To wonder who will look after us in old age?

[malificent7]

I am curently a care assitant temp until my permanent job in healthcare is sorted. It is very rewarding but hard, dirty work for little money.
They are understaffed and many are leaving due to bad pay. As we are an aging population aibu to think this is going to get worse? How can we get carers to stay,?

Disclaimer...there is no way i want dd to look after me...not fair on her...i'd rather go to a home.

@RachaelN

I personally will be looking after my parents when the need arises. They have done so much for me. I worked in care for 10 years, in terrible and fantastic homes. I see it as my responsibility when the time comes.

You won't know whether you are able to or not, until the time comes. What if their needs are so extensive that it's not in their best interests to remain at home being cared for by you?

I have done care work myself prior to caring for my DM. I can tell you that working as a carer in a home, and then providing care for a relative in a domestic setting are two completely different things.

I wish posters would say, “I hope I can look after my parents” rather than the superior “I will be looking after my parents”.

No one has a clue how a parent’s ageing and decline and care needs will look. Maybe you can manage beautifully because they will be just a little frail and die of a quick heart attack. Or maybe you will be turned into a mental wreck with a terribly bad back because they have turned into an abusive, non-sleeping, doubly-incontinent person who lives for 15 years.

Exactly, it’s very naive to state that they will be looking after them and that it’s their responsibility

Obviously sometimes you need additional professionals for specific care (like pressure sores, some 2-person hoisting) and people who fall frequently or have dementia and wander outside.

Good luck getting it! DM's care team is so stretched at the moment because of being short staffed, that her two-person team (because she requires lifting) is frequently one person. That single carer cannot safely lift so they quite rightly say they cannot do it - so it falls to family to have to step in. If we didn't then she literally would not move out of her chair!

We are on the waiting list for a hoist. Good quality robust equipment is expensive and it's not a simple case of picking something out of a catalogue. Ideally we'd have a mobile hoist as DM needs it in the living room, bathroom and bedroom, but the house layout won't allow for the hoist to be moved between these room without causing damage. Meaning that she will need a separate hoist for the living room.

DM is also on the waiting list for the district nurse to come out to treat two recurrent pressure sores. She has specialist cushions but they keep coming back. Between notifying the nurse and getting treatment is an average of 3-5 days.

It's really easy to say that you might need extra help from professionals, but the sad reality is that a lot of the time that help isn't available - either because your relative won't meet the threshold (which keeps getting higher due to resource shortages), or more commonly because there simply aren't the carers available to do it. Even when you are receiving help from a care team, it takes over your life - as I have explained above! The amount of time I spend on the phone and on email chasing, advising, updating, re-scheduling, planning - and that's in addition to the waiting and being on call to let carers in and out of the house, and being the back-up for the times that they cannot attend due to staff shortages.

We fortunately don't have a family history of dementia (we spread the loopiness ocer our whole lives) so I hope I'll be able to look after my mother at home.

Honestly, having worked in rest homes, there is nowhere I'd less rather send any human being I cared about.

I hope to get some sort of toyboy in his 60s to look after me in my 90s.

@Plipityplopity just to add a further note of caution to your plans, sometimes decisions can be taken out of your hands if a persons needs cannot be adaquetely met in a home environment - and rightly so. When my mum's husband got dementia he started wandering and despite her best efforts to keep an eye on him (and he had carers coming in as well) he ended up picked up by the police. This notified social services to send in an assessment team which concluded he was not safe at home - at night he would plug things in and switch fires on despite all the safety precautions mum put in place.

The coda to this story may surprise you - he is much more settled and content in a home. At home he was unsettled, scared, argumentative and unpredictable. The institutional enviroment seems to soothe him and he is much calmer and less fearful. So do not assume that keeping someone at home is always in their best interests (although it may be in your best interests with regards inheritance).

The bottom line is quality care costs. Assisted dying is an irrelevance as it doesn't apply to people without capacity and the increase in dementia due to successful treatment of other diseases is the biggest issue we face. Hopefully we will find a cure or treatment for dementia, but until then the crisis will not go away.

@WhiskyXray

We fortunately don't have a family history of dementia (we spread the loopiness ocer our whole lives) so I hope I'll be able to look after my mother at home.

Honestly, having worked in rest homes, there is nowhere I'd less rather send any human being I cared about.

I hope to get some sort of toyboy in his 60s to look after me in my 90s.

I hope that you can as well. Although my DM is the first person in our family to develop dementia.

I have worked in the good and the bad. There are some homes which do a good job, and where it's the right decision for residents to be in the home.

@Peggytheredhen

I agree *@babdoc*. The older people I know who were still active and driving at 95 still needed several years worth of care until they died at 100+.

My lovely Dad died suddenly of pneumonia in his seventies and we were all devastated but wonder if his reticence to ever bother a doctor was in fact a blessing for him.

Everyone over 65 is now offered a pneumonia vaccine. While it doesn't prevent all pneumonia, it does massively reduce it. Every time I give one (and I encourage uptake, because that is my job and my responsibility), I wonder if I am actually condemning that person to a decade of dementia or some other awful decline, rather than a quicker (though undoubtedly uncomfortable) death from an infection which used to be referred to as 'old people's friend'. Before vaccination and antibiotics, many would have died in their 70s say, from a bad case of pneumonia. I often wonder if anyone else thinks about this. MIL died of cancer at 67, though it was technically an infection that finished her off and she declined antibiotics as she was suffering enough and knew it was nearing the end.

I don't think I'll be accepting pneumonia, flu or covid vaccines if I reach my 70s. If I'm fit enough to fight off illness, then all well and good but if I'm frail and riddled with cancer or dementia, I'm sure I'd be grateful for a quick end.

Also agree with @Babdoc re heart disease etc. A lot of my job is early detection, prevention etc and yes we are just trading one death for another and in many cases the trade seems to be a loss, even if we are gaining years of life.

@Netflix345

People saying they will ‘book a one way ticket to Switzerland’ you do realise you can’t just book a ticket there and do it, plus it costs thousands of pounds

It costs about £10k including cremation. That’s the equivalent of the cost of a funeral and four weeks in a care home. It’s an absolute bargain.

Rag, my doctor father used to say pneumonia was the old person's friend (as it helped you die reasonably easily and a bit sooner before worse things struck). It is all a very difficult balance as people get older. Eg my grandfather died at 75 telling a joke at a Masonic dinner at the lodge (heart attack). His son, my father, had a pacemaker put in in his 70s and lived to 79 with terrible dementia and double incontinence in his last 2 years. I am not sure the extra years were worth it.

I’ve just refused pneumonia vaccination. I’m firmly in the old people’s friend camp.

I'm more than happy to pay £10k to go to Switzerland when the time comes.

In reality, the better off people are the ones more likely to opt for assisted dying in order to protect inherit
inheritance.

Reading this with interest. My grandma is 82 and very very healthy - attending church via Zoom, walking to and from the paper shop daily, getting buses and taxis, cooking roast dinners... I know that this is very likely to change within the next 5-10 years and would almost rather she just die of a stroke or heart attack at 87 rather than limp on until 92. She is lucky enough to have had 35 years as a grandmother and 10+ years as a great grandmother. I can't imagine how stressful it would feel if she was my mother and I was in the lifestage I'm at now - knee deep in kids, work, saving for a bigger house etc. As it is I have the "buffer" of my own parents - in their 50s - who will take the burden of lower level caring needs.

I find it so strange that having kids just 10-15 years later than I and my mother did, over a couple of generations, will lead to this double burden of young children plus elderly parents. I have a friend whose parents are my grandma's age - her mum was 38 when she was born, and she was 39 when she had her first child, so not old by any stretch! I don't really know what the answer is when house prices are so high and further and higher education (delaying starting earning) is essential for most jobs.

@BackBackBack

However, when those health problems reach a point where they are in constant discomfort, can not do anything for themselves, cannot control their bowels and bladder and are purely 'existing' there should be an option for assisted dying. - emphasis on the word 'option'. I don't believe it'll ever be something decided for them unless if they did not have capacity..

I have full POA for DM but until it was a nightmare we had confirmation of her capacity having ceased (via a geriatric consultant). Endless battles with the care team - she's not showered in a week, but we can't make her if she says she doesn't want to. Infections and pressure sores but what can we do because she objects if we try and clean her bottom properly. Sitting all night in the armchair because she'd refuse to be put to bed. It was a horrible situation and the carer's hands were tied because whilst she was deemed to have capacity, she had the right to refuse care.

And whilst she has no capacity now, it's still tricky. If she objects to care I have to keep reminding the care team that she doesn't have the capacity to make decisions for the best interests of her own health, so they need to wipe her properly, shower her etc.

But even without the difficulties around establishing consent to personal care and the capacity to do that, the practicalities of delivery are sometimes impossible. As your mum's carer, I may need to wipe her properly, ensure she goes to bed, shower her - but how do I actually achieve that if she physically and verbally resists that? Me knowing the lack of capacity and need for the care to be delivered doesn't change your mum's reaction to my attempts to deliver it. The 'training' says that we are to communicate with people, talk to them, build up a rapport - in the hope that it will lead to compliance. Unfortunately, with a staff ratio of 1 to 7, when do I have time to do that? If I need to take an hour to talk your mum into letting me clean her up effectively, the other 6 are still sitting in it for that time, ringing their buzzers, needing medication, wandering around which they can't really do so safely on their own. Then I have their family members telling me it's not acceptable that they fell, that their buzzer wasn't answered fast enough.

And when I approach my managers to say that we are not able to deliver the care needed, keep everyone safe and do everything that needs to be done properly, we're told to cope, manage our time better.

The needs of dementia patients or indeed pretty much any patients are really underestimated, as is the time and manpower to deliver person centred care to everyone.

People quite rightly see this from the perspective of their own family member, they don't take into consideration that I have the same duty of care to all the residents and while staffing remains the bare minimum, it's not about to change. The people making the decisions about staffing to the needs of the residents are the same ones controlling the purse strings.

Until there are real and enforced ratio's for staffing levels, and those positions can be filled and stay full, nothing will change. And they're only going to be filled and stay full if the pay and conditions reflect what we do properly.

The cost of elevating care to the standards it's already supposed to meet now are going to be astronomical, fees will massively increase, taxes will need to pay the shortfall. No one wants less money from their wages, or to lose their inheritance for it. Care businesses are not going to take a cut in profit to enable it either.

As I said in a PP, we can have the best standards in the world, on paper but when there aren't the people available to achieve them then they still don't happen.

@Xenia

Rag, my doctor father used to say pneumonia was the old person's friend (as it helped you die reasonably easily and a bit sooner before worse things struck). It is all a very difficult balance as people get older. Eg my grandfather died at 75 telling a joke at a Masonic dinner at the lodge (heart attack). His son, my father, had a pacemaker put in in his 70s and lived to 79 with terrible dementia and double incontinence in his last 2 years. I am not sure the extra years were worth it.

This is very true. I am reasonably sure that were we able to go back in time and my DM was able to see how she lives now, then she would be horrified.

She's been living with several chronic conditions - and near death on more than one occasion. And each time she has come back from the brink - weaker, more frail, less able, but still alive. She's gone from being an extremely independent person, to someone with dementia, who cannot move without help, who is doubly incontinent and who cannot look after herself at all. And the cruellest thing of all is that it will only get worse and that none of us know how much longer she will go on for - she's 81 now but her own Mum lived until she was 99!

@DottyHarmer

I wish posters would say, “I hope I can look after my parents” rather than the superior “I will be looking after my parents”.

No one has a clue how a parent’s ageing and decline and care needs will look. Maybe you can manage beautifully because they will be just a little frail and die of a quick heart attack. Or maybe you will be turned into a mental wreck with a terribly bad back because they have turned into an abusive, non-sleeping, doubly-incontinent person who lives for 15 years.

Totally agree. So much hubris.

Ditto the people who say they will just pop themselves off when the time comes. How, exactly? Suicide isn't simple or easy. It's almost impossible now to get drugs that would quietly put you to sleep, and other methods are fraught with the risk that you'll be left disabled, not dead.

As your mum's carer, I may need to wipe her properly, ensure she goes to bed, shower her - but how do I actually achieve that if she physically and verbally resists that? Me knowing the lack of capacity and need for the care to be delivered doesn't change your mum's reaction to my attempts to deliver it.

I know and I agree. Having worked as a carer myself and also watching the carers who work with my Mum now. It's so hard - you know that they need the care but dementia does not remove a person's ability to say (or shout!) 'no' or to refuse to move, or to turn themselves into a limp dead weight if you try and move them.

I am really lucky in that most of the carers who look after DM are very skilled at 'jollying' her along into doing what they need her to do. But ai am incredibly conscious that if the schedule says they are to be there for 15 minutes, then they cannot afford to linger - especially if their next call is 20 miles away.

@Xenia

Rag, my doctor father used to say pneumonia was the old person's friend (as it helped you die reasonably easily and a bit sooner before worse things struck). It is all a very difficult balance as people get older. Eg my grandfather died at 75 telling a joke at a Masonic dinner at the lodge (heart attack). His son, my father, had a pacemaker put in in his 70s and lived to 79 with terrible dementia and double incontinence in his last 2 years. I am not sure the extra years were worth it.

My late ILs were members of their local Conservative Club and a lady there died during the regular Sunday night bingo session. Nice way to go.

@Phobiaphobic you can starve yourself to death or opt for something which wouldn't be quick, but which would see you off in about a week, hopefully with some pain relief and midazolam to ease the distress, although, if the Daily Mail have their way, possibly not.

In the early 90's when grannie was 80 there was no alternative but a home. Mother and grandad were already exhausted after looking after her for 8 years. Support started with 2/3 afternoons in a local nursing home, then 2 weeks respite after 5 at home for a couple of years. By then she was regularly wandering, including during the night, smearing faeces on walls, and didn't know who we were. Notwithstanding the aggressive accusations about stealing her things. >more than 25 years ago she met the bar for a specialist geriatric MH nursing home. Physically she was as fit as a fiddle and was there for a further 4/5 years. At the end she was vegetative and under 5 stone. I am quite sure she lived for those 4/5 years because mother and grandad visited her daily because they loved her so much. People going into a nursing home is not a choice. My mother missed the infancy of her grandchildren and grandad who was still taking breaks in the South of France into his mid to late 80s and incredibly fit was diagnosed with cancer five months after she died - late stage and died less than 12 months later.

Dealing with it almost destroyed my mother.

This was an indomitable but charming woman who ran family businesses and rode daily until the disease gripped in her early 70s. It was horrific to see it ravage her.

I personally will be looking after my parents when the need arises. They have done so much for me. I worked in care for 10 years, in terrible and fantastic homes. I see it as my responsibility when the time comes

how will you do that alone if eg it takes two people to take them to the toilet? And what if they both need care at the same time?

@BackBackBack

As your mum's carer, I may need to wipe her properly, ensure she goes to bed, shower her - but how do I actually achieve that if she physically and verbally resists that? Me knowing the lack of capacity and need for the care to be delivered doesn't change your mum's reaction to my attempts to deliver it.

I know and I agree. Having worked as a carer myself and also watching the carers who work with my Mum now. It's so hard - you know that they need the care but dementia does not remove a person's ability to say (or shout!) 'no' or to refuse to move, or to turn themselves into a limp dead weight if you try and move them.

I am really lucky in that most of the carers who look after DM are very skilled at 'jollying' her along into doing what they need her to do. But ai am incredibly conscious that if the schedule says they are to be there for 15 minutes, then they cannot afford to linger - especially if their next call is 20 miles away.

I'm really heartened to hear that you understand that aspect of it, many don't and it's not uncommon to be accused of laziness in situations like this. Or to have relatives say that you're supposed to be able to do something because you're trained in dementia, no training in the world makes me able to cure it though sadly. It's probably easier in a care home setting than in the community to build a relationship and a rapport and learn to know what works with someone to get compliance, but it's still hard and we really do need to have more time with people in order to do that. But again, that will cost money that no one wants to part with. I don't know what the answer is really.

@Maverickess I don't either. I tend to find that people with no experience of the social care system for the elderly are the ones who expect miracles ("when X needs care we'll get the professionals in"). Only to have a rude awakening when the time comes, about the cost and limitations attached to the care system! I really wish that people could spend a week working alongside these carers and see the reality of the system.

I'm not defending it - and people should be cared for properly and appropriately. But if the system isn't funded, and the staff aren't valued and instead are constantly overworked and overstretched, then the fact is that people won't get the care that they need.

And as a previous poster said upthread, those with the financial resources to pay for good quality care will be OK - and those who don't will suffer. The irony being that care-work often only pays NMW or slightly above, so all of those doing the care work now know what lies in their future because they won't be able to afford to pay privately for quality care - which is a further lack of incentive to work as a carer!

@BackBackBack, I have to say that my DM’s (dementia only) care home was amazing at getting personal care done. While she was still at home it was a nightmare trying to get her to have a shower and wash her hair - usually I just gave up, to avoid the tears and tantrums. Her hair would smell, that horrible, unwashed smell, and she frequently wore grubby or plain dirty clothes and would get cross and grumpy if asked to change. She had formerly been very fastidious, but that’s dementia for you.

Once in the care home she was always nicely dressed, with nice clean hair. All the residents were the same. How they managed it I have no idea! It was an Abbeyfield home, in case anyone would like to know, and although by no means the most expensive, it was extremely good.,

[quote BackBackBack]@Maverickess I don't either. I tend to find that people with no experience of the social care system for the elderly are the ones who expect miracles ("when X needs care we'll get the professionals in"). Only to have a rude awakening when the time comes, about the cost and limitations attached to the care system! I really wish that people could spend a week working alongside these carers and see the reality of the system.

I'm not defending it - and people should be cared for properly and appropriately. But if the system isn't funded, and the staff aren't valued and instead are constantly overworked and overstretched, then the fact is that people won't get the care that they need.

And as a previous poster said upthread, those with the financial resources to pay for good quality care will be OK - and those who don't will suffer. The irony being that care-work often only pays NMW or slightly above, so all of those doing the care work now know what lies in their future because they won't be able to afford to pay privately for quality care - which is a further lack of incentive to work as a carer![/quote]
Yes to all of this, especially your last paragraph! I worry about it, I haven't had the opportunity to buy a home or save a substantial amount to pay for my care - and then you get told it's because you can't be bothered to do better 🙈 but where are we now with a lack of carers? If nothing else it's highlighting the fact that people rely on these services to look after their loved ones so they can 'do better'.
I do feel all this talk about assisted dying, whilst it's a conversation that needs to be had, yet again avoids the issue about the realities of the social care system and how it's failing. "It won't affect me because I'll take myself off to dignitas" doesn't address the issues present, and it doesn't get the care to those who need it now.
I think part of this current crisis is that carers have started to refuse to take the blame any more for the whole system, they're worn out and rather than digging deeper when demanded to (because there's nothing left) to bail the system out yet again, they're leaving because they have a choice at the moment, and that's causing this crisis we're facing around social care or rather lack of it.

@GETTINGLIKEMYMOTHER

As I said, it's probably easier in a care home setting to persuade compliance, and there's the institution feel alongside that too, uniforms, equipment etc that possibly leans expectations on people because they're in an environment they're not in control of. But, we're supposed to be moving away from that style of care, and giving choices and observing rights. I have good relationships with many that I work with, I can gain compliance where others can't in some cases, but I do feel at times they're doing it because they see me as an 'authority' which doesn't seem quite right, and not in line with the person centred care I'm trained to deliver, but, I'll take it because it means the person gets the care they need with minimal issues for everyone!

Conversely, it also assumes that people want to be independent, which often isn't the case. I get told a fair amount that I should be doing whatever I'm asked of by someone because they pay - even when they're capable of doing something themselves, there's a real 'customer service' vibe emerging in care, and that's at odds with promoting independence and the levels of staff available to provide care. You or I may think that you wouldn't be dependent on someone if you didn't have to be, but the reality sometimes is that if they're paying for their care, they want their monies worth.