had dementia, was alone, taking her meds at weird times, wandered the streets, didn't eat properly and lost concept of day and night (which is common).

She'd have been happier in a care home, she loved company and her last few years were lonely and miserable.

DMiL, with rapidly advancing vascular dementia, doesn't need a home, yet. She can afford to pay carers to stay in her own home for now, but when her care requires 24 hour care (and it will) surely the value of her house should be used for her care rather than to pay an inheritance dividend? Not that we wouldn't welcome the legacy; but we would rather her money kept her safe and comfortable for her natural lifespan.

I have a grandparent with dementia in a care home. Before they went in they were ringing my parents up to 30 times or more a day at all times of day or night asking the same questions day in day out. They were sleeping to midday and even with carers visiting not eating meals, not taking medications, not washing, not changing clothes, having falls, fiddling with electrics. They weren't safe at home. They were lonely. The best thing that could have happened to them was being placed in a care home.

I didn't see the earlier thread, but my MIL is in care, she has dementia and altzheimers. We cared for her at home as long as we could, but it was wearing my husband into the ground as it took hours a day pre and post work. We had carers for her daily too. But it just wasn't safe, she was wandering off (lovely neighbours kept helping intercept her) and cooking things that weren't cookable. Now she's in a lovely home, safe, warm, well fed and settled. She's well groomed, well fed and looks much less frail. We're lucky in that it's a lovely home with lovely staff and also that she can afford it.

Having seen my grandmother go through dementia, I am sure that a care home is best as they are properly looked after. My grandfather was then left living alone after she died and developed dementia but stayed in the house; he didn't know where he was and would be found in strangers gardens in the middle of the night having wandered out. Thankfully it was summer; we then got him a home after all the relatives agreed.

Yes that's exactly how it is and was for my Mil PlayOn.

I have saw carers nearly go under trying to care for someone, sometimes its just physically impossible to be there 24/7 and even if you are you can't always provide the support that is needed

Occasionally we get a new resident who's been previously living alone.

They're often in quite a state. Malnourished, medication a shambles, inappropriate clothes and unkempt.

Often they've fallen somewhere and been taken to A&E which gets the ball rolling in regards to social care.

Some relatives can't 'see' it. My dad's mum had dementia and deteriorated badly but my dad could never see it. Didn't occur to him that she couldn't cook/wash/tell day from night.

I never thought I would end up with a parent in a care home but I am unable to lift my doubly incontinent wheelchair bound demented father & attend to him 24 hours a day (he is up most of the night) & it takes 2 people plus a hoist to get him in & out of bed or his chair. Oh, and look after my own family & pay the mortgage? Some people are very judgemental. He is well cared for & in the best place.

Caring for a person with dementia at home is like fire fighting. You deal with one issue and another one crops up in another area almost immediately. Sure, getting carers in is the right thing to do for as long as it works but there does come a time when someone is no longer safe to be alone at all.

You wouldn't leave a young child who doesn't possess the cognition to use knives, cookers and keys alone to cope. Sadly, dementia sufferers also lack that capacity.

You just know when the time comes. Best thing is to have checked out all the options and be ready to make that heartbreaking decision when the time comes.

Care at home is a great idea, however, there just isn't the funding for it and vulnerable people are often left at risk

DMiL has been that patient KongJoffrey. Malnourished, not taking medication, unkempt. Carers are keeping things going for now, but it won't be enough for ever.

I agree. My mum doesn't have dementia but chronic MH problems (anxiety and depression) and has gone into a home. I wouldn't say she was happy but happier than she was living by herself (I live abroad) and my relationship with her is much kinder and better now that I am not trying to be her carer as well as daughter.

My grandparents both have dementia and have been in a home for nearly 2 years. They are both safe, fed, clean and have their needs met. Neither are overly happy there but I honestly know they wouldn't be happy anywhere (they weren't happy in their own home either). The home they are in is lovely, has lots of activities, the staff are lovely and it is light and airy.
My aunt is plagued with guilt for moving them there, but we had to do something, my gm had incontinence issues and gf couldn't deal with them, she wasn't and still doesn't sleep at night, they were both falling frequently and the worry of what was going to happen next was too much for us to deal with.
We never thought we would put them in a home, they had both always said they didn't want to live in one, but sometimes the decision is taken out of our hands because of the circumstances we are faced with. It's a very sad time when the decision has to be made, but in our case, it was the right thing to do at the time.

I've looked after my 95 yr old Mum for 4 years now. If I could find a home (she has been in many for respite weeks) which would look after her (for £1200 pw) to anywhere near the standard that I do, then believe me I would be there like a shot, because I am on my knees.

However, she deserves more than :

1. to be left for many hours without being checked or put on the commode, such that when I visited at lunchtime she was soaking wet, right through a pad and her pyjama bottoms. I know that it must have been a long time because in all the 4 years of caring for her, I had never seen her in such an awful state, and that's with checking if she needs the commode every 2/3 hours when she's at home. (She is continent, but can't walk).

2. to be taken her supper at 6 o'clock (at the latest) only for me to find it out of reach on her trolley at 7.15, when I visited that evening. She ate the lot when I sat down and helped her. The member of staff returned to get her dishes at 7.30, while she was in the middle of eating, so that's an hour and a half without anyone checking how she's getting on.

3. numerous occasions when I was with her, and she wanted the commode, when I rang the bell 2 or 3 times over a period of 15/20 mins before someone came. (I wasn't allowed to help her, because of her mobility issues, despite me doing it every day at home.)

Different homes, different times over the past 4 years. Numerous other examples I could fill the thread with!

Imo, the resident/staff ratio in most homes is not sufficient, by a long way, to care properly for dependent elderly people who are incredibly labour-intensive if they are to get the attention they need. I don't have an answer, but the problem makes me despair.

My two penneth worth. Once, a few years back, I was in hospital as a patient. Probably because they were jam-packed, I was placed on a ward that seemed to be the dementia go-between ward, and also had the occasional advanced stage cancer patient. Anyway. The elderly dementia patients were there having been at home and/or being cared for by family, who had reached breaking point. They had called 999 or brought them in, and the hospital were then liaising with social services etc to find them a place in a nursing home. Up until this point in time, I'd always believed that I would never resort to putting my own mum in a home, no matter how fractious our relationship. Having spent a week in that ward, I would be very understanding of anyone having to reach that decision. The degree of care, day and night, not being able to be left alone for 30 seconds, the repetition, the struggle to communicate, the bewildered and sometimes aggressive outbursts.... were difficult to witness from my bed, I can't imagine having to physically do it. To look after a dementia patient at home would require being on constant round the clock alert, one person wouldn't be able to do it alone, you'd need probably at least x3 people splitting the care duties, and even if you were lucky enough to have people willing and able to do that, you'd have to consider your own career, partners, children. It was the most intense thing I've ever witnessed, and it's stayed with me. I absolutely understand how people feel about their lovely parents, nobody would ever want for their parents to go into a home, not really. But full dementia, at the degree that I saw it, is not something that is really manageable for an average home and family.

keep those are safeguarding issues and need reporting to your local social services

The Alzheimer's society runs a very good message board, called 'talking point' for people affected by these issues. It really helped me when my mum was dying from vascular dementia.

Here is a link to it - the 'moderators' are really supportive and kind - you can message 24/7 and someone round the world will be awake!
forum.alzheimers.org.uk

Your're absolutely correct, PlayOnWurtz, but you make it sound bureaucratic! Taking care of aged parents, especially from a distance, is near impossible. DMiL wants to stay in familiar territory, which can't ever work for us, as we live so far away. If she would consider moving, we would be able to stop in most days, but she won't. We understand her reasons, but it is the old adage about a rock and a hard place.

I've both worked as staff in a nursing home and had two grandparents move from in home care to nursing homes when their needs became too great to manage there.

For one; she was more coherent, calm and had social relationships with other women there who were also confused but were sharing the same routine. The other was able to have periods of coherence enough that she had some friendships where at home she'd been lonely and isolated. Both of them found the consistency of place and routine comforting and were less anxious than they had been at home, and liked that there were people around and things going on. One lived eight years in the home and the manager was an amazing lady who worked with us to advocate for her, in particular helping us sort medical care for her that we wouldn't have known how to get or had the contacts for.

As a member of staff, there are people awake, alert and around 24/7 who can make cups of tea, have a chat, walk around the hallways and soothe someone who's become confused. If someone's having a bad day and is abusive, aggressive, upset, it isn't personal. That person isn't your family and what they say doesn't upset or hurt you. I often saw family reduced to tears by someone having a bad moment of confusion, and with support they could walk away, have a cup of tea, come back half an hour later and the person would have forgotten all about it and be thrilled to see them. The residents' rooms and wings were also set up to be safe, it was organised so that they couldn't accidentally wander into kitchens or fall down steps or out of doors. We had some who wandered all the time they were awake and needed to pick up and handle and explore everything, I can't imagine how family could have kept them safe in a home environment.

It was the right choice for both my grandparents when they reached a certain stage of need. To be honest, with both, they would have been better moving there earlier before things became too hard at home, had there not been so much guilt for family members in reaching the decision.

Perhaps but maybe it's because if I write out the full gory details it would be a) identifying and b)too upsetting.

surely the value of her house should be used for her care rather than to pay an inheritance dividend?

Of course it should.

I fail to see why taxpayers should subsidise the children in retaining "their inheritance." If you can no longer live in your house, you need to move. Moving from your house to another (a care home) is any different from selling & buying when you relocate for a new job, for example.

To think otherwise is sheer naked greed on the part of the children. I saw my grandmother die slowly with vascular dementia. She was far better when properly looked after in a nursing home.

And I hope, when I succumb to frailty and likely old-age dementia (my mother is succumbing to it now, very slowly), that I am looked after by some of the wonderful people posting on this thread.