Advice please on elderly father and care home

[MaggieTulliver1]

Have been on MN in various guises over the years, urgently need advice about my dad. He is in his eighties, had a stroke a few months ago, which has left him wheelchair bound, with little use of his left side and slurred speech, but his mind is sharp as a knife. Not many people can understand his speech now, I can, but noticed people who don't know him can't. He is also very deaf, so people often just assume he is slightly ga ga. He was in a community hospital for several months since the stroke, and my brother is main point of contact for him, and has been dealing with SWs and so on as they have been talking about needing the bed and transferring him to a care home as he can no longer cope in his flat. His main issue is needing help to get to the toilet as he is wheelchair bound. Whilst my brother was away working, they suddenly, without any notice, transferred him to a care home that we had not approved. I got a message from my brother telling me they had notified him he was being moved as they urgently needed the bed. I found my dad in this care home, and the staff are perfectly nice and friendly, and doing their best, but the home is very unsuitable, It is majority dementia residents, and the lift is so narrow that his hospital wheelchair barely fits into it, we want to get him an electric wheelchair in the long term so that he is not dependent on being pushed around [currently he gets parked up and is unable to move, we found him stuck right in front of the TV in the common room, in front of x factor, which he hates, surrounded by dementia patients.] But we can't get him a new wheelchair as it won't fit in the lift. He is in the only room they have which is much, much smaller than any other room, absolutely tiny, and impossible for him to move in, he can't reach the sink in his wheelchair as the space is so narrow, and he can't even fit another chair in the room. The SW just says she doesn't know he was going to be transferred so quickly, and now we have to make the best of it. Do we have any options? He has only ten grand of savings and a small pension, does not own his own home [ he was a vicar FFS - the C of E have let him down completely] . If anyone can advise on whether we can find somewhere that the LEA will pay for which might be more suitable for him [ie bigger room, not majority dementia patients] The place we wanted has no space, but need to search for another place, just don't know how to navigate costs, and don't know what the LEA will pay for. Feel awful for my poor dad.

[Pearlsaringer]

It sounds like your father qualifies for LA funding. They will do a financial assessment and tell you what the LA will pay towards his care. Your father’s SW will be your friend here. They can negotiate fees with care homes on his/your behalf. The LA are rigid about only paying within their tariff but they can sometimes secure ‘private’ beds at LA rates if the care home is amenable.

Also, have you thought of approaching any charities, either for assistance with funding or for a place in a charity run home? Pretty sure there would be a number for clergy in need. Similarly British Legion if he has any service history.

[NewspaperTaxis]

Hi Maggie, you are spot on about the dangers of UTIs. As for drink, Lipton's Ice Tea is one I recommend, we have never used the nursing / care home's offerings.

BTW POA is something you always put off because as you didn't need it last week or the week before, and probably won't need it in the next fortnight, it slips down the list of things to get thru on a daily basis. You can go thru a solitictor (it's pricey then, around a grand) or just do the forms and then it's about £150 ish only, a signature of sorts is needed from your Dad and also co-signed by a non-family member who has known him for over five years. Can't be you then.

Doctors can do it, but sometimes charge for a half hour appointment to do this one thing, and let's face it, GPs aren't necessarily too keen to grant POA. After all if you don't have it, any attempt to investigate failings in your parent's care via a Subject Access Request, and you'll get the jolly, brazen response 'Do you have POA? Well, we don't have to tell you then!' The care home doesn't even have to inform you about the medication your Dad is on, it can withhold that info from you. He could be on the chemical cosh and you'll be thinking, what's up with Dad? Is he on his way out?

Just sayin'! Google POA on Mumsnet for more.

[Athome77]

What local authority are you? you can usually find out how much they will pay online.

[Athome77]

Fees-ask if the home will accept local authority rates and if there is a top up. If they accept local authority rates then the local authority will accept x amount (whatever the authority rate is). To get the x amount the local authority will do a financial assessment, usually this means the persons pension (per week) minus £25, this is the personal allowance for toiletries, clothes, hairdressing etc.

If the Home want to charge more than x local authority rate (including persons pension) they can, it’s called a third party top up, and another person has to agree to pay, it can’t be taken out of the persons savings or personal allowance, so if you agree to a top up think about how long you can afford it for.

This is how it is my my local authority - others vary, and if the person is self funding or entitled to continuing healthcare funding (when needs cannot be met by social care, usually when more input is required from a nurse on site rather than district nurses- but this isn’t always the case) then things can vary....

[Athome77]

If they had been telling you they needed him to move then you had notice, however the proper process is to issue letters saying you have x days, after which they can choose where to move him to, contact the Pals service in the hospital to find out if it was followed and put on a complaint if it wasn’t. If it’s a community hospital then it may be the pals service at the nearest big hospital.

[MaggieTulliver1]

Ah ok thanks.

[CMOTDibbler]

The Order of St Johns in Blackbird Leys - sorry, I think of it as Cowley as its behind the plant.

[MaggieTulliver1]

Is that St John's Home, St Mary's Road Cowley, or one of the Order of St John's care homes CMOT? [there is two one in Iffley and one in Blackbird Leys]. I rang the one in St Mary's road, no vacancies at present.

I missed a call from St B today. Need to call back. Siblings against it as so far away.

[CMOTDibbler]

Any response from St Barnabus?

LA places are negotiated with the home - so if you were paying, it would be £1k a week, but the LA will have agreed to pay £450 (or whatever) a week for the same place.

My mum had a great respite stay at the St Johns run care home in Cowley which was funded by the LA. Not sure if thats a part of Oxon close to you

[MaggieTulliver1]

sandwich his visitors died out long ago [not literally! ] :D well maybe some. they just forgot about him, including all the people in the church he attended regularly in his older years when he retired. Have asked. He helped so many, and they have all bloody disappeared. Bishop has replied and got in touch with the ArchDeacon. So fingers crossed. But care seems so expensive - 1k to 1500 a week. And sister thinks LA will pay 450 a week - no idea if they really will or how the finance is organised.

[MaggieTulliver1]

Oh god he can grip my hand alright. I guess it is hard for you to know what he is like from words on a screen, but I can assure you he is very compos mentis. But agree SS and home may try to say he has dementia [though SW in an email last week said he shouldn't be in a dementia bed] He told me he is drinking loads today, and told me the squash they give him tastes like dettol. But they have put him in pads so they don't have to take him to the toilet too often, which means a UTI much more likely if not kept clean. Thanks for the tip re POA for Health and Welfare, I didn't know about that.

[NewspaperTaxis]

Re grip my hand test, I mean to a few practice tryouts so he's knows the drill. Also imperative for anyone with advanced Parkinson's.

NB I'm not trying to lump your dad in with the dementia squad, Maggie. I am saying others may try to, so watch his back, and yours!

[NewspaperTaxis]

Hi Maggie, thanks, just checking your sister has POA for Health and Welfare and not just Finance, because the latter is no help for actual welfare except tangentially. Like I say, without POA in H&W, once your parent is deemed to have lost mental capacity, social workers are the decision makers for their care and you can whistle for it.

A urinary tract infection gives confusion, sluggishness and doolally qualities, as do low sodium levels, both can be treated of course and are temporary unless not treated.

Get him to do the 'grip my hand' test in jest of course but do it. It's the highly scientific method by which someone decides if you have mental capacity. If they don't respond, it's curtains for you, but neither of these decisions are made with your awareness, presence or consent.

Watch out for his hydration levels ie how much he has to drink. Fluid charts in care homes are doctored as a matter of routine.

[thesandwich]

Oh Maggie this sounds awful. No wonder his mood is low with little stimulation or encouragement.
Contacting the bishop etc sounds like a good move. Is it possible to get more visitors etc via the clergy for stimulation etc?

[MaggieTulliver1]

I didn't say he can't speak - I said his speech was slurred. We know dementia very well - my mother had it, and i was acutely aware of the early signs. My father has no confusion either about twenty years ago, or, more importantly, about yesterday or the day before. He knew the date today and knows about current politics. He is however in a v low mood, in dirty clothes, has not had a bath since he was transferred or a shave. My sister has power of attorney. The SW keeps changing on his case, so we keep having to start from scratch. I think the home probably would try to suggest he is confused though, and easy to think he is not of sound mind when you can't understand what he is saying [ I can].

[NewspaperTaxis]

Just saying what I say on all these threads: you say you dad's mind is 'sharp as a tack'. Really? Can you prove it, seeing as he can't speak. What I am asking is, do you have Power of Attorney in Health and Welfare? He has to be in a position to grant it to you, ie mentally with it. If not, get it. If you have, well done. It sounds to me like you're going to need it as you are not getting anywhere fast at the moment. Please please get POA otherwise Social Services can assume control of your parent, and it's easy for them to 'fail' a cognitive test if they are vulnerable. You can't get POA retrospectively.

My mum's loaded and can afford the best care homes, but we are getting treated like dirt. It's the one area where one-nation Toryism holds true.

[MaggieTulliver1]

CMOT - I rang St Barnabus yesterday! It does seem like an amazing place, and I wish I had known about it earlier and got dad there before his stroke - he has been so isolated since my mum died. It is quite far from us though [oxon] but will hope they call back.

Thanks vdb for that info - I didn't know there was a local wheelchair service - I must look into it. Current assessment seems v vague - and unfortunately it is my brother who is directly in touch with SS - but I will try to find this out thankyou. The only C of E nursing home was closed last year [Hindhead] due to difficulties finding staff :( :( I have written to the Bishop to ask for help finding a suitable grant! Just nothing will happen fast. And poor dad just stuck in his wheelchair in this funny place [with lovely staff though, and v hard working] with women asking him where they are. :(

[vdbfamily]

Firstly I would request an assessment from the local wheelchair service for a suitable electrically powered chair for him to facilitate his independence. They will assess whether he has the cognition and visual ability to safely use one. Once that is done and they have decided on a chair, you can juse that as leverage for the social worker to find a place that is wheelchair accessible. A standard electric wheelchair is sometimes more compact than a manual chair so it may fit in the lift, especially as with it powered, he may manage without a carer in the lift with him. This placement should be about dad and his needs and no-one seems to be adressing them at the moment. Maybe also ask for a Speech and Language therapist to look at whether there is a communication aid available that he could use to express himself more clearly. If there is a long wait , there must be a CofE benevolent fund who could fund a private assessment. Hope you get it sorted. An emergenct transfer from a hospital bed to a care home should never be considered a permanent decision if the person concerned is not having their needs met adequately. Have you looked into ex clergy places?

[CMOTDibbler]

I think that it is really hard to find places that can deal with very impaired mobility without the need for dementia care - I remember that when my grandmother (who was a wheelchair user with a fused hip) needed to go into care it was a real problem. You should be able to get a list from the SW as to which homes they will pay for, and then try and find the best fit and then get your dad on the waiting list

If you are near Lingfield, there is a lovely place there, St Barnabas, which has nursing care for clergy and it seems like fees aren't a problem.

[MaggieTulliver1]

thanks sandwich. AgeUk sent me a load of paperwork info, but weren't specifically helpful on the phone.

[thesandwich]

So sorry to read your story. Have you tried age uk for advice? They can be really helpful. It sounds awful.

[MaggieTulliver1]

bump