Help: Mum in hospital, says she wants to go in a care home.

[YesIwillyesIwillYes]

My recently bereaved Mum is currently in hospital and says she doesn’t want to go home to her bungalow but wants to go into a care home. Although she’s late 80s she’s still in pretty good health and she has no sign of dementia (she does forget some things). She says she wants a care home near the bus stop so she can “get the bus places”. And walkable into town so she can go to the market and out for coffee. I really want to help her meet her needs but is a care home going to be the right place for her? Will a care home let her come and go like that? Might she be better off in an assisted living type place?

Must depend where you live - MIL has gone from care home to hospital to nursing home and funded partially through social services and partly privately. Nothing from NHS.

You need a good financial advisor to invest her money. I have LPA for elderly relative, she's been in an expensive home for nearly 7 years and hasn't burnt through the money from the sale of her house. She does have a good pension and also gets attendance allowance. You can also buy an annuity as another alternative.

Also investigate day centres/lunch clubs etc. My mum goes to a couple if daytime activities run by the Salvation Army and they pick her up and bring her back home. Mum has alzheimer's and probably wouldn't cope well with a move but getting out for social activities really helps her. I've also found someone who will come in and clean, do light gardening and admin or jobs like changing light bulbs etc, take her to appointments (which would really help with stuff like blood tests or vaccinations where there is no consultation) but getting mum to accept that she needs a cleaner is still work in progress.

That's absolutely not the case (OP Social Worker here).

Getting NHS funding for a nursing home is incredibly difficult and there is nothing to suggest that the OP's mum.needs a care home.

From experience yes it is the case. Must be down to area, circumstances and knowing the right people.

Sounds like she's too well in herself for a care home. She won't even be able to make herself a cup of tea or a sandwich.
That's the reality.

My own mother did this. Went into a home because of being frightened to be on her own,, but had to come out a couple of months later because she was just sitting in a chair all day and didn't want to mingle with anyone who was up to conversation. She wasn't 'bad' enough for the home.

A family member built an extension for her and she had the funds for that. They had to get carers in too as her dementia progressed.

Only if assessed as needed and only for a few weeks

My nan lives in retirement housing with her own apartment, she's in her 90s so it's more of a cross between assisted living/care home. She looks after her accommodation but has extra help and gets to socialise downstairs, they have bingo nights etc.
So something like that might be good for your mum.

Discharge to assess or intermediate care discharge would see the NHS covering the costs - but only for around 6 weeks.

After that (assuming there has been no level 3 mental health section) normal funding rules apply, with social services (not the NHS) picking up the bill only if they are below the savings threshold. ThE NHS would cover part of the cost if FNC or CHC are granted - but that's only the cost of the actual care, not accommodation, meals etc.

Yes I was going to say the same. There are some places with not only a restaurant, but also other facilities like shops, clubs, entertainment. Basically a retirement version of Center Parcs haha.

There is the independent living flat option, with shared communal areas which may be more appropriate currently to give her a greater sense of community and reduce her isolation. Although if she is very able just moving house to an area with better public transport and more community activities for older people may be enough. She could then have care in her own home if her needs increased.

My Grandmother was in sheltered housing in an Abbeyfield for a while before she unfortunately required more nursing care quite suddenly and it was no longer appropriate for her needs. She had her own room and bathroom and a small kitchenette. They had a shared dining room where meals were provided and communal activities in the living areas. She had to be self caring with personal care though as they could not have carers visiting to help with bathing. They did their own laundry in the laundry room. There were staff on site during the day and an emergency call system overnight.

For more support with washing, dressing, laundry then a residential care home option would be better if she doesn't want to stay in her own home.

I would say assisted living . You can come and go and have communal rooms and activities . My mum and dad did that and the rent was lower that their house.

Could you rent out the bungalow ? Then that rent could pay the rent on assisted living flat while she decides if it suits her ? My parents flat was great . And they had 24 hour emergency care on site .

@ToHellBackAndBeyond. NHS funding to live in a care home really isn't dependent on "who you know". In England there is a really strict criteria. Being discharged from hospital has nothing to do with it, unless we are talking about very time limited rehabilitation (6 weeks max usually). The OP clearly says that her mum wants to live in a care home.

It doesn't sound like she needs to go into a home just yet? Would it not be better if you tried to establish what she's really after. A ground floor flat close to shops and community things might be what she's after, or a sheltered flat with a warden but service charges are high and they're difficult to sell. Or maybe she really does want to go into a home and be looked after... I think you'll need to try and establish what she wants and take her to a few places and see what she thinks of them.

We’re talking about a woman who is not yet in need of a care home.

If she goes into hospital, and the hospital decides she needs “reablement”, they may suggest this happens in a care home and pay for 4-6 weeks.

If they decide her needs are medical and sufficient to require nursing decisions on a daily basis, she may get funding for her care. This would apply whether or not she was in hospital.

If her needs were decreed to be primarily medical, and she’s got less than 6months to live, the criteria for NHS spending are more relaxed.

This is how it works across England.

If your experience is different, be assured this is so very different from normal experience that it’s not actually helpful to raise it.

If NHS care is funded because of 'who you know', that's cause for a fraud investigation.

She can move into a nursing carehome if she's self funding, not all residents need a high level of nursing care but she may not want that environment if she is independent and likes going out.

A care hone cannot prevent someone accessing the community and coming and going as they please unless they enter a legal process and have a formal authorisation to deprive them of their liberty. This can only be done if an assessment takes place and it is agreed they do not have capacity to make a decision about something like staying safe on the roads.
A good care home would actively support community access.
But as your dm is so active maybe a different type of support like assisted living might be best.

I get where your Mum is coming from - she has reached a stage in life where she cannot be arsed with all the shopping, cooking, house maintenance, bill paying etc. etc. and she wants to move somewhere where all this is taken care of.

If she goes into sheltered housing at her age she is very likely to need a further move as she ages - she wants to just get on with it in a care home where they recognise and respect her current level of independence, but will be able to care for her as she ages further.

True, some homes have a residential and separate nursing floor or wings so if your needs change you don't need to move, residential is slightly cheaper.

My Nana decided she need more care at one point and booked herself appointments and tootled off on the bus to look at homes.
Definitely get someone from the discharge team to come to talk to you both. She may be happy with some sort of sheltered accommodation or assisted living.

She may be happy with some sort of sheltered accommodation or assisted living. The trouble with those options is that she might well need more care within a short space of years and she will have to make 2 moves at an age when I am sure she would rather not.

Thank you so much for all the input. It’s a very stressful time, not aided by a toxic family system that is total chaos.

I didn’t go to my mother’s husband’s funeral. I wasn’t close to him (I live far away and she married him quite recently). I left home in my teens and I’m now in my early 60s. I felt I should go to support my mother and I asked my younger sister of my intention to attend.. My younger sister asked me not to attend, she said it was going to be a very small funeral with no wake. She asked me to come on a different day to the funeral when she and I could spent time together. I was hurt by that request but I honoured her wishes as she was organising the funeral and I didn’t want to make a fuss at a difficult time. It turned out there was a sizeable funeral with a wake at a hotel. And she told my mother (and others) I didn’t care enough to turn up. Bizarre lies. My mother would have been really pleased to see me and I wanted to go to support her on that important day.

I’m low contact with my family because of the dysfunction (as children we spent spells in care). i care very much what happens to my mother and I want her to be content and comfortable so I am going to persist in ensuring she gets settled somewhere suitable.

It’s good news that she’s thinking ahead and her reasons (being near the bus stop so she can get places) sound great.

I think the best thing would be to go and visit different types of homes with her.

My grandmother moved into sheltered accommodation at 80 to be in the town centre so she could go to the market. She lived there for 20 years and has now just moved into a care home aged 100 after a bad fall. She hates the care home as she can’t cook for herself. I feel we should have prepared her a bit better for what care homes are like.

She’s still alert despite being now very old and I think the fact she moved into sheltered housing has helped keep her busy and sociable and prevent her from exhausting herself looking after a big house. I’d recommend sheltered housing any time.