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

Thank you- trying to keep up my list of ideas as quick as they're coming in!!

For those suggesting a live- in carer, we're not looking at that because:
Their house isn't near me or my sibling (no other family or friends either)
It's not very safe: no downstairs bedroom, whereas at mine there is. She's had repeated falls over the last year, so shouldn't be doing stairs at all, and their stairs are steep.
A good friend who is well placed to be very informed has suggested that live-in care is often poor standard and extortionate (and also weird! No offence intended to those who have to take that option, but my mum 100% wouldn't want to be alone with strangers in her house, and I'm certain she'd rather be at mine with me).

For those asking, yes I have financial and health POA (though can't find one of the certificates, so need to get a copy) and yes she has attendance allowance, not that I have any access to finances yet. I don't qualify for carers allowance as earn too much

I'm not sure outsourcing will be enough. I admire the fact that you want to do this but I think the stress will be too much for everyone. If DH is home 100% will he look after MIL as well as working? What do the children think?

I know that when our family member's condition progressed she rarely slept and would wander during the night. Can you and the kids cope with that disruption?

I think it's so lovely that you are looking to care for your mum in your own home but it's good to have a plan for when your mum's dementia really takes hold.

We are 7 years in to mum's Alzheimer's journey. She lives around the corner from me, with my dad.
I go round 5/6 days a week and my sister goes 3 days but it's getting really tough. Mum is now becoming doubly incontinent and will get up in the night. Dad will often have to shower her down in the night if she's messed herself. He's 84 and exhausted. We had paramedics in last week at 4am as she got up whilst dad was asleep and fell in the hallway. This is the third time we've had paramedics in due to her falling. Sadly, it's time for us to look at care homes.

Have you thought about how this would impact your family if you start experiencing broken nights? Will you be able to work well, will this affect your DC especially come exam time etc.

I hope you manage to find ways to help your mum but please don't sacrifice your own lives in the process. I've done this and it's now really taking its toll on my mental and physical health. Dementia is evil and will take everyone down with it if it can.

I think you need to plan for the future, when your DM can’t shower herself and needs supervision during the day and night. You will need to increase the care visits and probably have some overnight backup. If there is plenty of money, I would not rule out some kind of live-in care.

Edited to add - live in at yours.

You’re taking on a very challenging role , try to get as much support from charities/ social workers as you can .

What about a PA rather than carer to be in your home 5 days a week? Or 4 with 1 daycare if she does enjoy it?

Agree that someone at yours every working day would make a difference - though I think as a carer. So if you or DH get her up and ready, or breakfasted, the carer can take over being with her, toilet trips, making lunch and so on while you work. She will decline and though you may be able to get work done now with her there, there's no knowing how long that'll be the case for.

I know every sufferer is different, but my mum has late-middle stage dementia. She can't be left alone for a moment. Like a toddler she either gets distressed or in trouble. Sounds like your DM is more contented at the moment but she will only decline sadly. How will you be doing your FT job and her care needs at the same time?

I'm so sorry, it's an awful situation to be in.

I've just come out the other side of helping to care for my father with moderate then advanced Alzheimer's, and I work from home every day, with a huge amount of flexibility, and I still needed a live in carer for him for the last 2 years, in his home, 5 minutes away. And I was there every day too.

Therapy for you is a must, budget for that first.
More carers. Ideally the same ones, find more than one, but keep the same few people rather than a elation of randoms through an agency.
If you don't have room for live in, then someone every day you are out at work and atleast one weekend day for you to have a break.

And try to avoid hospitals as much as possible, they can have 'hospital at home' treatment rather than an even short inpatient stay, as each and every one, even just one brief night after a fall, hastened his dementia progression. Unfortunately it wasn't suggested until he'd already had several inpatient stays, by a lovely paramedic who was quite shocked it hadn't been suggested previously.

Be really on top of any uti or infections and insist on antibiotics as they too made everything worse and each infection we lost a bit more of his poor mind.

And I'd look for a carer who could live in temporarily or a local care home for respite, now rather than later, just so you and your family can plan holidays.

My friend with slightly older children had her mother live with her and I really admire her - it's not something I could do and am relieved that the crazy amount of stairs in my house made it practically impossible as well as emotionally.

However a couple of key differences:
a) her mother was frail but had no dementia.
b) my friend works full time from home.

This went on for about a year and was becoming increasingly untenable. They had to find someone to live in when they went on holiday, her mother wouldn't accept any other carer but my friend, my friend had no time for anything other than work and care. It's hard for me to say this but there were signs that her children were being emotionally neglected - she has a very unhappy son who I think has undiagnosed additional needs. However, I've thought this for years (as do others far more qualified than me) and they've always resisted any diagnosis, even when he self diagnosed.

Things were really reaching breaking point when there was a fatal accident. I don't want to give any details but it would have not happened in a care home. My friend, despite doing such a kind and good thing, felt constantly guilty throughout that year - because she was so wrung out by cooking picky meals, doing the bedtime routine etc she didn't have time or headspace for more emotionally rewarding interactions with her mother.

My mother has dementia and deterioration is not linear. She has lost all mobility in the last year and now needs two carers to get her up etc. Do think about what you would do in this situation. Her GP advised that we help her move to a home while she still had the capacity to make new memories.

PS sorry I'm going to sound selfish but I wouldn't have wanted to have sacrificed any more time with my children than I ended up doing so for my parents (really quite a lot but nowhere near what you're planning). These years are so incredibly precious and they go so fast. Do think about how you might feel when your 14-year-old leaves home and their last four years have been disrupted. Do not underestimate how draining A levels and GSCEs are.

I would recommend looking into mobile hairdressers who are used to older/frail/not fully coherent clients for an occasional wash cut and treatment. My mum works in a care home and provides hairdressing duties which makes such a difference to a person's disposition, she finds there is less disruption on those days, and some people who struggled to recognize themselves in a mirror would recognize themselves, which is very comforting to them. I would say this is not a vanity treatment, but necessary for self-care.

I wouldn't be rushing in to spending all that on day centres right now I would get her moved in and get on with her day to day care at home and to help things run smooth for you. She's not going to feel isolated.
Get through your dad's passing and get a routine stabilised then way further down the line looks at day care if she is up to it. Home care more useful now.
💐

I would get her in to yours and get the next few weeks over and see how it goes and make decisions later about linger term care.

I would up the carers to 4 x a day

I would have a tracker on her in case she wandered

Will she ever be alone?

Organise some respite, either a live in carer or her going away for a weekend at least every month so you get a regular break.

My mum had Altseimers for 10 years, and was well looked after in a care home.
In your position I wouldn't want to put my young children through having her in their home. It will become all about your mother, It will affect them negatively in all respects.

I wouldn’t commit to home care long term; keep your ear to the ground for excellent nursing homes for those with dementia.

An OT assessment of you home for things like fall risks, shower chairs. Mobility aids.

As ppl have said regular hair, nail and dental appointments. Many Care agencies will accompany her to these as well as hospital appointments, even making it into a coffee and cake out as well.

How bad is the incontinence? It can be a big factor as to why people go into homes. Do you have space for live in care if it came to that. If not you can work around it with say 2 carers doing 8 hour shifts.

I think this is going to be very hard to achieve without impacting on the rest of your family-I think either a live in carer situation or a care home would be much kinder longer term - I am sorry your dad is so unwell too but people don't always think logically when very unwell and I think the impact on you and your family will be very hard -

I would have a carer every morning 30-60 mins to help get her up, washed, dressed, and set up with breakfast.

Yes instead of the day care I would use the money to try respite care looking at longer term solutions.

Please think about the impact on your children and look for a good care home instead. They're honestly not as bad as can be made out.

I grew up in a similar set up (no dementia but very frail grandparent) and there is absolutely no way I would do it to my own children.

The elderly person's needs end up taking up all your time and energy, and that was without both my parents doing full time jobs as well. The disruption at home with carers coming and going. Having to gear everything to the needs of the elderly person - mealtimes, food, what is watched on the tv, how you manage weekend/after school activities whilst not leaving elderly person alone (but activities not suitable for them), how you ever manage to have a family holiday.

You can reassure your DDad that you'll
care for your DM, he just wants that reassurance at the end of his life that she'll be well cared for.

But "care" doesn't necessarily mean doing it yourself. Finding a good care home is just as caring.

Realistically, Alzheimer's only goes in 1 direction. She may be able.to just about manage in your home at the moment, but that won't last. Trying to manage her needs around your jobs and your children's needs isn't fair on her, or on your children.

And the further her disease has advanced, the more disorienting she will find a move to a care home. Better to move while she's still able.to take in the new surroundings, faces and routines.

Please don't move a person, however much loved, into your children's home.

I supported my mum, supporting her mum during my A-levels. It wrecked my grades, the anxiety was ever present. What's Gran doing, I told you to watch out/lock the door/ do this whole I do that.

I never got any public credit or thanks looking back. My mum shouldered the majority of it but inevitably I, rather than my Goldenballed brother, picked up a huge percentage.

I couldn't wait to get out of home and probably not coincidentally when I scraped into a course via clearing my Gran was in a home before I'd even got through Freshers week.