I think the time is coming soon for a care home - but mum is so scared and confused.

[ZaZathecat]

Dm has dementia but is still aware of everything, just confused and upset that she never knows what us going to happen to her. We were managing ok with me visiting daily to do jobs, take her shopping, make sure she eats/takes tablets etc. She was fairly contented.
However a fall a few weeks ago landed her in hospital with a fractured pelvis. She had no idea what was going on during the 2 weeks in hospital and the dementia was so much worse - lots of hallucinating.
She's now out of hospital but can only shuffle a little with a frame - needs help with everything. A care package is in place : 3 carers a day plus me in the afternoons.
Every day I find her scared and upset because she thinks I've gone on holiday and left her alone. She often doesn't remember that the carers have been. She can't get to the toilet in time so I have to clean everything up which is humiliating for her and not much fun for me.
If her mobility doesn't improve in the next few weeks I can't see much option other than a care home. However she's already confused and terrified in her own home - I feel like moving her somewhere unfamiliar to be surrounded by strangers could be the last straw.
I'm at a loss and worry about it/her 24 hours a day. Any advice out there?

Honestly? I'd plan a move sooner rather than later. Will say more later. Hugs

I think right now she needs someone around all the time to reassure her. This doesn't mean a permanent move to care, and a few weeks respite care to get her through this crisis might be all she needs to get back to being mostly independant.

Would you consider a 'couple of weeks somewhere nice while we get you well again' sooner rather than later? Then you can reassess in a couple of weeks

Thanks you both. Helen the word 'hugs' actually made me well up - and I'm not usually like that!
CMOT I guess the idea of 'temporary' care could work. I'm terrified of doing the wrong thing. So I guess I should be ringing round all the lical homes making enquiries - what should I be asking?

Just had a thought - what about funding? SS did not consider her needing 24 hour care hence the package of care at home. Does thim mean she'd have to self fund? She only has a couple of thousand in the bank and we can't afford to fund it.

Right now, the right thing is your mum being safe, clean, and made to feel as secure as possible. You aren't making irreversible decisions about her future, just doing what needs to happen right now.

Ring them and ask if they have any respite places - explain exactly what your mums current condition is and see what they say. Then pop in and visit them - look for people like your mum and see what they are able to do. Would she be able to go in the garden, are there quieter and more social areas, are staff chatting happily with residents, are the loos clean, are people being enabled to mobilise not just being pushed in a wheelchair and so on.

Get her care needs reassessed. Basically if she has night care needs - reassurance or active help say to point out its still night and go back to bed , then, in theory she qualifies for redidential care.

I say do it now because you have time to look / get assessments and move her for a " bit of a break" without it all being urgent.

She's probably going to be more easy to settle now rather than later and the " sales" points of a good home - entertainment , good food, trips out with the family etc mean things to her.

If you need guidance re how the money works I'm unfortunately pretty knowledgable having done it in the past year.

My dad thrived in care for much of the last year of his life - he ate better , got stronger , did more and actually probably got more out of life than the last 18 months at home with mum who was getting sicker herself.

He died 6 weeks or so ago of his dementia , well looked after to the end by the carers he loved and who loved him ( having known him when he had a personality and sense of humour rather than just in the terminal phase ). Yep it cost loads but was worth it . There were minor niggles - lost hearing aids and teeth being the memorable ones but they turned up and were nothing thinking back.

Search my threads. ( I was Theas18 pre hacker gate name change ). The lovely team here supported me through it all so there are lots of threads on the ups and downs !

Older persons social worker here OP.

is your mum able to make a decision herself about placement? Did they do a mental capacity assessment about accommodation when she was in hospital?

If she is not able to make that decision then SS need to complete a mental capacity assessment and any placement will need to make an application for a deprivation of liberty safeguards (DOL's). Part of that process is ensuring that placement is the least restrictive option - that may be placement if it is the only safe option, if support at home has been trialled and the risks remain too high.

Have you considered an extra care call, so 4 a day? Or day centre?
Please do PM me if you need anything.

Ask about evening staffing levels. In my experiernce, even 'good' homes dip in the evenings, as the staffing ratio drops, there aren't the extra staff, like activities coordinators etc., and 'evenings' can be from 6.30 onwards which is a hell of a long time if you go to bed at 10, and you're in your room, confused, needing reassurance, but with staff who only have time to pop in to administer medicine, collect supper dishes, toilet people, and have to be in and out of rooms ASAP. I have yet to find the home which employs a member of staff in the evening whose role is to spend a little time talking to those who want that, and reassuring the anxious and confused residents, and making sure that people have the TV on the channel they want, hankies within reach, a drink in front of them etc. etc. A high staff/resident ratio is fundamental, imo.

Thanks for all the replies. Mooey my dm is dianosed with dementia and I have LPA - would she still need that assessment? Re the 4th carer I am arranging one privately but this doesn't help with the fact that she's scared and confused between visits.
Helen, SS assessed her care needs in hospital a week ago and decided 24 hr care was not needed (I disagree). Should I go back to the hospital to discuss, or ask my LA for an assessment (or maybe they are one and the same)?

Yes, she will. Is your power of attorney for finances or welfare?

You need to go to the community team to discuss, not the hospital.

One week is very very early to be out of hospital, any move can make the person experience a bit of a decline. She is bound to be more anxious if she has spent the past few weeks surrounded by people.
I would have a chat with the duty social worker, see if there is any additional short term support that can be put in at home.

Re the confusion, is it worse than before she was in hospital? I would worry that another change of environment would exacerbate that.
Does she have any current infection?

Is she orientated? (Does she know where she is, who you are, what sort of time of day it is?)

I'm not trying to be doom and gloom, this is a really tough between point and is almost more difficult than when someone is clearly in need of placement but there are really important reasons why we encourage home wherever possible and there are really clear legal parameters to placing somebody.

Thanks Mooey. I have both LPAs. I agree it's better if she can stay at home, she is disorientated at the moment, often not sure what time of day it is and doesn't realise she's at home. Hopefully that will improve. Sorry for the eelay replying ' no orizes for guessing where I was@