Advice needed - time now for a nursing home?

[user1474905027]

My 85 year old auntie has dementia which has been gradually getting worse over the past year. She has never been married or had a family of her own so her care has fallen on her elderly siblings and a few close nieces and nephews. As a family we all do what we can for her - she has carers 4 x day, do her washing, cleaning, shopping. In the last year things have got so bad. She is not looking after her personal hygiene and not eating properly. She gives the carers and her brother and sister (my mum) a hard time refusing any help, gets angry and definitely not coping in her own home. The family have decided it’s definitely time to think about a residential home for her but just not sure how to start the ball rolling. Any advice would be welcomed xxx

Been through this with my parents.

Visit local care homes, check them out on CQC website.

Think about money - what is her funding position?

Someone can speak to her g.p. and say you're concerned, ask if she has capacity to make a decision about staying at home or moving, does anyone have power of attorney for finances and also welfare. If she has capacity and refuses to move it would be worth speaking to the carers and ask them to re assess her needs now shes getting worse. You can ask for a social services home visit to assess her care needs.

She owns her own home. Brother has power of attorney for finances and welfare. She does have capacity but becoming very very limited. One minute you think she’s ok and the next she can be shouting then crying. Such a dreadful disease. I know she’ll refuse to move. Carers having a hard time with her too. I just cant imagine how we are going to do this move. Siblings are in their 80’s and really needing some help to sort this out. GP first port of call I think xx

Horrible and difficult situation but yes, it's time to start looking. She may make the move difficult but once she is there she may be very happy, or sadly may not really be that aware what's happened. Start looking now as you may have to wait for a place at the best home.

Age UK and Independent Age both have information sheets on choosing a home.

Just phone up a couple and go and first visit the one that looks least likely: this will help you get your eye in. Ask for recommendations on your local Facebook pages. The homes are quite used to novice home-choosers and their attitude to you will help tell you a lot about the home. Pop in unannounced, see what happens, then arrange a proper visit. See the facilities, try the food, ask about activities, ask what care they have on offer 24/7. Definitely check their CQC report and see if the local Healthwatch has done an Enter and View. How do they involve residents in decision making? Obviously ask about costs: these generally come in two bits, the residential cost (which may vary depending on the quality of the room she has) and the care costs.

Once you get started you will find it easier than you think (that was my experience anyway).

Yes, I think a call to the gp would be a good idea, ask for another capacity assessment and try and get some idea of how she is likely to progress with this terrible illness. I think it would be worth asking the carers to re assess her needs and maybe also ask the adult social services to do a care needs assessment and a financial assessment. She may get some funding, even if its not full CHC funding she may get FNC contribution towards the carehome. If everyone feels she is better in a carehome ask what type, will she be ok in a residental home that doesn't have trained nurses on site but calls district nurses in or a nursing home that has nurses on site 24/7. Residential homes are a bit cheaper. You can view a few on line, go and visit them, have a good look round, read the review, social services might know of some places and help with this. Maybe a two week respite stay might be a good idea to begin with, see how she feels about that and might help her settle in.

I too have experiemce of this and I can tell you that it is very unlikely you can get her into a home. It has to be her free choice and unless she is a danger to herself or to another person it won’t happen. Unfortunately, living in filth, not eating and self neglect don’t seem to count at a ‘danger to herself’.

What normally happens is some sort of crisis. Going out and getting lost or having a fall and being admitted to hospital. Even then, there is no guarantee as even a little awareness is counted as “has capacity”.

I am sorry to be the bearer of this Information which comes from bitter experience.