Nursing home to home

[Puppymom]

I was wondering if anyone has any experience of moving and elderly parent from nursing home back to their own home.
mum has been in nursing home for a year after a few falls and I asked for the possibility of going home and it has been agreed we can trial it.
Has anyone ever done this? I’m very happy and hope it works out but I know seems funny to go back on it. I just don’t feel she’s in need of the home and the authorities seem to agree with me

What are her nursing needs now?

Its not uncommon for people to return home from residential care but much less common for people to go home from nursing care, especially after a year.

Is there quite a lot of support 'at home' for her and who will be funding the care at home?

Have you had all the assessments for beds, bathing etc?

Well she doesn’t really have complex needs and they just kept her there for no reason really. The team agree with this. They are putting a care package in place at home and we will be trying it to be sure with lots of support. She just kind of got forgotten in the system as she was supposed to just be on a placement

Is she bed bound or still mobile? My colleague used to work in the sort of team that supported people to return home from NH and I have worked on rare occasions with people in similar situations, some people are incredibly unhappy in NH and in an ideal world we should support people who want to be at home be at home if that is possible. As long as you are realistic about the future , if she’s mobile then falls are common in this client group so hopefully they will work with you to minimise this risk. NH residents become increasing de skilled due to lack of activity so hopefully she is amenable to doing exercise to keep her skills going….but ultimately she is at the stage of life where there will be challenges, I hope it all goes smoothly for you, just remember to put yourself first if you are taking on a long term caring role.

Thanks for your lovely words. She actually has become immobile in her time at the home and that strengthens the case to go home.shes very unlikely to fall as she can’t get up.

I have seen a similar scenario with a relative and it was a disaster from the start. Carers were a very mixed bag; a couple were ok and the rest of them were completely out of their depth. A 15 minute visit 4 times a day from carers (and that did not always happen) did not at all cut it; she had to move into a care home permanently.

What will happen at night?. If she cannot get up how will she be able to use the toilet?.

Does she have capacity? What does she want?

She's going home to be bed bound there? Does she live alone? So she will be down to 4 care visits a day - how long for those and how many carers? There is a very strong likelihood that this is going to mean you have to do a lot more heavy lifting than you are now.

yes I will be doing a lot more and she will have four care visits. She has sufficient capacity to say she wants to go home. It’s on a trial basis and if it doesn’t work she will be back to the home. Not ideal but we should try.

I have worried about this but they tell me she sleeps all night and never needs the toilet. Only time will tell….

Hmm I have mixed thoughts on this. My DF is in another country where there are no residential facilities and all the care is delivered at home. He is bed bound and requires care around the clock. It is a huge amount of work as it is rare for my step-M to be able to leave the house, and although he can't get up he does wake in the night and need emotional support. It has taken a huge toll on SM as she is pretty much only cleaning, caring and food shopping. And it has been like this for 3 years. Having said that, for my DF - he is clean, well fed, not left alone, medicines all well managed etc.

My DM is in the UK. She has just gone into a NH and it is a very different experience. There are activities and even though her mobility is limited / bed bound some of the time, they make efforts to involve her and get her up. She has carers going in and out all the time and people she can speak to. There are other, practical, issues but it isn't falling to one single person.

Neither care model is better or worse, but they are different. DF has been like this for 3 years. When you trial it, ask yourself if you can really coordinate and manage this for the long run. Carers 4 x daily is not a lot.

"When you trial it, ask yourself if you can really coordinate and manage this for the long run. Carers 4 x daily is not a lot".

I would concur with these above comments that Thingamebobwotsit made.

In our experience of them the vast majority of carers were completely useless in that they were given very basic training so were out of their depth. And these were from a company recommended to her next of kin by the council.

Puppymom - How long is the trial period?. Get everything in writing particularly in regard to a return to the care home. In your particular case I think this is being done primarily to save money and to free up a bed. It could be argued it is not in her best interests at all. And what if she does need to go to the toilet during the night?. Does she wear an alarm pendant?.

Carer burnout is a thing and you must set personal firm and clear boundaries as to what you are prepared to do.

What she wants and what she needs are two very different things. The council will be quite happy to go along with what she wants i.e to return home (which is understandable on some level) to save on costs. But the physical and emotional cost to you is high and she may well not manage there for very long at all.

I’m an elderly nurse so see the impact deconditioning has in hospital and it sounds like this has been the case in her NH

is she incontinent? I’d be concerned in someone bed bound with no positional changing overnight and incontinence would heighten that risk. I’d also be particularly concerned about general deterioration as after a year in her nh, although it’s her home, it’s kind of new again. Has there been any discussions on fire risk if she’s left alone overnight and is immobile and isn’t able to call for help? I do really hope it works out for her though! Just thought I’d raise some valid points to consider

Trial visits are common from carehomes. I suspect your mum is in a residential will help her settle. dential home not a nursing home. Does she get funded nursing allowance towards the nursing element? About £195 a week?

I considered this for my mum but we didn't go ahead. Is she mixing and using the facilities or staying in her room? Of course you could still get some respite care in the future. Remember no one WANTS to go in a home and I think it takes 6 months plus agreeing to participate in meals and activities to begin to feel like home. My mum was in a lovely place but complained constantly. They get bored with nothing to think about other than perceived slights and problems. Tough love can help, visiting less often for example or visiting just before an event such as an entertainment visiting so you can accompany her or take her to the necessary place.

Care homes are lacking at times with too few staff, too many agency staff, poor communication and failure to adhere to care plans being common. Either way she will have to learn to be patient as staff do not always have time to fulfil her requirements but neither will carers.