Alzheimer's care home, London area, recommendations please

[OkapiWoman]

My mother has quite advanced dementia - doesn't really know where she is, can't remember if she has just eaten, seen a doctor, had a visit, thinks I am her sister... she has several carers but has no idea that she is getting any help or that all her meals have been provided for the last year. She is terribly anxious and depressed, and keeps having the miserable revelation that she is going senile. I don't think I can cope any more and I think it is time to try and get her into residential care. Can anybody recommend any friendly, kind, happy, not too fancy (the expensive homes look like they are all about hair salons and pampering), not too ugly (my mother is an artist and a snob), homes in or near London? I am completely overwhelmed.
Thank you

[OkapiWoman]

No, true, me niether. And I've never got on very well with her, so I guess I am primed to disagree with everything she ever says, especially as she is wrong about everything! i.e. : "that dog is in agony, is he my dog?" "No she is my dog mum, you don't have any dogs, and she is FINE!" Arrrgh...

[chrissie28]

I get that OkapiWoman - my mother was never compliant lol - and I have to say neither am I so I did sort of 'get it' even though it drove me crackers. Fortunately my 2 kids are much more easy going and so they taught me a lot. I used to get dragged into a discussion before I had realised where I was going with it - I can laugh about it now but at the time I wasn't sure which way was up. She used to say to me "I think you need to see a doctor, your memory really isn't very good these days" arghhhhhhhhhhhh but the thing is she was right - my memory was shot to bits with the stress xx

[OkapiWoman]

Thanks Chrissie28, that is about as close to the 'contented dementia' method as I have been able to get. The whole 'theme' and everyone else in-on-the-delusion package is just too difficult. Your Compassionate Communication is a lot more achievable. I am trying... my mother is not the compliant type, so it's very hard not to ever argue, contradict, or reason.

[chrissie28]

you might find this useful - it is similar to contented dementia - we used it all the time and made the carers use it too and I can't even begin to tell you how much it reduced my stress levels and my Ma's too - I didn't believe in it at all but my teens got the hang of it really quickly and coached me lololol We had it stuck on our fridge www.ocagingservicescollaborative.org/wp-content/uploads/2013/03/Compassionate-Communication-with-the-Memory-Impaired.pdf and if you haven't already joined my group please give it go www.facebook.com/groups/dementiaconnection/

[OkapiWoman]

Thank you everybody - yes we are trying the live-in carer at the moment. My mother hates it and is constantly surprised to find soemone in her house. She has thrown out two of the three we have tried, and I've had to be called in to let them back in. I was hoping she would get used to it but she doesn't seem to be able to remember the person is meant to be there, let alone who it is. She comes over to my house - I'm staying next door to oversee and cover the breaks - several times a day to tell me that there is a horrible man in the house (it's a girl!)... Not sure she would/will adapt to a home any better. I might try the Lady, Helping Hands is charging £1015 a week for this torture. I thought the familair surroundings point was crucial, but my mother keeps asking where she is, if it's her house, if there's a bathroom, does she have any clothes,.. so I'm not sure the surrounds are that familair anymore. It's really quite terrible.
Has anyone tried the 'Contented Dementia' SPECAL method of dealing with this? Ask NO questions, Agree with everything, basically devise and live in a fantasy world where the 'client' is an expert something or other from their past? I've been trying it but it seems impossible.

[chrissie28]

someone i know recently found a live in carer in The Lady and is very happy £450 a week plus taxes

[Stephenfromhometouch]

Hi OkapiWoman,
Have you considered live-in care as an alternative to a residential care?
There are definitely some benefits to keeping an elderly relative in familiar surroundings, particularly if they're living with dementia.

My colleague recently published an article on this for my work -- hopefully it's useful! blog.myhometouch.com/is-home-care-better-than-care-homes

[Furrycushion]

The other thing that social services can do is sift out the ones that wouldn't be able to take her. Or at least this is what they did for my father but it may have been because they were trying to get him out of hospital. They sent a summary of his report to the homes that had vacancies & if they thought they couldn't meet his needs they said so. Someone from the home then visited to assess him & at that point we visited. You can of course visit wherever you fancy but depending on your mother's needs they may not be suitable anyway.

[Penfold007]

I'm going along a similar path with my DM. I contacted adult social services and requested an assessment under the Care Act. Social Worker came to see DM at home to carry out the assessment. I was then provided with a written report and book of care homes locally. Perhaps similar might help you?

[OkapiWoman]

Good points, I would want to visit without an appointment. I didn't realise my mother would be taking her social worker with her. In fact she doesn't have a social worker as far as I know, but she does have a memory clinic nurse who seems to be in charge of reporting and advising about her.

[malovitt]

Some places I visited wanted an appointment made beforehand because of staff ratios, others were happy to let you wander around communal areas where they had a lot of staff on duty. You usually get a feel for the place as soon as you walk in the door.

More important is finding a home where you will be able to visit whenever you like when your mother is a resident.

[Furrycushion]

To be fair, most places would want you to make an appointment, or at least to avoid their busy times (meals & personal care). I would still least phone ahead.

[MyYoniFromHull]

Yes, you wouldn't be roaming unaccompanied. I'd avoid mealtimes though. But in principle I would avoid places that want an appointment, you want to see what it's like when they are not expecting visitors

[OkapiWoman]

Thank you MYFH. I am trying to get together a list and I'll just have to bite the bullet and start visiting. Do you think all the homes will let me in unannounced? It sounds a good idea, but also potentially a lot of wasted journeys if there is no one available to answer all those questions. Do they just let anyone wander about with the residents? Much as I think I should be let in to cross question anyone I find, I'm not sure I would be happy for that to be happening once my poor old mother is a sitting duck in there!

[laptopdisaster]

Check out this company, you've had a recommendation for the Enfield one upthread and a relative of mine had good care in the Fortis Green one

www.springdene.co.uk/contact-us

[chrissie28]

I agree I would look in your own area - the easier it is for visiting the more your Mum will gain and the less stress on you too. I also agree -start looking now - there are not all that many good homes around and it may take a waiting list for a decent one. The LA will defer payments while the house is being sold often - talk to them about it now so you know what you are doing.

[toolateforbabyweight]

Appleby House in Epsom. I take my baby their for rhyme time with some of the elderly patients and have been been so surprised at how loving and caring all the staff are, the effort they put in to making the residents feel and Home and the place itself is a good mix of modern and homely plus they have residents pets

[Furrycushion]

I think you need to home in on an area and then visit plenty of them. Its a bit like "where shall I send my child to school?". There are just too many options! Decide on an area (at least a rough one and ask about specific homes. Good luck, it's a horrible process.

[MyYoniFromHull]

She can move out of the LA area but her social worker would still need to make regular checks, there's usually an annual review to check all is well. It can get a bit more complicated if she moves out of her usual area and then becomes LA funded ie stops being self-funded. But nothing insurmountable.

Do start looking, you may need to wait for a space to become available somewhere suitable. I'd also encourage you to choose somewhere that is easy for you/other loved ones to get to easily, somewhere you can pop in for 10 minutes several times a week is much easier than somewhere a good hour away that needs a day trip.

[OkapiWoman]

Thanks MYFH
You are right I’m going to have to bite the bullet and start visiting.
My mother would never ring a bell - she had one of those alarm services with a pendant for a couple of years before she was nearly this bad and never got the idea of how it would work. There are all sorts of things I haven’t even thought about!
Do you know if it matters which local authority home she goes into? I mean I live in a different LA to her, does she need to be in her own borough or will mine work the same? I think it will take her a long time to spend her house, so presume we are paying all the way...

[MyYoniFromHull]

I'm not in the right area geographically but I work in an EMI setting. It sounds like she doesn't currently have any nursing needs so residential or dual registered may be a good option. Dual registered can mean that if she needs nursing care in the future she wouldn't have to move to a new place.

There's some good info on the Age UK site about choosing a home and how funding etc works.

You've had some great pointers already. I'd definitely recommend making unplanned visits to potential places and watch how the carers interact with the residents. Are the food options suitable, are alternatives available? Are bells left ringing for ages? Will they encourage her to join in activities? Many places will offer an initial respite stay that can become permanent if everyone is happy. If she runs out of money then how much is the top up fee that family would need to pay?

[OkapiWoman]

Thanks malovitt, that does sound right, even though it is obviously an illness I can see we are going to have to pay, and I do think she will probably be happier with lots of things going on, so an EMI home would be good. I do fear condemning her to an institution full of potentially agresssive people. Her safety at home is an issue but can be controlled by just insisting on a full time carer. Eventually she must get used to it and I could re-organise her house to fit someone in. I just wish she could be a bit happier and enjoy this (extremely expensive) phase of her life. Perhaps this is just a bad stage of semi-awareness of the horror of her condition, and it will pass, it certainly is very upsetting.

[malovitt]

Sorry - was away.
Yes, I do have some experience - an elderly relative, very physically fit but with Alzheimers. I cared for her in her own home as long as I could but she eventually became a danger to herself - leaving the gas on, flooding the place, opening the door to strangers, wandering off and getting lost.

I looked at 35 homes until I found one I liked and that would suit her.

It's an EMI home for dementia/Alzheimers sufferers.
I found that in homes with a mix - the people who didn't have dementia became really irritated by those that did.

She was assessed by the NHS for continuing care but didn't come anywhere near getting enough points even though she displayed the same behaviour as your mother.
She settled in really well and I'm convinced I made a good choice.
Everyone there has dementia in varying stages and they all seem to rub along quite well.

[OkapiWoman]

Thanks Chrissie28, Yes, that's true about the nursing home, it might be a bit depressing if everyone else is very ill. What she would really like would be people who she would think need her help, particularly downs syndrome people, as she lost her downs son. I haven't found a way of looking for that home, although I'm sure it must be out there, as Alzheimer's does come to people with downs.
If anyone has any ideas...?

[chrissie28]

I would think about several things - if you go for a nursing and you don't need it the people around you may not be easy to socialise with - might be an idea to go for a mix of residential and nursing - some homes have dual registration. Check out the Care Quality Commission reports and don't go for anything that is less than 'good' in all 5 sections. Then begin the search. ....... Age UK have a good checklist google age uk care home checklist. Then visit unannounced - speak to residents, speak to relatives, go more than once and then ask if mum can go for a lunch visit. Don't necessarily go for the ones that look like amazing hotels - it's the carers you want to be really great. Find out what the activities are, how often they happen and check that with the residents who will soon tell you if there's not much going on. Ask what happens when the money runs out - some homes have started to move people out when the money runs out. just a few starter points which i hope will help a bit x