Mixed care needs of older parents

[PenCreed]

My dad has vascular dementia and is declining fairly rapidly. My mum is a decade younger than him and is disabled, to the point of needing carers morning/evening, she can manage during the day but has a degenerative illness. Mentally, she's fine but it's becoming clear that they aren't going to be able to cope in their house for very much longer.

The question is, what do we do? My siblings and I all live some distance away, the waiting list for sheltered housing is long, if Dad has to go into a care home then they get split up and Mum will find it physically very difficult to get to visit him, but I'm not sure both of them going is necessary at this time. We're going to try to speak to a social worker, but does anyone have any experience of caring for these kind of mixed needs and can make some suggestions?

My df is in a care home and my dm, who has Altzheimers, is managing at home with daily visits from carers. The carers will take her to visit dad if we ask them to, they also take her to doctors/dentists appointments etc.

Can they go to a residential home as a couple.

It's possible but my mum is capable of living independently so that's a preferable option while she still can. I think perhaps investigating an option for my dad and expanding care for my mum so she can get places would be better medium term at least. It's hard when we're all at a distance (moving is not an option for anyone).

What does your Mum want? She may wish to stay with her husband. I'm presuming she has capacity so she gets to say what happens.

I've seen a couple of examples of care homes that have higher and lower need areas, including one that had lovely little semi-sheltered one and two bed houses attached to a full service care home - so one parent could be in the home, another in one of the attached properties. It was private, though, and pretty pricey IIRC.

@unsync Mum would like to both stay at home and stay with Dad. Neither are practical long term, so what I’m trying to do is find out how other people have managed this kind of scenario. Final decision will obviously be hers but someone has to do the research!
@tobyj that setup sounds ideal but I’m not sure that option exists where they live. I’ll do some more research on it.

We have a care facility near us that has bungalows on an adjacent site as nursing, care and specialist dementia provision. So assisted living in the bungalows as you can call on the staff in the main building and their facilities can also be used. It seems like a really good solution. They also offer joint accommodation for couples in the main unit too.

Would live in care in their home be an option?

Would your DM be self funding if they moved to a Care Home?

Personally I'm not sure that sheltered housing is a sensible option for your DF if he has Dementia. A change in location can often make cognition deteriorate so that might have been sensible a few years ago but I feel that they've missed that boat for your DF.

Your DM would probably benefit from an extracare facility though. My DM's one has a restaurant, gym, cafe and hairdressers plus regular entertainment. More importantly it's in a main bus route and you can buy in cleaning and carers.

Thanks @TinyMouseTheatre, I agree that we've probably missed the opportunity for sheltered housing. Sadly the point at which it would probably have been most helpful is before Dad was diagnosed - he managed to hide that he was failing for quite a long time.

Some of the options you've all described sound ideal but sadly don't seem to exist where they live! We're exploring options and I think will have to have the hard conversations when all the family are there at Christmas. Something to look forward to...

Some retirement villages work for mixed needs. I know it depends on where you live though. My friend's Mum has severe mobility issues, her Dad had Alzheimers. They sold their house and moved into a fully accessible flat in a retirement village. Pretty sure it's run by a charity and you can be on benefits to move in if you can't afford to buy. They had carers in to help with her Dad while he could still live at home. When he was too ill for that to work, he moved to a home. The Care Home was very close by though so her Mum could visit him each day - she just whizzed off there on her mobility scooter. Her Dad died a couple a couple of years ago, but her Mum's still living independently in the village. She has Carers a couple of times a day, but is still living a full life and has made some great new friends.

ps: I just messaged my friend. Apparently the charity's called 'Extra Care'.

My lovely late DFIL (terminal cancer) moved himself and DMIL (dementia) to a flat in a care home. Neither of them quite needed it yet but it helped her so much to have FIL there and to be familiar with her surroundings as her condition worsened

What a very caring thing to do. It sounds as though he was a thoughtful, lovely man