Convincing parent to move to care home

[falstaff1980]

I've concluded that the current situation is unsustainable for me, I'm exhausted from work and worry, I want my mother to move to a care home.

My mother has early-stage alzheimer's, I've got an LPA and basically have to manage everything, along with my full-time job and 5 year old child.

Yet from my mother's perspective all I do is pick her up each evening, take her to my place for supper, then take her home again. She's no idea that I'm also managing the maintenance of her house, acting as secretary to make sure she doesn't forget lunches with her friends, chasing things up with GP, the list goes on.

If she moved into a care home I'd still bring her to my house for supper, but I wouldn't have to worry if one evening I can't do this. It would remove a huge weight of worry from me.

My mother currently says she'd rather have care at home "when the time comes", and thinks she's more independent than she really is.

What steps did others take to persuade their parent to move to a care home? I've been talking to her friends and siblings who are still in good health, and they all seem supportive of me, and some have taken my mother to visit friends she already has in a couple of nearby care homes (good ones).

So familar.. Parent was in a retirement complex initially but you do need to be able to live independently. They wont pick you up after fall for example but there are pull cords, onsite bistro, and you can buy some care i.e to do your laundry, change your bed, clean the apartment etc. Its like the step before a proper care home and some people do well in them but from what I saw people move into them far too late. Its very common to move from a retirement complex into a care home within 1-2 years.

In my experience (both parents were in care homes in the end) its the very frail that are in there. Some care homes seperate dementia residents and some dont. They are upwards of £1200 PER WEEK.

Its very normal for parent to downgrade what you are doing. Its awful and dont be surprised if there is some fibbing going on too.

Dont be surprised if they fight you tooth and nail to stay where they are whilst forgetting all the things you do. I ran parents apartment and life. Letters were collected every few days and half of the county had my telephone number as Mum couldnt be relied on to do anything and wasnt beyond lying about what was happening. She still told people that she was doing just fine on her own and didnt need to move into a care home - if I questioned her further on things that had happened she would cry. Its very very difficult but realistically NO ONE wants to move into a care home including all of us!!

It sounds as if you'd have every right to do it, but is care at her home a (financial) option?

What stage is she at - eg if she were at home alone to have dinner, what would happen?

My DM was at a later stage than yours - TBH she just wasn’t safe to be left alone any more. But she’d never have agreed to go because in her head there was absolutely nothing wrong with her - even when she could no longer even make herself a cup of tea.

So we had to arrange it all on the quiet, and get her there by stealth. I was absolutely dreading the day (planned like a military operation) but in fact it went rather better than we’d dared to hope.

(Should add that she was self funded - we hadn’t involved SS at all, except for a short visit by one, arranged by the care home, to ascertain that she did actually need residential care - we weren’t just ‘putting her away’.)

I can’t say that Dm settled very quickly - for quite a while, every time I visited, she was demanding to go home, but there was absolutely no way - she was a disaster or an accident waiting to happen.

She did settle eventually, and when she later talked of home, she meant the childhood home she’d left before WW2.

You can’t force her if she has mental capacity sounds like she does. You can step back and put carers in the home if that’s what she wants.

Goodness, you're picking her up every single day and having her round for supper?! That's a huge amount. What happens if you're not available?

I think you need an inbetween stage with carers coming in to support. That will take the pressure off you. So either take a step back so that can happen or maybe go on holiday for a week or two with carers there instead? Then just keep them going! Will she be able to afford to pay for this?

You can't put your mother in a home mainly because you don't want to have her for dinner every night.

If your mother has capacity you cannot override her wishes.
If she's managing to get out to her friends for lunch etc then she is unlikely to be at the stage where she needs full time care. You don't mention carers so I presume she is getting herself washed and dressed etc.
The real problem here is her expectations and you are exhausted- rightly so. You need to put some firm boundaries in and a plan so you are not at home worrying. It maybe worth employing a private carer, if she can afford it, to come and cook for her set days of the week.
I know this is easier said than done with someone who has expectations and has some confusion but a care home should not accept someone who is able to cope, with the right support( not saying you) at home.
It might be worth contacting your local social services and asking for a carers assessment. Also find out whether you have a carers support/advocacy group that is local.
It's very difficult and it's ok to put things in place so your mental health and well being is protected.

She's no idea that I'm also managing the maintenance of her house, acting as secretary to make sure she doesn't forget lunches with her friends, chasing things up with GP, the list goes on.

one solution is to cut right back on all of this and only do the absolute minimum such as essential house repairs and GP appointments.

also, the daily meal at your house - I think you might have painted yourself into a corner with that one. What’s or who is the driver for that - and is there any way of starting to cut down?

It doesn't sound like she needs a care home tbh. But maybe she could employ someone to do those bits of admin and be company for a couple of hours a day a few times a week? A friend of mine did this for his mother for a few years until her dementia progressed and she wasn't safe at home.

I had said all along that I’d help until there was a crisis of some sort, so when they had a fall and ended up in hospital, that was the catalyst to moving to a home. It helped that their house was entirely unsuitable for having care at home. They wouldn't have wanted me to sacrifice my life for them either, we’d had discussions about this in their late middle age.
Once settled in the home they lived there quite happily for nearly 7 years (at 5k a month…) the dementia fortunately never progressed past being “delightfully dotty” thank god, i know most are not so fortunate.
Good luck OP.

Thanks all, it's very helpful to hear other people's experiences here. I wasn't expecting any magic solution.

I think what I'll do is to suggest she has supper at home herself a few days a week, and if she struggles with that then there's an argument for a carer to come those evenings.

At the same time I'll see if I can get my mother to consider trying a one week stay at a few care homes so she can make an informed decision while she's still able.

My concern about care at home is finding a good carer and what to do when if/when they call in sick. Also the maintenance of the house and garden is still a concern.

Have you told her you're struggling? Does she know how much you are doing? Apologies, I don't know how her dementia might affect her understanding on this.
I'm not suggesting you go straight to "I'm not coping, you need to go in a home" More "I'm finding things difficult, we need to get some more help"

It may be easier to frame it as building resilience. It's never a good idea for all this stuff to be reliant on one person being available.

If she's got someone else coming in to sort out an evening meal that means she's used to an alternative should you not be available - and you cannot possibly be available every single day, what happens if you get flu, break a leg, the car breaks down or you go on holiday?

Carers are usually arranged via an agency so it's the agency's responsibility to send someone else if the usual one is off sick or otherwise away.

Gardening could a local gardener be organised to come for a couple of hours weekly or fortnightly (depending on size and state of it?). Then you don't have to worry about it. That's someone else around to check up on her.

House maintenance - are you talking the place is falling down, leaky roof and dodgy plumbing? Or cleaning, arranging annual boiler service, gutter cleaning type stuff? Could be worth getting a cleaner for a couple of hours a week (might be more palatable prospect than a carer?) to keep on top of things, then gradually increase hours as needed.

Age U.K. are a useful source of information for a lot of this stuff and should be able to signpost to things like approved handyman for basic maintenance stuff.

She doesn't sound like she's at the stage to need a care home.

In terms of carers, you/she should talk to an agency - then they manage the sickness issue. The sacrifice there is that you don't get as much continuity - it's true that if she employs a private carer she can build a relationship with them which could make the situation a lot more stable and even pleasant for her.

Wouldn't it be worth moving to a situation where you are the backup person who covers the occasional missed evening, rather than the default?

It has to be said there's no such thing as a perfect setup but there are a lot of piecemeal bits you can put in place if she will agree to them.

Do you think she would agree to a ring doorbell? That would help if she calls you saying that the carers haven't been when in fact they have?

It doesn't sound as if your mum's anywhere near ready for care. From my own experience it's something to be put off as long as possible. I've never been more stressed than when my mother was in a home. If she has capacity you can't just override her wishes. You don't need to have her for dinner every evening either. You can get an alarm system, prepared meals eg Wiltshire Farm, cleaners, carers if necessary. Certainly while meeting up with friends is possible it needs to be encouraged. Have you looked at the cost of care homes? 80k per annum is not unusual. Unless she's very wealthy capital soon runs out.

My thinking had been that it'd be better she chooses a care home while she can, rather than having it forced by urgent necessity. We have some good ones nearby that have different levels of care, thankfully my mother's house is worth enough for costs not to be a concern, and if/when the money runs these care homes do accept local authority funding.

Do you have the kind of relationship with your mother where you can have a conversation with her and make her aware of all the extras you are picking up, and that you are struggling? As it sounds like she can afford to spend money on care, why not ask her if you can arrange a gardener? I'm not sure what you mean by "maintenance" on the house - if it is cleaning, then get a cleaner, if it is more general odd job stuff I'm sure one of her friends could also recommend someone local who can be relied on for things like that? And yes perhaps suggest she has supper one or two evenings a week on her own.

Right now, it doesn't sound like she really needs full-time care in a home. However, are you going on holiday this summer? What happens then? Could that be an opportunity for her to have a week in a nice home local to you which at least opens the discussion to it being a more permanent solution later on?

@falstaff1980 sorry but what in the world possessed you to have your mother for tea every single night????? you should have started as you meant to go on. once a week would have been ample!

Age UK offer handy person services in some areas.

I think it would be really helpful to talk to the Age UK helpline. Having another person to bounce ideas off would be a good support.

I'm not sure that your mum is going to be able to choose a care home if she's in denial that you're supporting her. I also think that tbh a home that is convenient for you and where you get on with the manager, routine and ethos would probably be best.

My mums GP was all for mum moving into residential care while she was still compus mentis enough to adjust. The GP said in cases like my mums where the path of her progress is clear then the earlier the better as far as they were concerned.

However, as we all know on this board, making the practicalities fit the good theory is virtually impossible. Mum refused, even though I have two suitable homes within five minutes walk of my house (she is 90 miles away). She has a mindset similar to OP’s mum in that she sees me visit once a week and not the daily phone calls and admin. Therefore in her eyes, moving close to me where I could pop in for 15 mins once a day and be her daughter again instead of her shopper, carer, property manager etc, is more work than staying where she is. Plus she’s lived in that house since the early sixties so I’m wary that any move now is going to make her worse such that she wouldn’t last that long in care anyway, so why not keep her at home as long as possible. She’s just about safe at home with 4x carer visits a day.

i would also say that adult social serves at your local council could assess and advise, but to be perfectly honest the push these days is to keep people in their own home as long as possible so you may not get the outcome you want. I found the social worker helpful in signposting services in the local area though.

It took a fall for elderly relative to go hospital to care home. Self pay.
Have a look around to see care homes and costs
Maybe start by getting regular home help in to do shopping make dinner so you start stepping back
Eg 2x week someone goes in and does this so you do not

Try age uk for such help

If you there every single day nothing will change
Step back
Tell her you cannot do Tuesday and Wednesday so you will arrange someone else to come in
Start with domestic help later move to personal care

Do you have lpa for finance

@falstaff1980 we’ve just ‘extended’ a respite stay in a nursing home. It turned out that it is all actually quite nice, although I don’t think we can quite use the term ‘permanent’ yet.

You’re definitely doing too much and it sounds like your DM isn’t able to plan for her future herself any more. So while some posters are saying it sounds like your DM doesn’t need a home yet, you’re propping her up by seeing her every single day and it can be harder to see the level of need when it’s been a slow creep.

The right care home is not a prison, if finances allow your DM to choose then I strongly encourage some respite stays.

We recently learned about the Clinical Frailty Scale and reading through that helped us realised where DF was in terms of his needs.

She won't see the need to go into a home until it's obvious to her that things are failing.

They won't fail until or if you step back.

Don't bother stepping back on home maintenance, she won't notice that.

Stop having her round for dinner each night (come up with a reason - a previous posters idea about building resilience is good) and see how she copes.

Thanks everyone, I have actually now spoken to my mother and she'll be making herself supper several nights a week. I thought about making up excuses, but instead I just told her straight that I was getting tired with all the back the and forth, and needed some days where I get home, get my daughter fed and to bed, and then collapse early myself. She seemed to understand and accept it. We'll see how she gets on managing, and if she doesn't I'll look into evening care visits rather then return to taking her to mine every night.

Op, my dm refused point blank to consider a care home. We booked her two weeks in a home as 'recuperation' after an operation. She lasted 6 hours and got a taxi home. 😀
So we organised farm foods deliveries, a cleaner, gardener, home hairdresser, weekly taxi booked to an old people's centre lunch, and a neighbour used to take her to the supermarket once a week. One of us visited every weekend. She had something happening most days, and they all had our phone numbers.
It was a bit of a logistical challenge but she was happy and stayed with her garden.
Good luck