Been advised DM needs supported living

[adviceatthislatestage]

Hi there

Sorry this is a bit waffly as did t want to leave anything out.

DM(90) diagnosed with mixed dementia approx two years ago

Various health conditions but up until spring last year she was still very independent and able to go out and about without incident.

Currently, I am with her every day, as either work from hers during day, or visit in the evening. I also stay overnight 1 day a week) with DCx2 visiting one evening a week each. I have a DB but he is NC with mum.

She has had three falls since October - one of which required visit to A&E, but no admission.

She's having physio to strengthen balance etc in hope of preventing further falls, but after another one last week, I was told that she probably could do with moving into supported living facility.

We've a meeting on Wednesday about this, but Id like to know what SL actually means and / or if there are alternatives to her having to leave her home. I just know she's not going to be happy about this.

Just because it's their recommendation, does she have to actually move?

One option is that she live with us. DH and I have discussed this already and it would be a no brainier, if it wasn't for the fact that DH suffers from depression. When at his worst, a black cloud of misery seems to descends upon the whole house and I'd hate that DM got caught up in that.

What about if she had carers every few hours? Would that be sufficient, if it meant she could remain in her home where she's been for the past 49 years.

Does the fact that SL has been mentioned, mean that they think she no longer should be living independently. Are we doing DM a disservice by trying to accept her wishes about staying at home

TiA

My PILs moved into retirement accommodation a year ago and I have to say it's been excellent for them. Lots of support available, the flat is designed for poor mobility (eg no steps), and the social side of things is nice too (there's a restaurant and lounge area downstairs). IME it's a really good halfway house between living independently and a residential care home.

I'd have a look at the thread "I didn't realise how difficult this would be" also on Elderly parents. It would be a really bad idea to move her in with you - look at the other numerous threads on here. Plus your poor DH, never mind his depression affecting your DM, what about him having his home taken over by her?!

Supported living or a care home can be a really positive step and people get a new lease of life - meals, companionship, more people around, space set up for the needs of the elderly person. The trouble with carer visits to the house is the person is still on their own a lot of the time which becomes more and more difficult with dementia and increased frailty. Plus it's really difficult to get care needs acknowledged by SS and HCPs so if SL has been suggested wouldn't it be a good idea to look into it?

Hmm, that was a bit vague. What do they think this will solve? Is her home very unsuitable? Does she need care more frequently?

Realistically, she is going to continue to fall (combination of physical frailty, nervousness about falling, and forgetting that her mobility is compromised); and as her dementia progresses she is going to need help with more daily tasks. So even though you are there a lot (a LOT!) already she may come to need help getting up, getting meals and getting ready for bed.

Home with visiting carers may provide this. But if her home is all stairs and steps, no downstairs loo, expensive rooms she never uses, then a move may make a lot of difference.

A lot depends on her finances. There are some lovely retirement villages around. It would certainly be worth having a look at them.

Only you know the impact having her with you would have on your family, but sadly remember things are going to get a lot more difficult over the coming years.

Just ‘supported living’ in her own accommodation with help available may not be a good idea if dementia is involved.

At some point it - sooner or later - it may no longer work, if e.g. she forgets time, starts knocking on other people’s doors at 2 am, and forgets to use whatever call button help she’s supposed to.

I’m afraid that on a forum for carers of people with dementia (both DM and FiL had it) I’ve read of too many cases where after only a relatively short while, the person has been asked to leave. So then there has to be a second upheaval-move to a care home.

To answer your basic question,if she still has the capacity to make the decision, no, she doesn’t have to move. If she doesn’t have capacity, then whoever is making decisions for her will decide what is in her best interests, and they have to act in her best interests, not for their convenience.

Why does she keep falling? So many houses are unsuitable for elderly people, for instance they may be in a rush to get to an upstairs bathroom, uneven ground outside etc. Supported living accomm. is designed to address the risks. My mum had two falls before she moved to SL. If there is an issue with her house, it might be easier to persuade her to move.

SL will take a lot of the pressure off you, they also organise meds, prescriptions, vaccines etc, there is usually a hairdresser, they help to prepare meals and sort out washing. In my experience, carers who call to the home have very little time and the quality of care provided can be very patchy. The carer who called to my mother's house didn't even realise she'd a badly bruised arm following a fall, ffs.

Try to find a SL place that provides care when the dementia progresses to spare your mum the upheaval of another move.

She has had three falls since October - one of which required visit to A&E, but no admission

My DGM had a couple of falls in her very early 90s. The first one wasn’t too bad, but the second one she couldn’t get herself up. After that, she readily agreed to go into a Care Home. She was safe there and those falls were really the start of things declining so she stayed there and was safe, fed and well-looked after. Importantly, she also made some good friends and was happy and occupied.

Unless you’re watching or monitoring someone 24/7 you won’t catch all falls. My DGM had a ‘button’ but wasn’t wearing it when she fell and was unable to get to it.

IMO, if you can gently persuade her to consider an appropriate Home that would be best. The relief is immense.