Mum in care home temporarily

[Metoo15]

Hi. Mum had a long stay in hospital after becoming confused and feeling ill. She’s 92 and has been in the care home 4 weeks. The social worker is going to see her next week to decide if she needs to stay,or if she could be moved to extra care housing, or go home.
Mum is so much better is putting on weight and walking much better. I’m afraid the SW is going to send her home, but the main problems are still there, she has postural drop which has
ended up in 3 very bad falls, she’s slightly confused and has occasional hallucinations. Apparently the LA can’t afford to put every one in a care home because of these problems and she’ll be looking for a cheaper solution !
I’m so worried. She wouldn’t be able to manage at home she had carers 4 times a day before her hospital stay. How can I navigate the meeting with the sw. I haven’t got POA so apparently it is her decision whether she stays or not.

It sounds like the worst thing would be for your mum to come home. I've been there with my mum also vascular dementia which was suddenly and slightly "miraculously" instantly diagnosed on her final admission to hospital. it wasn't a surprise to dad and me but we were surprised they'd set us off down the memory clinic route if the head CTscans from her various falls over the years were sufficient to diagnose.
This is the point at which you have to stay strong and be very firm with the social workers. Just remember you are acting in your mothers best interests, she's too far gone to come home by the sounds of it if 4 carer visits wasn't enough. Just keep pushing back hard, and get everything in writing if you can as unfortunately SW have been known to twist things shall we say when things are reaching crunch point. I found it so hard having to act this hard nosed bitch to them but found it easier because I was doing it for my dad, he couldn't cope with her on his own age 96 and it was dragging him down mentally and hurting him physically. You will need to fight very very hard though as they were saying to us that my mum would be fine at home on 4 visits a day and a downstairs bedroom (no downstairs bathroom though), with would have been a disaster. fortunately M&D had the resources so we found her a place in a lovely nursing home (the SW were trying to say she didn't need nursing care!)
So I wish you all the very best with this, but you are going to need to push back very very hard for your mums sake as much as your own.

Apologies if this has been mentioned but if not you can get so much advice and support from Age Concern. They were 100% on it when we were in a similar situation and were also able to point out legal things that OTs, GPs and SWs had failed to tell us.
I'd definitely recommend a call to Age Concern (we used Age Cymru and they were great).

There are criteria as to who meets the threshold for different levels of funded support - note funded, those who self fund of course can choose. The threshold for residential care is pretty high, they will be assessing in the current home whether she can be trusted to stay in the house (a major issue with dementia is getting lost) pour cold drinks, make a hot drink, make a simple meal (eg microwave a meal), use the toilet unaided - if she can do most of these she will not qualify for state funded residential care but should qualify for at least one if not two visits per day to check on her and help her shower etc. you can also ask about getting help with shopping, general household tasks etc stating you are now unable to help. Funding for residential (not nursing) homes is pretty rare unless there is moderate dementia

FIL used Internet banking and had opted out of receiving statements and when he got sepsis there was no chance to change anything. MIL theoretically had access except she had never been set up for online banking and she was paralysed and non verbal - couldn't read, write or take so it really was theoretical. She had moved into a care home when FIL got very ill so cancelling the utility direct debits etc would have been a nightmare if there wasn't a POA for FIL. Basically as soon as we knew he was dying DH cancelled everything he could. He had just over 24 hours before FIL died to sort out as much as he could then we were stuck. Because MI inherited his meagre savings the assessment needed to be redone but we had no access to her account.

It’s a minefield ! And one I’m not used to, thanks to this thread I’m learning very fast.
At home during one of her confusions she flooded the kitchen, and fused the electrics, leaving her in darkness. but she has of course no memory of this, her short term memory is terrible.
I’ve had a long meeting at the hospital with SW O/t etc three hours long ! Everyone was in agreement that a care home, although temp was the best solution. So the SW is hoping she has improved enough to go home or move into extra living.
She’s not likely to improve at 92 ! and would be back in hospital in no time. She should be supervised when walking due her postural BP drop which in the past has caused 3 major falls. The SW said that’ll be the key factor in wether she needs a care home, but as far as I know their not recording her BP.

Only child here but now my mother is dead and MIL in a care home I actually have a life of my own and I no longer want to vomit when the landline rings. I know that your focus is taking care of others but if you don't take care of yourself then you are no use to anyone. As they say on the plane safety talk, put your own oxygen mask on first.

If your mother has capacity then it's her decision that counts. That doesn't mean that you have to then be responsible for what happens as a result. If it's her choice then what happens is her responsibility. If she doesn't have capacity then your phrase is "no, I can't do that". It's not your job to come up with solutions, someone has been trained to do that and is paid to do that but it's easier for them if you volunteer to take on the work. Tell it like it is, you're on your knees and can't go on any more. You can't continue to provide the support that you have been doing. Any proposal they come up with must cover all the assessed needs rather than relying on "the family" for support. If they said "the daughter" then it might be clearer how impossible the task is but "the family" implies a team effort.

@Metoo15

You know your mother has a sw visit next week . Can you get into contact with them and say before her admission ( hospital / care home ) you did xyz ( include taking her to appointments , paying bills , shopping etc ) but can no longer do that .
SW will assume they can offer a little extra help with family taking up the rest , you need to be very firm that you are not willing to do it .

It's worth looking into extra care options as there are staff on site 24 hours. It's more expensive than normal sheltered but she can claim HB towards the rent and service charges if she's on a low income.

No-one will be able to stop falls unfortunately, not even in residential care although there is of course closer supervision.

Knotaknitter. Yes you’re right I don’t have to volunteer anything, but so difficult. I am determined though to say if they send her home they need to make sure there is enough help with everything , including the jobs I did, shopping, medications, hospital and GP appointments,finances bills, cleaning etc etc.
The worst part is of course the phone calls, so many night and day. Light bulb needs changing the tv not working, the I’m not well today, get the GP when of course nothing can be done. But as you say if she still has capacity that is her responsibility Turmerictolly My worry about extra care homes is the lack of people around , the SW said they have wardens but like you say their not around all the time.
She is incontinent through the night and has to get up to change the bed, I don’t think she should be doing that herself, she seems more confused through the night too.

@Metoo15 , in extra care there are staff on site (care team) 24 hrs a day. She will have a lifeline pendant if she falls and they'll respond within a minute it's or two. The care package can include night time monitoring as well as all of the usual support with personal care, meal prep, meds prompting etc. The schemes that I'm familiar with also have social activities and outings too. However she will have her own flat which may make her feel more independent and in control of the situation.

Does she use pads at night? Does she have a waterproof sheet to protect the mattress?

You definitely need to switch your phone off overnight

Call the Age UK advice line. They’ll be able to go through it all with you. It’s freephone and open 7 days a week 8am - 7pm

https://www.ageuk.org.uk/services/age-uk-advice-line/

Thank you again. Yes she has pads and waterproofs but I haven’t found anything effective yet. She’s waiting for an

NHS incontinence assessment but it’s a very long wait. She seems to release a full bladder all at once, even the pillowcases are wet.

There are no template forms in Scotland though, so you do need a solicitor here.

I am determined though to say if they send her home they need to make sure there is enough help with everything , including the jobs I did, shopping, medications, hospital and GP appointments,finances bills, cleaning etc etc.

Unfortunately that's exactly the burden which drains the life out of carers, and is absolutely not available unless 24 hrs care in a nursing home happens.

There is nothing and nobody who will take this on. It will default to you if your mum comes home.

TheShellBeach. Yes that sounds about right. We’ll be back doing the hospital revolving door before you know it 😵‍💫

I am surprised the social worker is so reluctant to admit your mum to a care home considering her age, and care needs. Extra care is more for independent living however, if your mum requires frequent emotional reassurance and support then extra care will not meet that need.

Cost should also not be a factor when assessing need. What does your mum want? If your mum expressing she does not want to go into a care home then the social worker has to look at every option available.

This is the time to be honest with the social worker regarding your limits.

Sensible advice from @hatgirl. Have you had a carer's assessment OP? You have a legal right to one under the Care Act. This would be a way of getting the impact 'looking after' your Mum is having on your well-being discussed and documented.

Have you looked at the thread I linked earlier, OP?

Hi yes I’ve had a carers assessment and was supported during the hospital meetings. Apparently I can claim a small amount to put towards a holiday too, never knew before. They ring every couple of weeks to see how I am.
Been to see mum today, she does seem better physically, but a bit mixed up. Said she wasn’t very well yesterday and asked them to take her bp but they didn’t. These are the days that I worry about, even with four carers a day she’s still alone 22 hours.
TheShellBeach. I’m going out soon will have a look tomorrow. Thanks it sounds helpful .

Realistically, OP - what is anyone going to do about a high BP at your mum's age?
We shouldn't, as a society, medicate every facet of old age. It isn't sustainable and doesn't do the elderly person any favours - or their unfortunate carers.

What does your mum want to do? That is key (and whether she has capacity).

I'm not sure that what the OP's mum wants should be considered.
She's improved in the care home and the OP is exhausted.
I think the OP gets to decide this.

You are wrong. Her mum's wishes are paramount.

She’s has 12 hospital admissions during the last four years mainly heart related, two heart attacks and three major falls resulting in long rehabilitation stays.

Does the SW know this medical history? Because it's all very well the SW wanting to reduce cost by not paying for her to be in a care home but extra care housing would need to be willing to take her.

My parents spent 5 years in extra care housing and as their health declined I spent a lot of time there and got to know the managers really well. Both my parents were diagnosed with dementia while there and the managers were quite happy for them to stay as they declined. But the thing that made them say the housing was no longer suitable and they would have to move to a care home was if they started having falls. It is not safe for people having repeated falls to be living alone for 22 hours a day even with an emergency pendant and on site carers.

In the meeting keep mentioning the three falls, her injuries, the hospital and rehab stays and any other more minor falls she has had. You can also say how she was living before her hospital stay - you mention she lay in bed all day - and stress all your other work and family commitments and that you cannot do much caring of your mum.