Is a care home inevitable now?

[tobyj]

MIL is main carer for FIL who has dementia. Things increasingly not easy at home, but so far they've been managing with a little bit of bought in care and some regular respite weeks in a care home for FIL. MIL finding the situation increasingly difficult though, and things are pretty tense.

Last night, FIL started moving things around in the house in the early hours, and then tried to go out into the street. MIL had to physically restrain him (with difficulty) and is of course very shaken by the experience. Is this 'it' now in terms of home care? If MIL would consider live-in or much higher levels of home care, would this be workable? Or is an incident like this a sign that someone is no longer safe at home regardless? I realise that this has to be about MIL's feelings, but I'd be grateful for views on whether home care is a scenario that's even worth considering as one of the options?

Depends whether it is a permanent deterioration of his condition or a temporary decline caused by an infection such as urinary tract infection which usually makes an elderly person with dementia more confused. Some people do have privately paid for 24hr care at home but it would be very expensive and not funded by social services. First port of call would be GP to rule out infection.

Yeah, speaking from experience, once they start the night wandering, she’ll never have a decent night’s sleep again, and will become increasingly worn down, until he moves into a secure care home.

Sometimes you are as well going straight to the solution rather than ‘dangling’ to see if things improve.
@Mossstitch has good points and get an AirTag on FiL coat etc if you think he is a genuine flight risk.
I’d definitely put out feelers for care homes now - start asking where is good and actually visiting- even if you don’t need them for a few months, it’s good to know ones that you feel he might prefer and would work for MiL.

Even with live in care at night, unless they have a very large house, it’s likely that your MiL would still be regularly disturbed. And 24 hour live in care would need at least two carers on shifts, which can easily work out even more expensive than a nice care home - we did once look into it for a relative of dh who didn’t have dementia but needed help at night as well as in the day.

We had FiL with dementia living with us for about a year, but once he started wandering at night, going into other bedrooms to see who was sleeping in ‘his’ house, banging and shouting and demanding to go out at 2 am, the situation became untenable, and (after a lot of looking) we found a nice care home for him.

I do hope your poor MiL finds a manageable way - it really is an awful disease to have to cope with.

Yes, my Dad started wandering and my Mum could not sleep for worrying where he was and what he was doing.

It is really tough and decisions are hard to make when you are closely involved.

This. The air tag idea is a good one and would have saved a lot of anxiety had they been invented when my grandma used to wander.

I was in a more fortunate position with my mum - she was immobile apart from getting from her bed to the toilet and back - but she would phone me in the middle of the night to say that she had been up for hours waiting for the carers to come and she wanted her lunch. It wasn't every night but it was several times a week. If she had been mobile she would have been out the door and who knows where she would have gone.

Getting into a home can be a very slow process. It would be best to start looking for options now.

I would ask for another assessment. He may fall, wander off, injured himself, leave the gas on, run water. She won't be able to sleep. He would be safer in a carehome.

Thanks all. Funding is not an issue (very fortunately) - it's more about working out what's best for them both. It's a good point that her nights would still be disturbed even if someone else is on duty.

They've already looked at some homes, but all have their ups and downs (the nicezt one they found is quite a long drive, while the best of the nearer ones may not have availability). I think we're increasingly of the view that this probably is the right moment to start actively trying to find a placement though - thanks for all the perspective.

Loads of historic threads on choosing care homes if you use search function.
IMO the best are the ones which have had a long serving ‘visible’ manager, and a well trained settled staff who enjoy their work. If the care home is not served adequately by public transport then they will have problems recruiting staff. Ultimately it is the staff that make the home what it is…
Wishing you well.

We had about 30 incidents like this, each one getting progressively worse, think police, ambulance, firefighters before we managed to get my DM in a home.

I viewed 11 homes before finding the right one.

Have they liked the home he went for respite?

With FIL he went for respite stay (took a long time to wait for the availability) and while there, MIL decided he had to stay. The care home said this happened a lot.

The other key thing to take into account with people with dementia and care homes is that there is a benefit in them going in when they still have the cognitive ability to learn new places and routines albeit slowly.