Advice for carehome

[soisolated]

My mother has dementia, undiagnosed but quite progressed. She needs help dressing, washing, food preparation, occasionally toileting. She lives abroad with my brother and now he can no longer cope, so I am going to bring her home to a carehome near me.

We have found a really lovely carehome where she will be able to smoke (very important for her). However, they won't accept her without an assessment. I will bring her to my home for a few days so she can be assessed and hopefully then move in. All seems fine, good carehome, close to me, smoking allowed, private funding, no money worries. But and it's a big but she is in utter denial about dementia hence no diagnosis and has left everything for my brother and I to sort out, no provisions at all, made us promise never put her in a care home.

I have difficulty feeling guilt, we are not close and she was a toxic parent. I need the assessment to go well so she can be placed as I can't take time off work to look after her indefinitely and she gas money to be card for properly.

Does anyone have any tips for relaxing her for the assessment? We are telling her she needs to return home for medical treatment and to get a new passport and will she staying at a guesthouse.

My brother is very concerned at lying to her but if I don't she will be resistant and maybe they won't take her and she will have to stay somewhere less nice, further away from me, no smoking etc... I will have to place her soon as her living with me is not viable.

I was hoping for details about assessment and if they won't take her advice on what to do next

They may ask her if she understands why she is being assessed, is she happy to move into a carehome, what sort of help does she think she needs. Do you have power of attorney for her, if she has the mental capacity to make her own decisions she can refuse to move into a home and also leave at any time.

They may well want a GP review, a memory test, a capacity assessment , a diagnosis before they consider taking her, you cannot just place her in a carehome. She may be able to stay just for respite but this will all need to be discussed with the home manager. If she is accepted they will ask her what she likes to do, hobbies, social activites, favourite food , all general stuff. They will also want to know who paysand how it will be paid for. Age UK have a lot of info on their website.

I think that you are taking a big risk. My experience is that SS will ask the person concerned about their wishes. They will not go against those personal wishes unless the person is a danger to themselves or others. Being unable to care for yourself is not considered a danger. They will likely advise home carers. Similarly with a Doctor, they will not usually do an assessment just on family say-so. Even if you do manage to get an assessment and agreement the whole process takes ages.

My experience was,
GP appointment a week.
Memory Clinic appointment 3-4 weeks
Brain scan a ppointment 3 weeks.

From assessment to admittance was 9 was 11 weeks.

I would get in touch with Age UK, your local adult social services and the Alzheimers site before you make any decision.

What kind of assessment are the care home wanting? Is it an assessment by their own staff? Do they take residents with varying stages of dementia? If so, and it's their own assessment by their own staff, it is likely to be just so they know what they will be dealing with.

Does the home know that your DM is unwilling to enter a care home if she knows it's a care home? And is so, and presuming she lacks capacity to make her own decisions and a decision will have to be made in her own best interests, how will the care home manage the move?

I really wouldn't be bringing her home until I had the answers to those questions.

I should just add that reason why care homes insist on SS involvement and an assessment is two-fold. One is so that they know what the persons needs are. The other is to ensure that relatives are not going against the personal wishes,

Sadly even though you are trying to do your very best for your mum, you will have many hurdles to jump.

SS will ask your mum if she knows why she's being assessed & as PP says, if she has capacity then she can refuse.However if dementia has reached the stage where your mum cannot wash/dress/cook etc then it could be she lacks insight to her needs. Denial about the condition is extremely common & both the SW & home will have experience. (some care homes are able to meet the need of residents with dementia, some are not, are you certain this home can as they do have the right to say at any point if they cannot meet her needs & she needs a new placement, even once she has moved in?)

You are also able to explain that she cannot stay with you/toxic parent/you work full time as your wellbeing is also important.

Also if you don't wish to manage her money then Age UK can do this for her.

Its not just a straight choice of home or staying with you forever,there are levels of care & options will be available after the assessment.

Thanks for all of the advice.

Perhaps l need to elaborate, her dementia is advanced she cannot make decisions, her capacity to reason is gone and most of the time she is not sure where she is. I am guessing latter stages of Alzheimer's, though obviously this will need to be diagnosed and due to both her and my brother's resistance I have had to resort to Dr Google.

She has funds to pay for a carehome, my brother has Lpa and she also has a property which is uninhabitable and will need work doing on it before it can be sold or rented. As I said she was living with my brother and the house was left and has decayed. She cannot stay with me for longer than a few days. Both myself and my partner work full-time we have three young children and a small house with only one toilet upstairs. I would have to resign and probably lose our home have a massive detrimental impact on my children, as I said not viable. She broke her hip last year and getting up the stairs will be problematic anyway, washing her, getting her into the bath will be impossible. She cannot be left alone as there are lots of steps in my home and when she stayed last year she turned on a gas ring trying to light a cigarette. We will have to use stair gates as she wanders in the night. I am taking a few days off work to try to enable the move. I visited a number of care homes, some of which require no assessment and I could take her there from the airport. However, I don't want to do this I want her to go somewhere that is nice which she can easily afford and where she will be taken care of. She has no where else to go, my brother will no longer look after her, her house is unsuitable and I cannot ensure her welfare at my home.

Also she was in a carehome for some weeks after breaking her hip, and they just assessed her in hospital, no ss involvement at all. Care homes all seem to differ but the nicer ones appear to be very picky. The one we have found are aware of the situation and said she's needs assessment for her needs prior to entry, which will take a couple of days. This seems contrary to the reply?

The care homes have to complete an assessment before they can accept someone as part of their registration. It's usually pretty straightforward and it's just to ensure that they can meet her needs.

A social services assessment is entirely different and if you are self funding there is technically no need to request an assessment from them at this point.

However, because your mum lacks capacity it's highly likely that the care home will have to apply to the local authority for what is known as a deprivation of liberty safeguard. This basically is to ensure that your mum is being held in a care home against her will for good reason (they have to do this even if the person isn't actually complaining about being there).

So although you don't need social services to be involved in the initial admission don't be surprised if they do get involved in some way. They will also be able to provide you with information and advice and should also screeen your mum for funding known as continuing healthcare funding from the NHS (although of course how long your mum has been out of the country may effect her entitlement to public funds).

The good carehomes will do an assessment and draw up individualised careplans, i would be wary of one that didnt want to do this especially if its for permanent care. Have you looked up the CQC report for the home you like. They will need proof of health and welfare POA and also proof that she can afford it, usually 1,000 a week average, they will need proof of financial POA too and some ask for a couple of weeks money in advance. If she lacks capacity this needs to be confirmed as her care plan will have to take all this into account and as p.p. said she will need care given in her best interests. All this info is on the capacity act website. Was she in a carehome and hospital in the UK, if so they might have some info which could help, is she still registered with a GP. Good luck, I hope you find her somewhere nice to live.