To ask for carers for my Mum when she doesn't want them?

[missb10]

My Mum is at the stage when she is struggling to manage. Up to now she has been very independent and does for herself around the house, does her own shopping, makes simple meals and walks without sticks etc. She had a fall recently and was unable to get up due to weakness and has been in hospital since then. They have been suggesting that she has carers come in but she doesn't want them, says they are too expensive but I'm not sure if she is against it because of money or privacy. She does have the money to afford them. It would put my mind at rest if she did have someone coming in daily to get up and dresssed at least but not sure how to persuade her. She may not be able to go home without the help and a care home is even less desirable.

Of course you can ask for them, but ultimately it's your mum's decision as long as she has the full capacity to decide for herself. If she's not able to go home without some help safely then the hospital staff can usually be quite persuasive and will make professional recommendations, but if your mum can show she understands the risks, can weigh up her decision etc then she can say no. Would she qualify for any help towards care costs at all? Some of it can be means tested, if it helps?
What will she do without the help? How would she manage? Is she expecting you to care for her? Ask her these questions and get her to really think about it, often it is a huge adjustment for older people to have to rely on others and accept they are no longer independent, and it's hard to accept so it could just take a little time?
Has she had OT and Physio and explored equipment etc that could help with independence too? X

I was in a similar situation with my dad after he had an emergency op.
I focused on the two options, care home/rehab unit or carers so try that. Tell her that she will not be judged fit to return home so its either agree to visits at home, or don't go home.
Dad agreed to it on a trial basis, he didn't think he needed them but as I'd worked in care he eventually agreed to trust me. The 3 weeks without being able to have a pint helped! I reassured him that if they came and felt he didn't need them then it didn't have to continue. In the end, once he was home and they were visiting twice a day he realised it wasn't as awful as he had been imagining. He did 8-10 weeks of them visiting and then was recovered enough to stop the visits.
Reassure her that you can be there when they visit to start with, and that it doesn't mean you'll disappear either. Those were my dads fears.

She can refuse them if she has capacity. However does your area have free carers for 6 weeks post discharge? And only after this time if you still need them you have to pay? There is also a difference between normal carers and enablement carers, maybe explain this to her? Ultimately even with the 'free' care package on discharge, if the carers find they are not needed they will pull out, even before the 6 weeks is up.
However she may be waiting ages for carers which might be why she is not keen, and the longer she spends in hospital the more de conditioned she will become, it's a bit of a vicious circle.
Has an OT assessed her certain function / care needs? What does she need help with atm? Has she got a falls alarm at her home? Does her area have a local falls prevention team she could be signposted to on discharge?

My parents were reluctant at first. Firstly they don’t want to acknowledge they’re getting old, plus it took a long time for them to get used to having them . Ie, telling them what to do.

Also it’s worth contacting g adult social services who can provide resources, equipment etc.

Ask for ‘continuous healthcare’ its free and is for around 6 weeks i think

This will give her carers for a little while and she can then decide if she wants to keep them and how much help she needs

We did this as everybody was struggling however the family members in question cancelled them so back to square one.

If she doesn't want them that's her choice. She's not a child. Just make it clear to her you won't pick up the slack.

My dm also refused carers.

So we persuaded her to have a course of physio to improve her strength and then we organised a cleaner one morning a week, a gardener (2 mornings a week), a farm foods delivery, a weekly taxi ride to an old folks keep fit, a regular home chiropodist/ foot care and an emergency call button that she wore as a bracelet.
Plus a family visit most weekends.

It meant she always had a reason to get up and dressed. They all had my phone number if they thought something was wrong, and she didn't feel intruded on.

It took a bit of organisation but we managed to keep her in her own home until the last three weeks

Tell her the alternative is that Social Services will put her in a home if they feel she can't look after herself!
Make sure she has both a Medical and a Financial LPA.

Social services will not "put her in a home" against her will either. In fact, they won't put her in a home at all because there is no indication that she requires this level of care. Telling otherwise to an elderly and vulnerable person as a way for them to agree to the "least bad option" is surely borderline abuse.

We had a similar situation with an elderly relative. Every time the carers came round he sent them away!

My mum refused carers.

You can't make someone have carers...

One way to suggest is to try, if she has money and can arrange herself she can agree to meet a few people to see if she can imagine them helping her. Go for individual rather than agency at this stage. Hopefully someone will be professional and she might be prepared to discuss the care she needs and is willing to accept

YANBU to suggest carers.
YANBU to make it clear the extent you will/won't be able to assist her yourself.
YABU to force her to have carers.
YWBVU to threaten her in any way (a a pp suggested).

You mean intermediate health care. Continuing health care is something else, and not relevant here.

Quite. What an appalling suggestion. Also a person with capacity has to agree to grant power of attorney. You can't unilaterally "ensure" it.

If you just want a reason for her to get up what about meals on wheels if they are available in your area? It's not technically a carer but they do have NOK contact details.

Also, find out what she is saying to the hospital staff. My cousin discovered her elderly dad had been telling staff he could go home as his daughter was coming to stay with him. She made sure it was written into his notes that his daughter was not, and could not, stay with him whatever he said to the contrary.

My late MIL didn't want carers. However, she really did need them. She had alzheimers and was on quite a lot of medication. The carers visited just to make sure she took her correct dose every day.

We framed it so that having carers enabled her to remain independent, so she reluctantly accepted this. As she deteriorated the carers would come more often and heat up a meal in the microwave for her. Also, as she lived on her own it meant that she had interaction with another human being every day.

We lived 150 miles away so couldn't help on a day to day basis.

The fact is it is expensive she is right. But she can't expect everyone around her to subsidise her if they are already stretched. It may be worth stressing the interim nature of it to get her home and things back into routine - so the 6 weeks intermediate care which is not assessed. She will then need an assessment by the Adult Social Services team to assess her level of need for carers and once that is established they do a financial assessment to see if she can be funded in any way. Most people need to pay as the bar is low! However you can encourage her with the idea of physio, temporary cleaners/gardeners which take off the manual labour load for those relatives that do go to help - caring whilst still manual is in my view less onerous than gardening or proper/deep cleaning. Do sort regular food deliveries/collections that you drop as that is a big job as well if running your own families, We would have housekeeper style people come and get food deliveries that day that they put away, they did cleaning and clothes washing, plus bed change and wash and also did cups of tea and snacks. Mum felt that was a lot let intrusive than having "strangers" around. The first couple of times they were there we stayed as well so Mum got to know them too.

Just remembered - my cousin didn't use the word carers to her dad, I think she called them his assistants. She also pointed out that "in the olden days" it used to be quite common for older people to have "a woman wot does" to pop in every day, it's just that nowadays it's men and women and you get them from an agency not the village. I don't know exactly how she described it, but she put it into this context which he was comfortable with rather than just "carers".

Why would you lie to her?

as long as her brain works they can’t force that!

That’s a brilliant way of looking at it. So they’re not caring for him, but are more of a housekeeper.

I’m not sure the other posters are 100% correct. I have experience of social services not allowing a family member to go home from hospital because she couldn’t look after herself. The first time she was placed in a care home temporarily and the second time she was returned to hospital because a care package wasn’t set up. However she really couldn’t look after herself, couldn’t get up after a fall and refused to stop taking the stairs on her own and more. People do receive care packages they don’t really want all the time because they can’t safely look after themselves and it’s in their best interests. But I wouldn’t lie to your mum or scare her to get her to agree. I do agree you need to make it clear that you won’t be acting as her carer and won’t be looking after her yourself.

i used to talk about delegating some jobs to make sure you stay independent to people I was setting up a service for. ‘Carers’ sounds so infantilising, personal assistants is much better.

Why is she still in hospital? Is there some short term injury? If it’s just because she’s weak then the sooner she’s out the better, she will continue to weaken in hospital.