AIBU to put mum in care home

[Cantaffordthecost]

So my 85-year-old mum, who is widowed, has become doubly incontinent and confused. We are in the process of getting a dementia diagnosis. We’ve recently had to start carers (sourced by social services) as she can no longer manage her personal hygiene and can’t make herself meals or clean herself properly when she is left in a mess from her incontinence. We’ve just had the finance assessment from the council and we have been told we need to pay £142 a week and we just don’t have it. She has a monthly income of £1,143 in pension but our costs for heating alone last year - which they don’t take into account - were £350 and that’s without the rise. We pay for a stairlift and spend best part of £100 a month on incontinence pants - not counting the numerous washing machine loads etc we are doing daily. That is in addition to travel costs to hospital appointments on a weekly basis plus general living costs. We expected to pay some but we just haven’t got the money to pay this much. But she can go and live in a nursing /residential home and have £34.75 a week pocket money with the rest of the costs met. It will leave us financially better off but obviously cost the council far more. Where is the logic in that? Am I being unreasonable to think we have no choice but to find her a residential home or does anyone have any suggestions? The one thing we can’t do is find that much money.

Sorry if I missed this but what is the £142.00 for? If she has no savings & the house isn’t technically hers to sell then she should be contributing £185.99 per month regardless of how many carers she has.

I’m sorry I’ve not answered more quickly but I’ve been tied up with my mum.
Thank you to everyone who has offered suggestions and their own experiences. It has made me realise we might not be doing her any favours by fighting to keep her at home.
It looks like so many of us have to face making these decisions and it is so hard worrying if we are doing the right thing.

Also thank you for the practical advice. I’m not sure if we are too late to get POA as her dementia has come on so quickly - she was perfectly fine in November and is still formally undiagnosed as we are waiting to see the consultant. We’ll look into the POA though.

I’ve spent the past hour looking at care homes online and requesting appointments/brochures. We might see if we can take up 2 weeks respite - that has been approved - and it gives a bit of space to have a look and see what looks best. Thank you so much for helping make me feel less guilty

People can still have capacity with a dementia diagnosis, it depends on the stage of the dementia.

(It’s not clear she can’t cook, feed herself or clean up after herself from physical or mental disability). If mental then potentially the dementia is too advanced for PoA.

PS We put my aunt in respite care at a place we thought she might like long term - she did - and it meant she was going somewhere familiar.

People can still have capacity with a dementia diagnosis, it depends on the stage of the dementia
This is what we found with my DM, she had four capacity tests and it was only on the fourth one it was found she didn’t have capacity.
Plus people can capacity for decision and not another.
OP view as many care/nursing homes as you can. Do you have a social worker, if so they can advise you what you should be looking for? I viewed eleven for my DM and chose the eleventh one. She is thriving now and had gone up almost 2 dress sizes as she simply wasn’t eating or washing etc at home. Honestly it’s such a relief and I am sure you will look back and say to yourself you and you DB did all you could to keep her at home but then the time came when this was no longer possible.

Please look into applying for Continuing Health Care funding. This is a little-known nhs -funded benefit which is not means tested. If she is turned down for it, appeal.

Perhaps you should think that moving into a care home is moving into appropriate accommodation.

My sister's MiL was unable to live on her own and only managed to stay in bed own home as much as she did because she literally lived over the road from them. Eventually her calls for help meant she needed to go in a home. After asking people she knew about homes and what they thought about them, then followed by some visits they chose one and she moved in. Dsis and her DH were feeling so guilty but after she settled in the started ending visits early as she was due to do an activity or wanted to watch TV with her friends. She even refused to come for Christmas dinner as they had Carol singing and a Santa visit.

I'm not sure where you are but if you are look in around Weston-super-Mare I can help you find a good one.

has She been checked for a urine infection and could she be constipated? Both can worsen confusion and cause incontinence. If she’s soiling without realising she could be blocked up and it’s overflow this happened to my Nan and after a couple of weeks and of laxatives she stopped having accidents. Also if buying continence pants buy in bulk online it’s much cheaper than in the supermarket.

The figures are a bit odd, the numbers you've given would leave her with less than the minimum income guarantee unless she had some other income than pension + maybe some savings.

Most councils have a care costs calculator around. Here is one from Bristol:
www.bristol.gov.uk/residents/social-care-and-health/adults-and-older-people/money-and-legal-matters-for-social-care/how-to-calculate-your-contribution-towards-your-care-costs

Which you can use to check if the figures sound right. There's a useful document on that page which includes some worked examples of care costs both at home and in care.

As a previous poster mentioned. If your Mum's care is funded at all by the local authority they would have to agree (and she would if she has capacity!) that her needs meet the level for requiring 24 hour care and can't be met with 4 visits a day. They won't pay towards a care home for people otherwise.

People who fully self fund can decide themselves the point they want 24 hour care (but care homes may want proof of funds for a number of years if they are worried the LA won't pick up the tab if you run out of money).

Yes @Jessbow the £142 is for carers three times a day five days a week. If she goes into a home all her income will be used to pay towards it and she will have about £33 a week to spend on things like clothes and haircuts etc. I am not questioning the care home cost as that seems more than reasonable to me.
She has no savings and no equity in the house - we have a letter to confirm this. We get the pants from Amazon and she gets through about 6 pairs a day. They are 53p each as we buy so many we get a discount. On top of this we have to use disposable mats on the bed - yes I know you can buy reusable ones but we change the bed at least twice a night and can’t keep up with the washing as it is. They were around £8 a pack but luckily I’ve just discovered they have some of them in Home Bargains at just under £4 a pack. However as we use 2-3 every night it’s still going to add up. And we did try the Home Bargains absorbent pants but they leaked on her so not suitable.
Oh - and I’ve known there was no inheritance for years and really don’t care. All I want is my mum to be happy and well cared for. I just wish she did still own her home as I’d happily have sold it to get the care for her that she has given myself and my brother and our families all our lives.

Quick comment. The pads and pants aren’t working well from what you have said. The GP or social worker needs to get the incontinence team in asap to assess and provide decent products. Good luck!

Fansandblankets · Today 18:58
There is no logic to how financial assessments work. My adult son lives in a residential setting. It’s actually over £5k per week, at the moment due to using agency it’s nearer to £7k per week, due to his high care needs. I told the social worker at the time that if they gave us parents even half of that we could care for our kids at home. We’d be able to move house or build an annexe and employ care staff 🤷. It’s bonkers .Thankfully as is funded by CHC he doesn’t have to pay a contribution. Two of his friends have to pay a contribution and are left with around £30 per week plus the mobility part of their pip.

This is what I was thinking. For my mum to go into a care home will be much more expensive to the local authority but it looks like we have no option.
I’m sorry you’ve been left with this for your son- there does seem to be no logic

@Babyroobs

AA is taken into account as income when LA does the financial assessments

Sorryyoufeelthatway - thank you - we’re waiting for an appointment after she was referred in January but I’ll have another go at chasing it up and trying to speed it up

I’m sorry but I know I’ve not answered everyone. On the funding - because we know mum hasn’t enough even though she should be responsible we are picking up some of the costs between us.
If I’ve missed any others I’m sorry but I do appreciate all you comments and advice. I’m not sure I’ll get a night’s sleep yet but I’m feeling better about it. Thank you all

Yes of course but if the local authority says she needs to pay £145 a week, she will still get paid the AA.

Taxpayers paying children's inheritance is exactly what happens when anyone dies after medical care. They don't need their house any more - why should they not pay their own medical fees?

I agree with this. If someone is wearing the correct pads the. You shouldn't have to change the sheets twice a night.

Does she have a urine infection? Would a catheter be useful in this instance? To save her skin from getting sore and to help ease all the changing?

I think it's a hard choice. Are you able to look at the registered homes that provide the type of care your dm needs? Check the CQC website for reports on care homes in your area and make enquiries. Look at the inspection reports. You can always apply for funding for your chosen home.

She does have a fairly constant urine infection but we’ve been told a catheter wouldn’t be the answer by the doctor who said it could make her even more prone to infection. We’re seeing a consultant urologist next month to see what they say. But this is separate to the incontinence clinic we are still waiting for an appointment for. We thought the infection could be making her confusion worse but the GP just gives three days of antibiotics which don’t work and then after a week they give her another three days worth which also don’t work and that’s how it has gone on. She’s had an infection pretty much continuously for months now.

I’m going to have a good look at homes tomorrow when I’m more awake and not feeling so rubbish - it’s been a long few days. I’ll make sure I look at the cqc reports, thank you

OP she needs amoxicillin for 7 days. Or even another antibiotic for a month or 2. Ring the GP tomorrow and insist on it. 3 days is often not enough for UTIs they’re just being stupid. UITs can make elderly people seriously confused and she is also running the risk of the infection spreading to her kidneys.

You're not 'putting her in a care home'. She might have to move into a care home as she can no longer look after herself. Big difference

Although I appreciate that in many cases there is no practical alternative, however you wish to put it, most people in care homes are not there because they have made a choice. They haven’t booked themselves in. They have effectively been ‘put into a care home’ because in a lot of cases, they have had no real say in the matter.

Your mother will have to use the £700,000 to pay the full cost of carers or a car home until her savings are lower than the LA limit of around £23,000. The LA will not pay anything.

My mums care home charged £1150 a week in 2022, ie almost £60,000 a year so the £200,000 your family mention will last less than 4 years. The home was a not for profit one so fees were slightly lower than others nearby, staff were paid more than minimum wage and the staffing ratio was higher. Even so, the fees went up 5% a year so that needs to be taken into account.

Carers at the house are only cheaper if the hours are limited, say to four x 1 hour visits a day. If more hours are needed or overnight care, then costs can be more than a care home.

In my mums case, she was 87 when she needed to go into a care home and lived there for 21/2 years before she died. She had a good income from pensions and we rented out her house so we reckoned she could live there for 13 years before we would have to sell her house.