How much influence does a GP have over care home decision?

[Gooden]

Would appreciate any insight. My mum is my grandmothers carer. My grandmother is 87 and had a fall two years ago none since. She lives in a one bed council flat. She is mentally capable and physically a bit frail but not too bad - eg. I took her shopping to the local town today and she walked around but couldn't go out on her own. She still goes out to restaurants with family for example.

My mum also lives in a one bed flat and is desperate to get DGM into a home because she (my mother) isn't coping. She pops in most days and arranges appointments etc but IMO DGM isn't that bad to look after. She needs help showering but is mainly independent at home. Carers come in twice a day to help with basic tasks she may need and more often than not she doesn't need much they just chat to her and make some toast or something. She is however lonely.

My mum is desperate to get her into a home. Social services have said a few months ago she doesn't need one but my mum said she has deteriorated since then. I am at university so only see them in holidays but speak to gran most days on the phone. None of us own a property or have significant savings so it would have to be a council funded place. I personally don't think she needs to go into a home - DGM will go along with anything so isn't expressing a strong will either way.

Mum's close friend is the local GP and she has asked them a lot to recommended to social services that Gran goes into a home which they've now said they will do. Does this mean as a medical professional is recommending it that it will happen? How much influence does the person's doctor have over this decision?

@Nosyguest i think some of this is very true. Not all residential care homes are full of jolly people in their 70s and 80s looking for company - plenty are full of elderly people with dementia or chronic illness.- because if people are coping and are self funding in particular they rarely opt to pay £1500 a week rather than have carers in at home. If grandmother is all there but just a bit frail and a bit lonely sounds to me like she would be better in a warden controlled flat with a communal lounge etc- ( unless of course that's what she is in already ) if she isn't - and as she is in council - this is worth approaching the council for .

Yes to be honest I think it's as much mum who needs more support as gran. I don't see putting gran into a nursing home just to take the pressure off mum as the right thing to do and it is worrying me that she is so vehemently pursuing this, she's like a dog with a bone trying every which way to get her into a home. I was shocked when she told me the 999 idea.

I'm going to google day centres and see if there's something like that locally we could use.

@Gooden and whilst I understand your mums pressures she needs to make that aspect clear to social services. It doesn't sound to me like your GM needs care home, it sounds like your mum needs a lot more support to keep her at home as long as is suitable. As she isn't self funding a care home the criteria will be tight and if she is deemed to be ok at home but with carers maybe a bit more often it's far more likely that will be what's agreed- but your mum will need to push for it -

She pops in most days and arranges appointments etc but IMO DGM isn't that bad to look after

I'm afraid your opinion counts for nothing. You are miles away, and frankly you're not in a position to have a clue what your mum is dealing with. You're being extraordinarily arrogant, from a position where none of this affects you.

Visiting and showering and generally taking responsibility for an older person is stressful and emotionally difficult. Your mum is important too. She's already going above and beyond by showering her mum (something I just couldn't do) rather than having carers do it. So she's not being hard hearted. But this kind of care responsibility is never ending, plus the worry about what's happening when she's not there.

Do you care about your mum's physical and mental health, or just your gran's?

If your gran still has capacity then no one else can make the decision about her going into a care home. She would need to want to go.
There is also no way that social work would accept her going into care unless her needs could not be met safely with a full care package at home. It doesn’t sound like it’s at that stage yet.
Im sorry that your mum is so stressed but that’s the situation.

My MIL loves hers. She was desperately lonely after she was widowed. Now she can wander (well, shuffle at a snails pace) into the lounge and have company, chat with people over lunch, take part in bingo etc.

Ultimately it’s her nan who would be losing her home, her life and her independence. Her mum can advocate for herself clearly, she’s advocating for her grandmother who she’s worried may just go along with this to keep her daughter happy.

the best outcome for everyone would be for carer to take a step back for her own wellbeing and tell social services they’ll need to arrange additional support

It might take your mum pressing for a care home to get SS to provide a more comprehensive care package. Your mum clearly isn’t coping. She’s extremely unlikely to secure a care home but let her crack on and she might get the support they BOTH clearly need.

It’s telling that you’re not offering to put your life on hold to provide daily care that “isn’t that hard”.

It sounds like your mum is at breaking point. Looking after someone is relentless, particularly when there is no end in sight and you know its only going to get harder.
Maybe try a warden/assisted living type place.
But ultimately you can’t force your DM to care for DG, are you prepared to take over OP?

I personally don't think she needs to go into a home

Take over your mother roll for a month and then you'll be in a better position to say that. Seriously dude. Easy to say when it's not in your life.

You say your mother is desperate..your mother was desperate long before she brought it up.

My mum asked for a care home months ago for gran and had an argument with the social worker whose words to her were "why are you so keen to put your mum in a home?" At that point she was offered four carers visits a day but mum refused them as she doesn't actually use the carers to do much.

I know I'm not there every day but when at home I visit multiple times a week and I'm close to my gran. My issue is I believe my mum is wrongly trying to exaggerate her care needs to get her into a care home so that she doesn't have the responsibility. I'm not saying it isn't hard work - but that's what I see happening. As I said mum refused the four care visits a day months ago as gran doesn't really need the two visits she gets at the moment! Obviously if mum withdrew care then she would. Maybe that's what needs to happen. I just want gran to stay at home for as long as she is able and happy to, however we achieve that.

The GP has no say and adult social care get quite frustrated when GPs (or any one else) make referrals to us stating that someone 'needs to be in a care home' because they are under pressure from families rather than because it is actually indicated.

The GP is going way beyond their professional duty if they write a letter to insist. I suspect the letter that will actually be written will be a request to review.

Your mum is deluded if she thinks that paramedics will take someone to hospital that doesn't need to be there - ambulances are queuing up outside many hospitals already unable to handover people who really do need to be there!

Your mum can ask for a carers assessment for herself if she is struggling and all local authorities would increase the visits to 4 a day before even considering residential care unless there had suddenly become a huge risk to the person if they stayed in their own home.

Who's this we you're talking about? Your posts sound breathtakingly arrogant and selfish.

What I would tell your mother if she was here, tell SS she's no longer going around there to help and they'll need to sort something out.

When it's you helping your mother to shower and caring every day you might think back to how you're sounding here.

The GP may do a capacity assessment
this depends on the GP, you'd probably have to pay an admin fee and often they won't do this if they dont already know the patient
but if deemed to have capacity it may help her case in advocating for herself

They can usually arrange with the chemist to put any medication into a dosette box

I think thats all a GP can do.

Some care homes offer assisted living. you live in the grounds of the home but in your own place. can go into the main home for meals etc

care homes offer respite care when needed if your mum needs a break from being a carer

but if your DM isn't coping with being a carer and you DGM wants to stay at home its then a discussion of would she rather carers or a care home
you cant force someone to be a carer

If a council home is her only option then almost certainly she won't get a place until she's so frail/bad that 4 carer visits a day won't cut it.
I'd agree with a PP and suggest you try a weekend of it either helping your mum or looking after grandma all on your own and see what it's like on a daily basis.

Both my daughters were helpful and supportive when my parents got old and frail and ended up passing within a year of each other but I don't believe they knew or realised the full extent of the pressure it put on me.

You’re really not correct here, it very much depends on the situation at home. My DGM lived alone, her house was immaculate, she had carers 4x a day plus my own DM every other day. But she was lonely and scared, and wasting away. She thrived in a care home for 7 more years, living her best life.

Why is your mum showering your grandma even if your grandma doesn’t want to be showered by anybody else? That’s not the point? That’s what the carers should be doing so I think your mum needs to find out how much care she gets what it is assessed for.
Because I get carers and the social services write what they should be doing and then it’s all in black-and-white
problem is a lot of the councils haven’t got a lot of money and some of these carers only come in for like 15 minutes which is ridiculous. I don’t have that but I can see that that could be really bad so I think your mum needs to talk to adult social services and explain that she’s not letting anybody else shower her and she doesn’t want to do it anymore and that should be factored in the care plan and potentially needs more carers

Also, if she is in a council property, why doesn’t she apply to the local authority for a sheltered accommodation? Because it’s like a care home? You get the stimulation of everybody else plus you can get carers there

The problem isn't your gran, it's your mum- if she has been offered 4 visits a day and refused but then is moaning she wants her in a home- then your mum is just being a martyr- and to be frank I have little sympathy- your gran might actually enjoy the company of different carers popping in too and a couple of day centres etc.

@Gooden , your grandmother has mental capacity and no one can force her to do anything against her will. They can however use all the powers of persuasion at their disposal. Lots of old people feel a burden to their loved ones and accept going into care homes when they would much rather not.
Contact Age UK and adult social services to ask for advice. Speak to local churches, your nan does not have to be a member for them to offer help. Could she afford a cleaner once a week? There are charities which offer company to elderly people in these circumstances. Can you get her out during the days to activities for older people at a local community centre? There are many avenues you’ve yet to explore.
Good luck, it seems like your nan needs you on her side. X

I just want gran to stay at home for as long as she is able and happy to

And what if a care home, with 24/7 company if she wishes for it, is the best thing for her?

Your own reason for dismissing a home is that your dm wants it! There's no awareness of what could be good for your dgm whatsoever in your posts.

@titchy she won't be choosing a care home it's going to be a council funded place if she even gets one where those around her require very high levels of care. It's not going to be right for her or her needs.

Oh I think it's unlikely she'll be funded for one so it's a moot point really.

But again, you keep saying it won't be right for her. Have you ever looked at a care home? Do you know what it's like to be old, housebound and desperately lonely? No. You are really not in a position to say she's better at home. And again you seem to be motivated simply by disagreeing with your dm. You have no insight into either of their day to day lives - which is good of course, you're at uni!

What support does your mother have? Has she had a Carer's Assessment? If not, it sounds like she could benefit from one. https://www.mobiliseonline.co.uk/carers-guide-to-carers-assessment

It sounds like you are trivialising your mother's responsibility towards your nan. Being a carer for your parent is not just physically tiring, it is mentally exhausting and it sounds as if your mother is reaching overwhelm and carer breakdown.