Dad being nasty to, and making dubious care decisions about, his elderly father

[JaneDidion]

Hi all. I've just created a Mumsnet account to start this discussion in the hope that someone can help!

My paternal grandfather (96yo, physically ill but mentally "all there") has just been put into a care home by my dad and uncles. Grampy is really unhappy there, and the care doesn't sound great; there's one hoist for the whole building, which is on the ground floor (Grampy is on the 2nd floor), and he's been left for up to 1.5 hours at times when he's fallen or soiled himself, because it's so understaffed. He wants to go back to his own home, in a village where he was a really pivotal part of the community.

He does need 24-hour care, but this wouldn't be impossible - my dad and one of my uncles are wealthy, and there are two other siblings and loads of grandchildren (myself included) who could chip in. Which leads to my first problem: Dad is citing finances as the reason why Grampy can't go back to his own home. Dad recently retired from a job that paid about £80,000 (conservative estimate) a year. His wife (my stepmum) has also recently retired; she was a consultant doctor, so earned probably around the same. They recently spent about £35,000 on an orangery (which they saw as a "bargain") and bought a brand-new mobile home for £40,000.

Now, I realise that 24/7 care is expensive, but I can't help but think that it's not exactly unaffordable to them; it seems to me more a matter of priorities. And, as I said, one of Dad's brothers is also very wealthy, and he has another brother who could chip in a bit of money too (though nowhere near as much), and grandchildren who would want to help as much as we can (though I'm on less than £20k a year, so realistically it would be negligible compared to how much Dad and his wealthy brother could afford).

So, that's one thing - the finances.

The other thing is the way my Dad speaks to / treats my Grampy. Dad has real problems with vulnerability - he can't stand it in himself or in others. He thinks Grampy is just being lazy by lying in bed all day, for example. He tears open the curtains when he goes there, demands to know why he's not sitting up in his chair, why he doesn't have a smile on his face, etc. Grampy has always been a "look on the bright side" kind of person, never one to complain about anything, always laughing and joking. But he's 96, FFS, and he has late-stage cancer, and he misses his dead wife, and he's incontinent, and he's in a home that he doesn't want to be in. Dad has absolutely no patience with him, storms out of his room in a rage for no discernible reason, etc. It's just really horrible to see. (For context, Dad has always been short-tempered, impatient, explosive and rather aggressive like this - it's not just now, and it's not just with his father.)

Dad and I had a few words about this yesterday (after he stormed out of the care home again), which wasn't particularly productive; he ended up walking off when I suggested he COULD afford for Grampy to live out his final years at home. I feel bad now - I do realise it's really hard to look after an elderly parent, and I feel sorry for Dad in the sense that he's REALLY bad at dealing with his emotions, and I know he's stressed and probably feels very guilty, deep down - but I'm also really worried about Grampy, and just want his final months/years to be as good as they can be, or at least not totally shite.

Any advice would be greatly appreciated. Sorry for the essay!

Thanks!

Poor grampy. Did he agree to move Into to a carehome and is he able to make his own decisions. He should have been assessed by a doctor, nurse, therapist and social services before he moved. People cannot just be moved into a private carehome without their permission if they have mental capacity to make decisions. Does anyone have power of attorney for his finances, how is the home getting paid at the moment. He should have a full care needs and financial assessment which is free in the UK.

If he is reaching the end of his ,life then he may qualify for full chc fast track funding. If he is being verbally abused by anyone then you can call Elder Abuse UK for advice. Age UK also have lots of info.

Thanks for your replies. I don't know what the financial situation is, to be honest, but I know he's had all the assessments etc. (I should probably mention that we're in Wales, where the system is slightly different, I think, but still - he's had the care assessments etc.). He was in hospital before being moved to the nursing home. He didn't want to go into the nursing home, but he went along with it because my Dad and his brothers pressured him into it, e.g. telling him to "just give it a month and see how it goes". He's not being forced to stay there, I guess, except via a huge amount of pressure.

I don't think it's abuse, what's happening, just Dad being explosively short-tempered with him. As I said, Dad's always been like this, but it's horrible to see in this situation.

Dose your DGD have a house he owns ? If so , equity release could pay for care ? Also it’s sounds like abuse to me , maybe all the kind members of your family could have a rota to visit , so yr dad doesn’t have to ? Good luck with this x

If grampy is unhappy there and wants to be at home in his final years there may be ways to organise this. You could speak to him and ask what he wants to do, where he wants to be. Would hospice care be better for him, either at home in the community or in a hospice or a different carehome. If the home has a manager then speak to them to see what they can help you with, if grampy agrees to you talking to them of course. If you are really concerned about poor care at the home you can call the social services. No one should be shouting at him, calling him lazy, it doesn't matter that your dad is ill temperered, that's not an excuse and maybe it would be better if he didn't visit at the moment. The staff should be monitoring this type of behaviour.

If he has late stage cancer then presumably you have a reasonably good estimate of how long he would live?

I am unsure exactly what you mean by 24/7 care - do you mean actually someone living with him providing care round the clock? Some jobs take two people so you will need 2 people there fore some parts of the day, and also different people for day and night. You would presumably also need adaptations to the home like a hoist, etc.
The first problem is probably sourcing the care, the second problem paying for it. Sourcing the care is difficult, and can take many iterations to get exactly what works - would this be the best thing for your Grampy?
And I think you need to be realistic about the money - do you know how much the care home costs, how much the care at home would cost, and how certain you are about how long it would be needed for? If you do, then you may be in a position to say - I think this would be £80k (say) well spent. If not, I think you need to get some facts first.

could he come and live with you? I think your dad sounds like he is struggling seeing his father become so frail and needy. It sounds unpleasant all around, but its very easy to have opinions on what other people should do, and less easy to do it yourself

That home sounds horrendous. Can you look up and visit some alternative homes and put his name on the waiting list for any you think are more suitable for him, in the same price bracket?
Can you also look into the costs of care in his own home?

This can include offering a free room for a student or young person on a low wage who guarantees to stay overnight from, say 11.30pm to 7.30 am to be on hand if he needs anything; care workers dropping in twice a day - to dress him in the morning and undress him at night, check meds are correctly taken and give him a wash or bath as needed; a cleaner/home help twice a week and meals on wheels, so there's a flow of people in and out throughout the week. All of that is unlikely to cost more than full time 'care' in a rubbish facility like the one where he is now.

Presumably if he was popular in his village, he'd also get social calls.

I think you'll need to do the leg work and present your father with a better option that costs no more than he currently spends and requires no more effort than he's already giving. That way, he can;t complain. I wouldn't be against commenting that you are taking note of how he wishes to be treated when he's old and vulnerable by seeing how he treats his own father.

The care sounds really inadequate for his needs,which is the first thing.
Secondly your DF is struggling to cope with what’s happening. Thirdly your GF is facing the end of his life and has been moved to the place he’s likely to die.

If he’s got cancer have you spoken to someone at Macmillan about how all of you are coping with what’s happening, and what other options you might have for end of life care? Maybe a hospice?

You might not be able to influence your Dad and his brothers but you can try and spend time with you GF and make him feel as comfortable as possible?

this is a difficult situation.
how much do you know or could you find out about the arrangements that are being , have been made.
how involved do you want to get.
how much are you willing to stand up against your father.
how is the care-home being paid for. doubt it would be less £1000 a week. does someone have power of attorney, for finances, and/or welfare. is this being operated, it should only come into play when the person loses mental capacity to a degree that they cannot make decisions. this does not sound like the situation your grandfather is in.
you could try to get social services involved, but they would need GF to explain what is really going on, which he may be reluctant to do. he probably doesn't want to say anything against his son, even to help his own situation.
can you speak privately to your GF, ask if he would like you to act for him, this would need to be taken down legally, with a solicitor.
how involved can you get.
good luck.
maybe put this question on gransnet where many people will have had recent experience of these issues.

co-ercive control, being overbearing, causing emotional distress, pressure re living situation, finances, etc in a family setting is abuse and indeed is a criminal offence.
maybe you could remind your father of that, along with who how will look after him in frail old age...

I don't think it's abuse, what's happening, just Dad being explosively short-tempered with him. That is still abuse.

Talk to the care home - in the short term while you work things out you might be able to pay someone to go in to visit your father and supplement the care. ie they can go as a "visitor", but if he's wet/soiled when they get there, they can help him clean up. Does he have a mobile phone? - if care home staff aren't responding to his buzzer, then a phone call from a relative "can someone help X, he's not getting a response to the buzzer" can sometimes work wonders.

Though are you sure about the 1.5 hours? My father claims to have been left 8hrs in the toilet - but they feed him every 3 hours and there's no way they'd have seen him miss two meals without sending out a search party.

He shouldn't be falling in a care home. That would be reason enough to move him.

You can get social services involved about the care he’s getting in the care home and whether he wants to move to another home or not.

When my gran had to go in a care home she was allocated a social worker to make sure Gran was happy with the decision and we weren’t putting her somewhere she didn’t want to be.

But neither you nor SS can make your dad or uncles spend their money on either a more expensive care home or 24 hr home care.

Your dad doesn’t sound like he’s been nice at all. Call him out on it as much as you can....remind him one day it will be him in a care home and how would he like it if you talked to him like this. And just visit your grandad as much as you can.

I worry you might be underestimating the scale of 24/7 care in the home financially. You talk about a hoist, is that necessary for your grandfather now? That would require double handed care. He could be entitled to 4 calls a day, morning/lunch/tea and night. These calls can be anything from 10 minutes to 1hr.

Does your grandfather have a social worker? Who’s funding his care home currently?

I think you need to step back and also consider if your father and his siblings are capable emotionally/practically of arranging and providing this care. Perhaps your father is already in the grieving process to be losing the man he knew to be his dad, it’s a very difficult time and not everyone handles it in the way they would hope to do.

I agree that while I completely understand that this is a horrible situation for you to watch, I don't think you realise quite what you're expecting other people to organise and pay for. If he needs two people 24 hours a day then that's actually a medium-sized team of people working shifts. The house would also need extensive adaptation. None of that can be achieved overnight. I don't mean to be nasty but it's very easy to commit large (and uncertain) amounts of other people's money; you start off saying you'd pay too, but then later admit that it would be a token amount). I think it's important that you don't lead your grandfather to think that moving back to his own home is possible if you don't know whether it is, and if you don't have the ability to make that decision.

I've heard it suggested that 24/7 live-in home care can actually cost less than full nursing home fees (this was in the context of financial planning rather than actual need for care). So yes, if you are willing and able to get involved you could investigate how such care could be sourced and whether it might be a viable option.

A lot of people will pay lip service to contributing, financially or practically. When the reality hits, it’s a much bigger burden than anticipated. Would you be prepared to do overnight stays with your grandfather? 3/4/5 nights a week? Perhaps having to double up with your own siblings/cousins for any manual handling requirements. You’d get possibly 6 weeks respite in a year, but beyond that there’s 323 nights to cover.

I've heard it suggested that 24/7 live-in home care can actually cost less than full nursing home fees

A bit like having an au pair, this is very dependent on having the space, and also living somewhere where getting a free room is a significant draw to a job. I also suspect this was referring to a situation where a person can't live alone but essentially needs supervision, in which case the live-in carer is doing a reasonably light duty. See also the cases referred to above where students live with an old person for free accommodation - they're normally supposed to provide companionship, some housework and a watchful eye, not bed baths, manual lifting and changing incontinence pads.

It's also going to take time to get this into place. You'd want to be very picky about applicants and do a lot of vetting, because a heavily disabled person at home alone with a carer is very vulnerable to abuse or neglect.

He might be better off in an actual hospice rather than a care home especially if he has all his mental faculties. Equity release is expensive and honestly if there is money elsewhere that is best used first. Alternatively the brothers could purchase the property and give Dad a lifetime residency to release funds for care. 24/7 care takes 6 or 7 people a week with shifts and holidays and sick covered. Look into Direct payments for care - takes a bit to organise but alongside social services can be fastracked to some extent. My Mother currently gets 22 hrs per week and that is likely to increase. They too are in Wales and the most they will pay each week for the care is £90. They do have assets (although Mums are below the 16 odd K threshold at the moment) and a house but for DP this is for medical need rather than residential so that may be a better option for him.

I should say on top of the 22 hrs Mum has Dad there full time and one of my siblings or myself for the majority of the rest of the time and it is utterly exhausting

I know someone suggested hospice care but ime it's usually only for respite care or very end of life care. Not longer term. Places are hard to come by, we couldn't even get my dad in when he had days to live and the GP said he needed to be there.

If your Grampy is incontinent and has late stage cancer it would be very hard to look after him at home.
I'm not excusing your Dad's behaviour but it is very hard seeing your parents become frail and unwell.
Do you know for certain he was left for a long period unattended too? Many care homes have regimes of regular checking on their residents to make sure they're ok. If the home isn't up to scratch maybe a different one would be better?
Care homes are inspected and have ratings for how good they are. It doesn't tell you everything but it's a start.

I've heard it suggested that 24/7 live-in home care can actually cost less than full nursing home fees (this was in the context of financial planning rather than actual need for care). I've heard the opposite said.

My father's nursing home costs £40,000 pa. Minimum wage works out at about £16,000 per year. To cover full time care you need at least 4 people = £64,000. And you haven't yet covered pension and NI contributions, sick pay etc.

A bit like having an au pair, this is very dependent on having the space, and also living somewhere where getting a free room is a significant draw to a job. This is going to get more difficult with recent court rulings on payments for overnight stays.You will be able to offer a free room with the job; what will become more difficult is ensuring the person actually stays in that room to be on call overnight.