How to explain to MIL she’s in a care home

[Meandacat]

MIL is in her 80s. BIL lives a half hour drive from her home, DH and I live a hour away but DH doesn’t drive. After a series of events late last year, she was taken into hospital where she stayed for several months before being transferred on the recommendation of social work into care. She has no formal diagnosis… there is no dementia or Alzheimer’s. She does have a history of depression and I have long suspected bipolar but they haven’t diagnosed that either. But at home she refused help from carers but was unable to care for herself, was making silly mistakes (like switching the fridge off) and had started having delusions and paranoia which put her safety at risk.

Since being in the care home she has thrived. She still thinks she’s in a hospital situation and is therefore accepting of the care. She enjoys the activities and is very well, to the extent one might question why she’s even there! She still talks about going home but has refused point blank to accept having carers there. We want her to stay in the care home as it seems to suit her very well and is such a weight off our minds. However, BIL is now talking about selling her home as it’s costing money to keep it. We agree, but don’t want to do this behind MIL’s back.

How can we gently explain to MIL where she is and that it’s not temporary? She is a very stubborn lady and, like many her generation, has a “you’re not putting me in a care home” mentality. We’d let her just coast but selling her home without her knowing feels like a betrayal.

Realistically is she ever going to accept it? Or is it just a recipe for stress and arguments?

Can you tell her she is in hospital but it's a private hospital which is why it is so nice but sadly not available on the NHS so assuming she wants to stay there, and she seems to be having a great time, there are bills to be paid?

If you tell her she will be very upset and not remember the next day anyway. And then you will need to do it all over again.

Do whatever you need to do to keep her safe and contented.

Does BIL have the authority to sell her house eg LPOA? If not, you are all stuck.

Has your BIL got a legal financial Power of Attorney and has your mother been formally assessed as lacking Capacity?

If there is no Power of Attorney he can’t just sell her house and you should seek legal advice.

I’d discuss the situation with the care home manager.

I assume someone has PoA to be discussing house sale like this.

OP is describing fairly significant cognitive decline. She is not the person she was, so who exactly would you be betraying? If she was now the person she was 15 yrs ago, what would she advise you to do with this problem?

FWIW, neighbour had to coax her 95yo dad into staying in a CH, and it took about 2.5 yrs before he would consent in principle to his house being sold. I think it was pitched to him as the proceeds helping his grandchildren and great-grandchildren out & he would always have a home with his adult kids if he really didn't like the CH. His daughter used to take him to visit his home when he asked & increasingly he would just walk in the house for a few minutes then wanted to go back to the much nicer CH where he felt safer & he liked having other people around and things were set up nicely for him... the CH became more familiar than the property he still owned.

I’d discuss this with the Home Manager too. If she’s deemed to have capacity she will have to sign documents for the sake of the house?

I wouldn't tell her she is in a care home, if she is happy where she is. Agree with PP, tell her it's a private hospital, as she seems to accept a hospital environment.

I work in a nursing home. Lots of residents ask us why they are here, and for how long. If we try to tell the truth they usually either won't accept it or become distressed. They all have dementia, so it's not in their best interests to tell them the truth.

So we tell them "Oh, it's only temporary, it's like a hotel it's because your son/daughter/usual carer is away for a while but they're coming in a few days." And they accept this, every week.

Thank you. Yes, BIL and DH have PoA so that’s not the issue.

i think those who’ve replied already may be right that telling her could cause distress. We wouldn’t want her to suddenly refuse to accept her current situation.

The proceeds of the sale will eventually be needed to fund her care, so if we do need to explain, that much would be true.

lljkk - you make a very good point re her not being the person she was. That’s is helping DH see this differently.

Replies so far have been a huge help - we just want to do the right thing.

*sale

You need a Mental Capacity Assessment..for this decision, and if she is found to lack capacity for this decision then a Best Interests Decision to be made re where she lives

Say it’s a convalescent home for the time being.

This is the best way to go about it for sure.

DMIL would often ask for her own DM. I used to say that she had popped to the shops to get something for tea and she would be back soon.

This kept her happy as it was a scenario that seemed familiar from her childhood.

DFIL saw (who has always been a bit of an arse) was dead against what he saw as lying to her and caused her so much distress over the years. Truly heartbreaking to watch and so frustrating as he would just not take advice from anyone on how to pacify her and keep her happy.

Why do you need to tell her. Let her think it’s a private hospital if that’s what makes her happy.

We used to do this with my mil who was in a dementia home. And I used to tell her I was popping out for a DRs appointment but would be back soon when I had to leave (otherwise she got stressed about being left).
But it sounds like this lady doesn’t have dementia so this wouldn’t work,

The questions change over time. MIL went into CH fairly willingly (FIL died and we couldn't care for her long term in our house) but kept asking when she was going home. Except it wasn't her most recent home she was asking for, it was a previous one. So we knew what she was really missing was a sense of home and familiarity. She did settle but never really liked living with lots of people around her.
Tbh tell her what will make her feel happy and secure.

Absolutely this. Legally she must be assumed to have capacity. Although any Home Manager should have done this already before admitting her, especially considering her history. You don't need a formal diagnosis to be ruled to lack capacity.

I honestly wouldn’t bother telling her, not if it’s going to upset or distress her. If she asks about ‘going home’ a standard answer is ‘when the doctor thinks you’re a bit better’, or ‘when the heating/plumbing/any other imaginary problem, is fixed.’

Probably a different scenario, since dementia was involved, but one resident of DM’s care home thought she was running a boarding house! She once told me in very miffed tones that another resident, ‘….still owes me nine quid for last week!’

Dementia is more than likely to be present considering she doesn't seem to be able to recognise where she is and the past history of bizarre behaviour.

Id like to clarify we explicitly had the support of family members to say what would keep them happy and calm, even if it was a lie. Some we had specific care plans for what to say which would work better. One lady had a son who routinely travelled for work so we would tell her his flight was delayed, for example.

@BunnyRuddington, I do so agree about (not) telling the truth when dementia is involved. We were new to dementia when FiL first asked where MiL (dead 10 years) was. We explained as gently as possible that she’d died years ago, but he was terribly upset and cried - only to forget and ask again half an hour later. So we soon learned to say that she’d gone to the shops, or to visit Auntie So and So, which would keep him quite happy.

Some years later, when DM also had dementia (😰) there was a stage when she’d often say she ought to go and visit her parents (dead some 30 and 50 odd years) ‘…because they must be getting old and could do with some help.’

I’d just tell her that I couldn’t take her today, because my car was in for a service/any other plausible sounding excuse - ‘but maybe we could go tomorrow?’
Her short time memory was practically zero by then, so this always kept her happy (or as happy as she was ever going to be.)

I used to be a regular user of the Alz. Soc. Talking Point forum (a lifeline for ages) where such fibs were known as ‘love lies’.

I had a similar problem with DM. She was diagnosed with Lewy Body dementia (which is like you described). I let her house and used the income to pay for her care home. The income was enough and saw her through until just after she passed away. She never had her home sold from under her

With both my parents we've found the phrase convalescent home useful as its a concept they understand from their youth.

I also had a family member with Lewy Body dementia, I let her house to help pay for care and didn't mention anything to her as I had PoA, I was acting in her best interests and it would've just distressed her.
I don't think it's common for people to tell people in care homes what's really happening unless they are definitely "all there" mentally and involved in their own care decisions. You just let them think whatever they think, say things like 'you need to stay here for a while where you're looked after' and let time pass

I should add I had Power of Attorney - hence I could rent out her home.
“I had a similar problem with DM. She was diagnosed with Lewy Body dementia (which is like you described). I let her house and used the income to pay for her care home.”

Would like to point out that most care homes are now £1,200 a week so that won't work these days unless you charge astronomical rent and have a house in London.

Actually it does work. A house the same as DM’s 3 bed currently brings in rent £300 more than care home fees. North of England