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

Very gently, OP, I think you should disregard your father's wishes here. It's not really his place to basically lump you with a massive amount of household discombobulation.

An elderly alzheiners or dementia patient who is incontinent needs a great deal more daily care than you and your lovely husband can provide.

There are also huge safety concerns. Patients can wander at night. Kitchens are extremely hazardous. Stairs are very dangerous. The patient can exit the home. There are health concerns - falls, bedsores, mistakenly taking otc medicines, etc, and potential refusal to bathe, change clothes, eat, drink. Changing mental states are better monitored by trained eyes. She may need to be lifted sometimes. This is best done by people trained to do it

Your mum is going to experience disorientation regardless of where she goes to - your house or a home. Her comfort and safety and your peace of mind are more important than the wishes of your father.

He's probably thinking your home would be more familiar and comfortable for her, but it's possible too that he hasn't really taken on board the difference her diagnosis makes.

YYY to UTIs, minor cuts becoming infected, etc.

She's going to need more care than you'll be able to give her. I'll echo other posters, even if you didn't have your current commitments it would be incredibly difficult. Also, it's very likely that some event will force a removal to a care home. It's better to have something arranged in advance than being forced into a decision.

My grandmother resisted going into a home, but did so much better when she was in one. The activities and carers available 24/7 really improved her day to day quality of life.

Well realistically you need full time carers while you working. An elderly with alzheimeres and incontinence needs someone on hand 24/7 just like a toddler.

You cannot wfh with a toddler nearby and you cannot with this level.of care. So hire a full time carer(s) ...

Will you break an important teams meeting to go clean her up when she soils? Or find her when she wandered off?

Another point to consider OP is that sadly, it’s fairly inevitable that your mum will end up in a care home at some point. It’s so much better to make that move when she’s better rather than further down the line. It will be much kinder as she’ll at least have a chance to adapt and get used to the place and the people in it.

You'll need full time carers op.
More than one.

This. So sorry op x

I think organising all those people and services will be overwhelming and there are still gaps . Personally I'd go for ease and get a full time live in carer .

Also, when this move happens, your DM is unlikely to be as 'good' as she is now. She will just have experienced the loss of your dad, and she'll be moving to a new environment (even if your home is relatively familiar, it will still be very disorientating compared with her current home). That combination of factors means it's sadly very possible that she'll have an immediate step down in her cognition and her ability to cope, even before the inevitable longer term progression of her dementia.

My DM is at a much earlier stage than yours, and I still wouldn't consider taking this step. There's no way I'd be able to handle it, much as I love my mum. Can I recommend a book? Have a read of Keeper by Andrea Gillies - a woman who decided to move her elderly in laws in with her, when her MIL had dementia. It's a tough read, but very good.

Alzheimer’s gets worse.

She’ll be doubly disoriented by moving in with you then going into care, which is now inevitable - she’s still physically fit when her brain and continence have gone.

Your post is so optimistic my heart bleeds for you and DM.

What have you planned when she shits the sofa? Who is on duty at 3am when she sets the kitchen alight? How will your children react to being insulted and hit? Are they ok with parenting being withdrawn as they hit the teenage years?

Are you?

Alzheimer’s care is a 24/7 job for at least three trained full-time staff to one patient.

Sorry - so sorry - but the chaos a dementee brings has no upside. She’d prefer a care home. It’s not DF’s decision, and if it was he ought to have the decency to rate his own DC and DGC just a little bit.

Here’s the clincher: no matter how hard you and your DC work for DM and take the damage and the punches, she’s just going to get worse.

Probably faster in an environment she can’t cope with.

I think you have good intentions and I think your Mum is very lucky that you want to be so hands on with her care.
However I would caution you regarding the impact this will have on your children and your marriage.
There is a limit to the amount of giving each of us can do.. and your kids are not getting a say in all of this.
Please forgive my negativity.. just talking of my own experiences.

Absolutely this. No one who hasn't had an elderly needy relative (or non relative) live with them has any idea how hard it is. And add the dementia/incontinence and both you and DH working from home I can see many many issues. Being gentle (but practical....sorry if the truth is unpleasant) your DF will not be involved in her care, and although might have been doing a sterling job, he is worn out. And you will be too. A nursing home will have expertise, consistent care, equipment for handling/coping with incontinence and mobility issues. Leaving you to enjoy your Mum on your visits rather than stress over the practicalities. You also will not start to feel resentful if she takes up all your free time (which she will) and enable you to enjoy a family life with your children, who need you more than your Mum.
Please reconsider.

Echoing all these posters. Had my DF here just a few months at the end of Covid until we really couldn't leave him on his own in a room safely (Parkinsons's and Lewy Body Dementia). We had my DM too who is in good health but was caring for him and at the end of her tether and exhausted.

I wouldn't wish it on anyone and I did feel bad for what my DCs had to witness with a very deluded and sometimes distressed and crying man.

Honestly don't underestimate the toll this will take. As well as the caring it's a full time job arranging logistics.

In a home all of that is taken care of - a GP visits regularly and there is no getting people to appointments and the upheaval that takes, no continually phoning doctors, dentists, carers, podiatrists, falls team, continence nurse, district nurse and so on.

What you will get back though, is time with your DM, not time caring for your mum. This is precious, and you just won't have this. At the end of a day you will be so exhausted and peopled out that you won't want to spend any more time with her.

I promise you that Every. Single. Person I have spoken to in this situation (lots as I am at that age where frineds all going through similar) has felt terrible guilt when they have had to put their relative in a home, and Every. Single. Person has also felt immense relief, and in hindsight has realised it was 'not before time'.

Totally agree

I would also outsource :

gardening
increase cleaner hours - as an extra bedroom to clean, sheets to change etc

main concern would be can you still get your children to all their activities if have to be more in the house for your DM?

So much wisdom and sad, but informed experience on this thread. I can see this in our future with a parent too, but having seen this with a grandparent, sadly you’re not at the “advanced” stage yet. We had many, many years of grandma after this stage (possibly due to the excellent care she had in her residential home at the end). Good luck with your choices ahead, and it is ok to recognise that what is right today might not be right tomorrow.

Care homes are much easier to cope with than a family house if you’re demented.

No impertinent strangers cheerily greeting you as if you’ve met them; no one calling you Mum when you know you never had kids; no one saying ‘but you know where the kitchen is’ when you don’t have a clue what a kitchen might be and you look for it helplessly behind the toilet.

No strangers frightened of you if you’re understandably angry and lash out at a small old woman who says she’s your daughter. She tried to take your knickers off!! For a bath!! What on earth is that - water is very frightening to
the demented.

You get the idea.

I appreciate all the responses. To be clearer: I'm not under the illusion that this will always be possible. I know that there is likely to be a point at which I can't cope and she has to go into care... while I respect that there's a lot of wisdom here, I think probably cases are fairly individual. My mum isn't needing a care home yet: she always appears pleased (if surprised) to see me and my family and and be told that she's staying in our home with us. Obviously if her default state becomes to be violent or distressed, we need to reassess.

FWIW good luck and I hope it works out. You are going through it with your dad and I think it will be easier for you to be together and the home option is there if you need it or for respite.
It's doable and everyone's experience is different. I hope it works for you all.💐

Much sympathy and admiration for you. Won't repeat existing posts but add just one thing. My father was suffering from LB dementia and dying by degrees. He told me to care for and be company for Mum. I couldn't fix him, but I could accede to his wishes, so I agreed because it was the only good thing I could see coming out of a horrible situation. He died. I had no idea how my promise would affect my existing family relationships. Please don't commit yourself to anything long term until you have mourned your father, and please make sure that you do grieve for him however is right for you. Again, sending many good wishes and support, whatever your decision.