Many care homes are very depressing environments

[Meandsusiehadsomuchfun]

I know not all homes are like this but many are. What is also alarming in the home I've been in is that many residents in the advanced stages of dementia are only in their early/mid 70s, which is no age at all really.

There are obviously funding issues which means most carers are not well paid at all, and staff numbers are low. It can cause people to be overworked, stressed and to start resenting the job.
A lot of residents with dementia no longer have any autonomy over their lives, and it's sad to see. I understand some of it is necessary as otherwise they can forget to eat and drink, forget to wash themselves.

But I see homes telling night staff to start getting people up at 5am so there are enough residents up for the day staff, a lot of care staff neglecting oral hygiene and residents being put in someone else's clothes because their own have gone missing.

Put into a chair and left there all day apart from toileting, told to sit down, wait a minute, stop shouting. Put into bed at 7pm and again the next day. I haven't seen any entertainments in some of the homes despite management claiming there are always things going on.
I know some homes are really nice and allow residents a lot more choice, and of course with dementia it's difficult as you do need to encourage residents to do certain things.

It's just sad to know these people are in the end stages of their life and would probably be horrified if they could see themselves now. It doesn't feel dignified for them. Care work will likely always be underpaid and under funded though and I don't see things changing.

I think the only way to reach and maintain the standard of care that residents, families and most of the care staff want is a great deal more staff, smaller homes and no profit involved.

I loved care work, I still do bank shifts now and again in a different environment, but even in the most perfect environment, it's physically, mentally and emotionally hard. When you factor in the lack of resources, from equipment, to staff to money and it becomes impossible to do to a good standard.

I left care a couple of years ago after working 14 hour days on Christmas Eve, Day and Boxing Day and every single shift was short staffed. No extra money for any of those days, the staff that were on duty run ragged, and then a family member complained to the manager that we didn't make what might be that person's last Christmas, special.

The senior had to do the drugs rounds, which left two of us dealing with 20 residents, all with dementia, at least half needing hoisting for mobilising, all unable to do most things for themselves, and many needing a lot more time than we actually had. We were in the position of giving everyone the bare basic care, or some good care and others none. We're not miracle workers and we can't defy the laws of physics and be doing two things simultaneously.

I get it totally from the family members point of view, but the management knew we were short staffed, the owner knew, they had time to do something about it, they weren't going to get agency staff in, the reason given was that we would resent them because they were on more money. We didn't see management on any of those 3 days. And we got bollocked for it and the relatives told we would be 'spoken to'.

We got completely thrown under the bus and no one cared at all, not the cqc, not the local council, not the relatives and certainly not the owners who saved three days of one wage, or the manager who would be praised for staying under their budget. They all had the fall guys in place and we took the blame, were made out to be uncaring,

I only have my mum and luckily she has her own home and money, and my siblings and I will engage private carers for her and fill the gaps ourselves because the last place my mum is going is a care home.

Due to their very nature they're depressing places, most of the people are just tired, they don't want to make Easter bonnets or Christmas cards, many don't understand the fundamentals of life any longer because their brain is being destroyed, they are looking for a life that no longer exists and that is distressing. In order for someone to be as comfortable as possible, as calm as possible and as pain free as possible, they need time, they need space, they need compassion and kindness, it very nearly destroyed me knowing that I couldn't deliver those things that were desperately needed. I couldn't cope with the guilt - despite giving everything I had it would never be enough.

So I left. If things changed I'd go back in a heartbeat, but they won't because despite the demands for high level care, it's completely unvalued, and I'm not talking about pay here but the standards you are expected to deliver with nothing to deliver it with, and then blamed for the results.

Funding needs to be increased and the profit raking stopped, but that won't happen either.

@TheOmbudsmansComingtoGetYoucare homes are “the last resort”. So what’s the first resort when people cannot manage at home? Who is going to do the work a care home does? My DM was offered 4 visits a day to be imprisoned in her own house. Was that the premier division of care? I’ve no idea what the best care is when the elderly can do very little for themselves.

I had to find a care home for a friend with early onset dementia. After a couple of homes that couldn't meet her needs, she moved to an absolutely brilliant specialist dementia care home that treats people who live there (they are never described as 'residents') wonderfully. My friend seems to be genuinely happy. The level of care they provide is expensive, but the extra appears to be the difference between meeting basic needs and providing a good quality of life.

I suppose family members could supplement home care. Otherwise we'll all have to be prepared to pay more tax and N.I.

@notquiteruralbliss Who is paying? Your friend?

Look at the Chocolate Works in York! It’s something else, like an entire village with an indoor garden, pub, hairdressers etc. It’s impressive

Yes - we sold her house and decided that the best use of her £ would be to spend it on excellent care

Near me, the less good care homes smell awful too. Like boiled cabbage .

My DH is often in care homes for his work. Some are good (he rates Bupa) . Most are not. Some of the companies run the homes on incredibly tight budgets eg. the outside patio is a trip hazard, company don't want to pay to have the patio re-layed, no residents can go outside (staff ratios are so tight, there is no time to take them anyway). If they have a decent activities coordinator they'll have no budget to do anything, eventually anyone passionate leaves. The care staff in some places just don't care, are lazy and can't even be bothered to follow basic procedures re infection control. It's a shambles. Any good care staff don't stay long as the company doesn't treat them well and working with colleagues who do the bare minimum is awful. The care home managers have a rubbish job, trying to run somewhere with whatever staff they can get and no money. The residents welfare barely gets a look in, you'll be lucky if the care home is compliant enough to be safe, nevermind nice.

The reality is most families don't have a choice, especially where dementia is invovled, it's not safe for that person to be at home.

We need to pay more for care and that money needs to not just line shareholder pockets.

The problem is that good carers and support workers need to be literate, numerate, emotionally intelligent, vigilant to moods so they can spot early signs of distress, patient, good at time management, meticulous with paperwork with high accuracy, calm in a crisis, and passionate about preserving people's mobility and autonomy.

Such people can find jobs that pay more than care does. We're perpetually under ratio and relying on staff who should never have been in the care sector.

I've had a parent in one
I've got a friend currently in one

They seem ok to.me people are looked after and there is loads going on entertainment wise.

Each week a planner is printed of what's on

My mum has now been in 4 care settings. One was a hellhole, frankly, worse than your description and luckily totally unsuitable for her. One was amazing, a specialist rehab wing, high staff ratios with interesting work and great leadership. One was the long term floor of the same facility which had some really positive aspects but also a lot of negatives, and it went sharply downhill while she was there with staff turnover, And her current one, where I devoutly hope they will care for her until she dies. It’s still not perfect but the staff are so sweet and they seem to stay a long time. They do their utmost. I’ll take it. Mum is usually bedbound, doubly incontinent, largely nonverbal, still capable of interaction and smiles but not a lot else.

It is intrinsically a depressing idea to be in a care home but given really positive leadership I think they can at least be ok. I hope so, because I would do anything rather than force my ds to care for me. And I hope the owners of the companies that make a fortune out of the shitty homes rinsing taxpayers for cash while treating both staff and residents appallingly die in their own shit.

Absolutely, lots of entertainment.
I was at one at the weekend and there was bingo.in the garden
I'm not against them and there is definitely a need it's a service too

I think.in a way it's better than being at home on your own

There is always company. You won't be lonely.
Always things you can join in with if you want too.
No bills or running a home to think about.

Not likely to be burgled, or conned by doorstep callers, bogus people on the phone etc.
Doctor if you need one.

I’m astonished at the 5/6k a month costs for these places.
where does the money go? It’s not on the staff is it?
Follow the money - write to the pension fund that owns it. In a home of day, 30 people - paying 1.5k a week , that’s a hella profit.

I don't think it's possible to deliver outstanding care at an affordable rate for residents and still make profits for shareholders.

I agree. I wish something would change.

I had a relative self funded in a home. They rarely gave him a shower. He was never taken out on day trips, none of those with dementia were, as were seen as too much of a risk. The home smelled of wee, we visited many and they all did.

Glasses, hearing aids, false teeth constantly missing. Wearing clothes that were not his.

Costing over a thousand a week too. When he had to go to a new specialist home that cost even more, and as he was self funding it was up to us finding one and arranging a private ambulance to take him. Apparently if you're state funded you get help with that.

So where is all the money going. It's not on the staff, I know they're not well paid and are under staffed. But spending hard earned life savings on sub-optimal care and poor quality of life in your final years, it's sad. I believe some countries have better models of care but don't know much about it.

My friend is in a good care home. They get him up when he wants. But he’s been there five years and only just been seen by a dentist, and his teeth now look awful and are broken. The home doesn’t have a dentist visit them, which I was horrified about. My friend is the only resident there who doesn’t have dementia. It is very depressing seeing all the other residents like that.

Staffing costs are huge though. I don’t think people quite appreciate that even on minimum wage to have one carer on site 24 hours a day costs in excess of £100k per year.

I worked in a small home with less than twenty residents. There were about 20 carers, two nurses, half a dozen domestics, two physios, a chef, admin bod, two maintenance and a manager. Admittedly some were part timers but the wage costs were nearly a million quid despite no one being paid particularly well ( we did get over min wage)

When I was in hospital there was a lady being moved to another care home. Think her daughter was saying how it was different.

The lady from the new care home came in to have a chat and was saying how they had all these activities and she wouldn't get depressed and spend all her time in her room on her own like the old place.

It was a real eye opener.

I'd guess the money is spent on the building, much like maintenance and sinking fund charges like a block of flats, so the building doesn't depreciate in value. That would be much guess.

Exactly why assisted dying should be allowed! I can’t bare the thoughts of actually ending up in one of those places

I would much rather be dead than even have to spend a day in a home. It’s no life.

Sounds very much like the care home my friend was in a few months ago, but they did do entertainment. There were a lot of patients with dementia and we could always hear people crying out which was hard to hear. My friend was only 57, and admitted for end of life care due to advanced cancer that had spread to her brain and meant she needed 24-7 care. The staff were lovely, and treated my friend with a lot of care and compassion, but they worked so hard and were clearly short staffed at times, as these patients all had substantial care needs.

My friend often had PJ’s on that weren’t hers and when she died was wearing someone else’s PJ top so we had them find a nice Pj set i’d bought her so she was wearing something nice on her final journey. Her clothes were named, but even the personalised blanket ended up in someone else’s wardrobe. We had them find that also when she died as we wanted that to go with her. The staff saw the dog on the blanket every day as I took him in to see my friend (was her dog) but still somehow the blanket was missing for 2wks. Overall it was a nice place in that the staff were lovely and welcoming and treated my friend with care and dignity, but it made me realise I don’t want to live to a grand old age if that’s what awaits me. £1500 a week for the privilege too.

@Fupoffyagrasshole a small minority only need this kind of care, and most of those won’t be cognitively able to consent to any form of medically assisted dying. It’s incredibly rare for governments to have laws allowing people who can’t consent at the time to be killed, for obvious reasons. If you want to die before you become impaired in the same way, then that’s medically assisted suicide, which is even rarer. And tbh you have to consider what the alternative is to a specific form of care. If you do need 24 hour care, who are you expecting to do it, if not a nursing home? If you literally can’t move, can’t make decisions, can’t manage your own catheter?

id recommend an Advanced Refusal of Treatment- I have one in my GP notes, refusing life-prolonging care of any type once I lose mental capacity to decide on my own care, and I have applied to give Lasting Power of Attorney to people I trust, having explained my views.

There are many threads on https://www.mumsnet.com/talk/elderly_parents

Unfortunate as it is some people, not all, do walk into old age with their heads buried in the sand about what they may NEED to remain in their own home. A lot of talk about what they do and don’t WANT.

Living in a large family home that has not been maintained, has unsuitable bathroom facilities etc becomes problematic especially if the elderly people in question refuse to get in carers, cleaners, gardeners, food deliveries etc.

The upshot of all this tends to be a crisis and then perhaps a DoLs where the person and the family no longer have choice. Certainly in my case our parents ‘wasted’ years ignoring our please to move to more suitable accommodation-their home was completely unsuitable for our DFs diagnosis 15 years ago but they knew better. Buried their heads in the sand, stupid cliches such as a previous poster said about ‘put a cushion over me’. No regard for the stress on the wider family.

The home we found is not fancy to look at but it is excellent. None of the comments regarding clothing, showering etc are my experience. They have a policy of visiting being at any time - not after bedtime obviously. Entertaining activities but often no one is interested in joining in.

Say 30 beds at 1.5k a week … that’s more than £2.3m a year. If they didn’t make profits they wouldn’t be being opened!
once the staff costs and mortgage (assuming it’s got one) and bills are covered.
Care home investors rake in billions from ‘cash cow’ pensioners - you should be able to read this…

https://www.telegraph.co.uk/gift/d5baab254b29dcb3