What could I outsource

[Marmaladegin]

Would love to hear from those more experienced on this road, as I'm only just starting out.
I'm taking on the care of DM. My dad is dying and currently in hospital. Weeks left. DM will move in with me. Currently I am splitting her care with my sibling. She has advanced Alzheimer's, is mostly incontinent. She is can be persuaded to shower, is unsteady and cannot prepare food for herself. DF does not want DM to go into a home, because this disorients her completely so if I can manage to care for her I'd like to.

I have 3 dc- 14, 11, 6. DH and I both work ft in quite intense careers. I am wfh 50% and DH 100%. DH is amazing and very caring.

I am fortunate that there is money. DP are not wealthy but both have healthy public sector pensions.

With this in mind, what would you outsource?
So far I have planned:
Nice daycare centre for DM 3 x pw (£1200pm)
Cleaner of our house 3 hours pw
Cleaner/ carer for my mum (2 hours x 2 per week) to tidy up after her, change sheets, hustle her towards the shower etc
Booked babysitter so DH and I can go out for dinner every other month.

But what else could I do to make our family home smooth-running and happy? Also, any tips for specific jobs I should ask these people to do? I'm not adverse to booking more help too, but not sure where it would be most beneficial.

I should add that I'm not suggesting misusing my mum's money- I will be paying for the bits that I should, eg the cleaner for my house has been with us for years. But essentially it's all quite a lot to cope with so there's some pooling of resources where appropriate

Do you have a chiropodist to do her feet, and they will cut finger nails too?

I'm not sure how it's going to work. How is your mum coping at the moment as it doesn't sound like she can take care of herself at all?

How are you going to work full time and look after her full time?

I would say that you need a full time carer for her. To help her to the toilet, make sure she doesn't trip or wander off, keep her hydrated, keep her calm and comfortable.

Have you got power of attorney over your mother's money/

Please remember that a day centre will disorient her as much, if not more, than a residential home. You might need to think about live in care or day care in the home so your OH can get on with his work.

If you are both working full time won't you need carers twice a day 5 days a week to help in the morning and evenings. What about when you are working in the day who will be looking after her. Will the day center be willing to change and wash her if its needed. Do they own there own home. Wouldn't it be better to get a live in carer at her house. Have you thought of the upheaval it will have on your children.

Your mum may well be seriously disorientated and or very difficult with strangers.

She will most likely prefer people she knows to do care such as showering etc, although some people refuse any help at all.

It isn't the organising care that's difficult. It's persuading the elderly person to go along with it.

Similar with toddlers - you can organise nursery etc all you like but if they are regularly throwing tantrums and crying at the thought of going it gets emotionally very difficult.

You have skated over the fact that your DM is 'mostly incontinent'.If you are out, who is going to change her if the carers aren't there? Do you expect your DH to do that?

Find a carer who is also happy to do light housekeeping and cook. Get them in for 3 or 4 hours a day to keep an eye out for her, help her have lunch, shower etc. But also to cook a family meal and leave it on the stove for you, to do the family laundry and to keep the house clean and tidy between cleaner visits. This will save your sanity. Basically organise it so you have no household chores or cooking to do in the week.

Bear in mind OP that the move will disorientate her however much she has been to your home before

she may well wander and wake you multiple times a night on top of the issues listed by others. How will you manage work on top of all this?

gently it should be about what is best for your mum to meet her needs and keep her safe and cared for. What your DF wants is not the same thing as what is best for DM

I would arrange a care needs assessment, she may qualify for some funding for things like adaptations to the house.where will she sleep and use the toilet. If shes incontinent she needs a district nurse and continence nurse referall, they assess, provide pads and disposal. She may need a mobility and pressure care assessment, if she's incontinent she is at risk of bedsores so might need a hospital bed and pressure mattress. She may find getting to and attending a day centre disorientating. I'd get a formal care needs and capacity assessment ASAP, is there poa in place. Also apply for attendance and carers allowance.

My mum is in a care home, she has full mental capacity but is physically unable to look after herself. What the care home provides is 24/7/365 care and company and food and drinks, it has a lot of staff to deliver the care and residents and activity co-ordinators to achieve that and carry the mental load of doing so. They also organise hair cuts and eye appointments and hospital appointments, but not transport. Before she went into care she was living with my sibling, which left my sibling utterly exhausted with zero family life. My mum is much happier too.

If you want to provide sufficient care in your situation, and I admire you for wanting to do that, I would be looking at live in carers. You may also want to source transport to hospital appointments and respite care. If you can get people in to provide company and take her to / do activities with her while you are working that would also help.

I think the reality of trying to deliver the sort of care needed for someone with alzheimers is a 24/7 job and not sure how you and your husband will cope given that you will both be at work at the same time, you will want time off and probably more than once every two months.

I think she may find the day centre and different people disorienting. My FIL absolutely pushed against a home when he had dementia, but it was the best thing for him. He put on weight and enjoyed talking to others in the day room.

If she has advanced Alzheimers and you are both working FT and 3 DC I think she is going to need more paid care in the home and the need will sadly only increase. I don't think you should rule out residential care even if it is against your DF's wishes. Can she be left alone at all? If not that is going to seriously impact on your family life. I'm sorry you are in this situation

Cleaner/ carer for my mum (2 hours x 2 per week) to tidy up after her, change sheets, hustle her towards the shower etc

if she’s incontinent she’s going to need showering or at least washing every day as will sheets etc not twice a week

also have you discussed with 2 oldest DC about the impact on them?

Get an OT assessment done and ask for a dementia social worker, they will be with you until the end. Good luck OP.

I’m sorry but you shouldn’t have her coming to live with you, she should be going into a home where she can get can get care 24/7. What is the situation going to be like for your children and how are you going to cope with working? If you are really going to have her in your home you need a live in carer. You need to be realistic about this situation, no matter what your DF said.

Who is looking after her at the moment while dad is in hospital, it sounds a very difficult time for you, what care was in place before apart from you and your sibling.

Ooh thank you for all the prompt replies. I see I should have coloured in more detail:

My mum will shower herself- we fortunately have a very accessible one- but needs reminding to do so and taking to the shower, it switching on, towel laid out etc. she can then shower in private.

She has stayed at my house for respite over the past 10 years and has now been living half the week at mine for a couple of months since my dad was admitted to hospital. She changes her own incontinence pants though sometimes needs prompting.

She has gone to the daycare centre a couple of times and enjoyed it, yes they provide washing. When at home with us she mostly sits in the sitting room and naps or we put the news on for her.

All queries and tips welcome- good to have ideas of things I'd not thought of.

What's the plan once your father has gone? I think you need to think longer term, a good starting point is what @MissMoneyFairy has suggested.

Do not underestimate how long everything will take. By the time incontinence has become the norm, most people are in residential care. It is exceedingly hard work to keep the person's skin healthy and prevent breakdown by this point.

I don't really see how you will be able to care for her properly whilst working FT even if you WFH. You need to be able to focus your attention on them to keep them safe and healthy, have endless patience, compassion and kindness. It is draining, frustrating and exhausting.

I say this as someone who lives with their elderly parent who has vascular dementia. I don't work. I do everything, including personal care but outsource cleaning and foot care. I know I've made it sound grim, but I am happy to do this, it was my choice and I feel fortunate to be able to spend this time with my parent in their final years. We do still have many enjoyable and fun moments together.

DF does not want DM to go into a home, because this disorients her completely so if I can manage to care for her I'd like to.

She is going to feel this way no matter what, it sounds like she needs a lot more care than you can give and ultimately your DF isn't the one having to look after her. It sounds utterly miserable, for both you and your DM.

I'm so sorry OP.

DM has lived with us for years with a 6-month left terminal diagnosis (she's determined to stick around as long as possible!) ~ some things I do:

• Laundry service is a non-negotiable for me. I use it to clear all our laundry bar the 'accident' stuff which obviously I do myself, so I only end up with as much laundry as I was doing before.

• You might want to up the carers if you're not prepared to shower/help her yourself. DM is incontinent and as much as I use all the 'stuff' she still needs a shower at LEAST twice a day, most of the time more.

• Not sure about your DM, but mine has so many GP/hospital appointments and it does take a lot of time up. So maybe talk to the agency you use for a carer and see if they ofter any ad hoc appointments where a carer can drive her to/from the appointments.

• Some good quality Cook meals in the freezer, figure out what she likes and let her have it as often as she wants. When DM moved in I was committed to feeding her healthy/nutritious food and between trying to track her calories (she didn't want to eat ever) and constant worrying I wasn't going 'enough' I nearly drove myself to a breakdown 😅 As long as she's eating, that's enough and if she's struggling to eat much, cakes/biscuits/sweet treats are your friend. Protein powder is great to smuggle more protein in if she's anything like DM and actively avoids anything protein-y 🙄

• Not outsourcing, but I'd suggest you get yourself into therapy (if you're not already) ASAP and find coping mechanisms for you. Watching someone you love dying is horrendous even from a distance but living with them and seeing the deterioration firsthand is actually trauma you're actively putting yourself through. It's okay to feel all the feelings, be gentle with yourself! I'm so glad I'm doing this but it doesn't mean I don't want to throw something at a wall and scream daily 😂

• In terms of the babysitter, check they'll be okay with your DM around. Our sitter is amazing but when they're not available I can't find ANYONE who is comfortable babysitting with her in the house.

Have you thought about her staying in her current property and having a live in carer?

Sorry you are in this position. It is so difficult and unfortunately there's not much relief to be had.

Like others, I think it's asking a lot to aim to look after your mum at your home. You and your DH seem caring and generous. But it really is a big ask. You've said you have full on careers too. Things like

• Who's going to get your mum up, washed / showered and dressed every morning? Even if one or more of you is wfh that's time to account for.
• Same question for preparing her lunch every day.
• Same question for taking her to the toilet, and potentially changing and cleaning her up, every day.
• How's she going to occupy herself during the day? You can't rely on her not wanting your attention when you're in a meeting.
• Are you thinking she'll spend evenings with you as a family? How would you deal with her wanting only to watch TV programmes she likes and knows?
• Babysitter gets you so far. What happens when she needs the toilet or cleaning up while you're out? Do you get the kids to do it, or does she have to wait and you end your night out by changing her when you get home?

I'm trying to show how hard this is to do. But I would also support you using your parents' money in whatever way is needed to help. I would also tell your dad right now whatever he wants to hear and is reassured by, then reassess the situation afterwards.

Oh gosh OP, I understand why you want to do this but, and I mean this kindly, you are deluding yourself. You cannot imagine how hard it is to look after someone with dementia unless you have actually done it. There is a point, and from your description, I d say you’re reaching that soon, when someone needs support at all times. It’s not just keep them occupied, it’s doing all personal care - brushing teeth, washing face, all toileting…., it’s dressing and undressing them, it’s following them around when they wander, it’s washing their bedding every single day because pads don’t hold enough adult wee overnight, it’s being unable to to leave them alone etc etc and to do that with a young family, even with paid help, is both on impossible. I know as I’ve done it. I would also say that it’s incredibly difficult for young children to witness the decline of someone and I absolutely would not want my kids to live with this.

Please don’t think I’m being unfeeling - I totally understand the desire and need to care for the person who has loved and raised you. However, it’s incredibly difficult and I don’t think what you’re describing as putting in place is enough unless it’s very early dementia. Hopefully your mums progresses slower than my parents but it can quickly progress and leave you unable to cope.

I wish you all the best but think about yourself AND your responsibility to your children.

I honestly don't think it's doable, the stress will be unbelievable for you all.

I don't think the care/support you have listed will be enough Tbh.
Caring for someone at home with advanced dementia and incontinence is a 24 hours a day job.
If you weren't working and didn't have kids, it might help but it's not going to touch the sides.
I looked after my Mum for 3 months in my house, she was mobile and continent but had terminal cancer and moderate memory loss. I was working part time and had an 8 yr old DD at home. DH very supportive and hands on. It nearly broke us all. It was relentless.