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?

Brutally, you either need to move home to help or stop judging your mother so harshly.

Providing care for someone all around the clock is so hard. It's a huge mental load. If you can't get home, can you help find carers for more time during the day?

Depends on the care home and the home they left behind. And what they can afford, which wouldn't apply in this case as it would have to be funded by SS. Usually if someone doesn't have their own savings to pay for care SS won't consider a home until they need more than four carer visits a day (ie unsafe to be alone or needs care overnight).

One of my relatives chose to move into a home and it was a very very positive move. She went from being alone for much of the day, eating freezer meals, worried about the house being secure and having to organise a cleaner and gardener and house maintenance, to having freshly cooked meals provided with interesting company around and a range of activities if she wanted to join in. But that home didn't take anyone with dementia.

You must be off Uni for Christmas soon? Here's a suggestion - how about you take over ALL the care and admin for your DGM over the Christmas holidays. And I mean all of it- shopping, showering, liaising with carers etc. Give your poor Mum a complete break.

Then what about dropping out of University and taking over all the care of your DGM instead, or do you think it's only your DM who should sacrifice her life?

I suspect it's your DGM pressuring your Mum, possibly subtly by guilt tripping her, to do everything for her. You've already suggested it regarding the showering.

That's a really good idea - give your mum a few weeks off from the stress, the shopping, the phone calls, organising appointments, checking on the carers, helping her shower etc. Of course it will mean no nights out as you could be called at a moment's notice but it sounds like your mum is not coping and needs some time completely off to recharge.

ignore all the comments goading you in to thinking about your ‘poor mum’ ultimately that’s a choice she’s making, just because she is finding it difficult doesn’t mean she gets to ship gran off to a care home. If she stops what she’s doing, tells social care I can no longer cope. Take her off as nok, they will need to provide more support. You shouldn’t be made to feel bad for advocating for you gran. She’s a person too and your mum doesn’t need to martyr herself. Everyone can get what they need here. She’s unlikely to get a care home placement but I’ve come across plenty of people in care homes whose family have pushed hard enough that some inexperienced worker has relented and placed them. So do what you can do to get social care back out supporting mum and gran in a way that works for both of them

I work with people who live in care homes, I deal with the safeguarding incidents that happen in care homes. Everyday I get notified of 30 or 40 incidents in the care homes of the place I live of poor care, neglect, assaults by other residents, falls, improper use of restraints, lack of dignity in care and medication errors. Care homes are not some lovely social club where people go to make friends. The ones who accept banded rates from social care underfunded and understaffed and the people who live in them are often treated like a conveyer belt for care. 5am morning routines start and 7pm bedtime routines. People told to urinate in pads because they don’t have staff to take them to the loo. I know not all care homes have appalling practices but even the good ones have their issues. Care homes should be a last retort: not a way to cure loneliness. There’s community support that can help with that

@Nosyguest thank you I will do what I can to keep her at home with more support.

Totally agree. My mum moved to one 6 months ago and even though she will say she hates it, the social media posts, days out, upturn in her demeanour and her weight gain say otherwise!

The angry posters having a go at the young woman who posted this question in good faith re her concern re. her grandmother should be ashamed of themselves.There are ways to point things out that the OP may not have thought of - without lowering yourselves to such nasty rudeness and sarcasm.

If you are at Uni, you will have a couple of weeks off soon?
Relieve your mum of all her duties and take over for her with all she does for your gran. Including the things you probably don't realise she does
Then sit down again and think about what's best for everyone else

@Gooden to be very blunt @Bannedontherun had it. Give your DM all of Christmas off if you’re around and take over ALL the stuff your DM does for DGM and see how you feel after two weeks.

It sounds like DGM is asking your DM to do things carers could be doing and your DM is actually having a really tough time with no time off. Walk in her shoes and see what it’s really like.

If she's lonely but otherwise ok, would day services be an option for her? It would allow her to have companionship and usually a hot meal while still living at home.

You need SS to do an urgent care assessment

I’m a full time carer for my very elderly DM as she is adamant that she wants to stay in her own. You start off doing a few jobs and errands, than it’s the “social needs” - pressure put on you to be there as she’s lonely, then the personal care and before you know it, you have no time for a life of your own. Luckily, I’m retired but after working my whole life, it’s not quite the retirement I was anticipating. Most of the time I’m okay about it but I’m sure that neither my sons or my nieces who all come to visit are truly aware of the toll that it’s taking on me. They see Granny for an hour or so every couple of weeks, she’s clean, well fed and looked after and probably imagine that’s how it is all of the time. They don’t realise all the admin involved keeping a house up to date and paying bills, collecting medication, cooking, shopping etc. Then there’s the washing after bouts of incontinence and generally trying to keep her spirits up. My health has suffered greatly so @Gooden your own DM could just feel at her wits end! A carers assessment might help, but if your DGM refuses carers (as my DM does), it’s difficult. You could ask AgeUK if they have the befriending service in her area, they only call round to chat for an hour or two on a weekly basis but it could free your mom up that day at least

@Cantgetlessthan3onWordle it is the slow creep… I understand and I hope it is at least appreciated. You start off wanting to help, seeing more things you could do, do more and before you know it, it gets so much, it takes over your life, along with the expectation you should do it all because that feels better than accepting paying for help from strangers professionals and the elderly parent can continue to be in denial about their decline because little changes over time don’t feel like the big change they are.

Please look after yourself and remember that some outside help is essential - what if you are ill (or god forbid have a holiday) or worse. Getting outside help is vital if they couldn’t survive a week with no help from you at all. I had the flu, couldn’t risk giving it to my elderly parent and couldn’t help.

Exactly, it’s so insidious the way that it takes over your life. Holidays are on hold and as for illnesses, we’ve had to muddle through with limited help from her grandchildren but they all work and have families so I don’t like to put it on them.
So nice that someone understands 🙂

I think also there is the fact that things are not going to get better for DGM, this is just going to continue with her abillities getting worse. So that is saddening and it's hard to keep cheery.
Though there is a possibiity of her being happy in a care home but no one knows how that will go.

@Gooden
What was their relationship like before your DGM needed care? I'm sure being the carer for someone nearly 90 would be draining enough, but if they didn't get on really well before then doing it for someone who you have a difficult history with would make it far harder ajd might be behind this.
FWiW, I fully agree that a care home is a last resort, my great gma went into one and we used to visit there. Even if their needs are met its just old people farming, got up and put to bed and fed on someone else's schedule and most the day sat in an armchair. Or if you are really lucky you get Taken On A Day Out like a bunch of schoolchildren.

Is your mum showering her because SHE doesn't want strangers doing it or because your gran doesn't? As obviously if she is in a home then she will have to be being helped by the staff so she might as well have them helping her in her own home if it takes the burden off her daughter.

I agree with pp that look into more support for her and your mum where she is would be first choice. Day centres, cleaners, more carers, meal deliveries etc. Therr are various community lunches for seniors around us, are there any hobby groups she would be interested in? Anything that gives her a network of peers to interact with and something to do. Bingo, knit and knitter, memory Cafe etc. Obviously transport needs to be sorted for it but there are various ring snd ride community busses in our area. Worth looking into.

The ‘slow creep’ is exactly right, creating an illusion of independence, a house of cards that will come crashing down the minute on of the small insignificant tasks isn’t done.
Appointments not made, bills, general admin, medication not ordered, shopping, tradesmen organised. Etc etc.
Its like being a lobster in boiling water - you start off cleaning the top of the windows because you don't want them falling off the step ladder or picking up the newspaper because the pavements are icy and before you know it you are running a separate household, who tells everyone else they are fine on their own and manage fine!

That depends in the home tbh..
My aunt could no longer live at home on her own and went into an excellent care home, she blossomed there, chairobics, craft classes, trips out in the home minibus and a weekly trip to the local primary school to listen to the kids read enriched her life immensely.
Granted she was self funding so no social workers were involved.

Firstly, GPS have no input (as has been said) in fact we found my mums to be more obstructive than helpful and we were reporting full blown physical attacks on my dad.

2 care visits a day need reviewing, why wont your mum accept the 4 visits a day? Is it because care visits don't take the pressure off of 'life admin' ?

Things you can do to help.. find out about day centre services, ask about 'befriender' volunteers, offer to give your mum some respite by taking over every now and again. Showering someone is extremely physical and hard work, talk to your gran about being more accepting of help. Could you take over doing an online shop? Things that all too easily become time consuming and stressful. Sit down with your mum and find out what her day looks like, is your gran demanding to your mum, can she be 'difficult' sometimes? Is she calling your mum on the phone very late at night or very early in the morning?
To me it sounds like your mum feels burnt out. My sister has had this with my dad , he thought he could demand attention 24/7 whilst she was trying to manage her own life as well. He is a very gentle man, but still expecting everything to happen exactly how he wanted when he wanted, he'd decide he wanted a loaf of bread, why couldn't it be brought exactly when he wanted it etc.

Sorry just noticed the original thread was posted in December ... oops