Residential home plus nursing?

[EMGEMG]

I'm looking for a residential home for my mum who's post-stroke and now living with complex needs but has potential for rehab.
Nursing homes are too depressing for her as she's 78, alert and engaging in her therapies/ rehab. However, she still currently needs nurse attention but not 24/7. I know she won't do well in that environment 😕
The local, lovely residential homes don't have onsite nurses, so I'm thinking of finding the money to pay for a private nurse to visit her daily in a home to prevent her having to go into a nursing home before her time.
The flat she shares with my step dad is no longer suitable and my step dad is refusing to let carers help him more. He's not eating properly and is putting himself and my mum in danger by trying to move and handle her without help.
Has anyone found a solution for a loved one which is not a nursing home?

If its more she needs rehab and intensive therapy, are there any rehab centres nearby? I had a private MRI at a private rehab centre in Birmingham recently and was impressed by the facilities and what was going on. It had full nursing faciities.
Would she be able to fund care?

What exactly does she need a nurse for that an experience carer can't do?

A residential home won't take her if she has nursing needs

Nursing home residents don't all need 24/7 nursing care but if they need some nursing care then residential wouldn't be appropriate

Has she been discharged from hospital yet? If not, the discharges team should be looking at an appropriate rehab facility for her.

A residential home isn't the right environment at all. She needs nursing care, and even if you find a residential home that will take her, the first time she's ill/needs nursing care she'll be out the door and you'll be finding another home.

The best option would be to find a larger style home where they have both options and at least that way it would be a move from one wing to another.

You could look for a home that offers both residential and nursing care?

Lucky you 😃 The provision here in East Suffolk is rubbish. It's very hard to get into intensive rehab and other NHS rehab place is day visit only and 40 miles away with a 6 month waiting list. We have Headway who offer day rehab. That's it. Private rehab is either in Norwich, Cambridge or Colchester. Not doable for my mum right now.

My dad was in a home which had a residential wing and a nursing wing. That enabled them to be (informally) a little more flexible about who they could keep in the residential wing.

A residential only home might be reluctant to allow an external nurse because it would be difficult to assign responsibility if anything went wrong with care.

It depends what her nursing needs are,

If it's something a visiting district nurse can do then she can go to residential.

Does she want to go long term? Can she not live at home with care going in?

Since it is stroke rehabilitation I would assume she also needs a room big enough for physical therapy for 30-60 mins a day, or similar?

My relatives residential home used to regularly have short term residents recovering from hip/knee replacements. It’s worth asking, I’m pretty sure they wouldn't have minded outside physios or similar visiting.

Thanks for your comment. She's not 'bad' enough for a nursing home and it'd be counter to her mental health. She'll also have a low level of engagement which is also bad for her.

So her care needs falls through the cracks of NHS and council provision. She needs a medically trained person to check her chest as she's at risk of aspiration pneumonia due to a compromised swallow. But that could be daily, every other day or less.

Background: Her NHS speech and language therapist has taken 3 months to see her, so they're only getting started with assessing her swallow properly (the stroke ward failed to give her a thorough swallow assessment after her stroke) and help her strengthen it. In the meantime we're going round in circles.

The NHS just doesn't have the resources to this level of need, despite it being quite common based on my experience talking to other carers and stroke patients.

That sounds ideal!

I've answered your question above.

With my dad’s home, they had a linked GP who visited a bunch of residents at once. I don’t know how often she came (and we had to register my dad with her surgery specifically) but it was part of her job to nip to the home and prescribe things. So it might be that you could find a home that had that Gp visit fairly regularly, to do the swallow test alongside other appointments.

But by the time she had aspirated on her food due to an unsafe swallow it is too late. Prevention is the absolute key here - thickened fluids and correct diet etc. Once she has aspiration pneumonia she will need a Dr/antibiotics/potential admission

@EMGEMG if her swallow is compromised then experienced carers would have the training to feed her safely. - there's no where a nurse would pop in just to check in case of aspiration - if she needs suction etc then a residential setting wouldn't be appropriate.

I have many patients who have compromised swallow who are seen regularly by SALT - they have specific textured diets fed to them by trained/experienced carers. Nurses don't come in and visit just to check just in case.

There are many hones that have residential and nursing sides - the residents often do mix for activities etc. nursing homes are all bed bound/non communicative/dementia patients

**I meant aren't all bed bound etc