May be time for a care home - moving near me

[TesterPotQueen]

I'd really appreciate some help on this, or anyone's experience of a similar situation.

Dad is 93, has a diagnosis of vascular dementia, and it's clear he is gradually going further downhill. He is a very difficult and stubborn person to deal with so will not agree to anything without a fight but he has lost any logic and just doesn't understand things, it's utterly exhausting to deal with. I can see that if he is still with us, he will probably have to go into a home at some point this year. Currently lives at home alone with daily support from lovely ladies who do lunch, shopping, laundry etc.

My sister and I I live 2.5 -3 hours ish away and have both types of POA. If dad needs to go into a home it would be much better for us if he were nearer one of us, to save us these soul destroying 5-6 hour drives every couple of weeks. He doesn't have anyone else who could ever visit him in his home town, all either dead or too infirm themselves.

My question is about local authority funding. Dad has enough funds to cover around 3 years in a home, after which he would need to be funded. He had 2 relatives who lived to be 103 so this scenario is a real possibility ( I am trying not to consider this! )

If we move him to our area, and he lives in a care home, does our local authority have to fund him when his money runs out, or is there a problem because we've moved him from his own authority to ours, knowing he may need funding?

If we need a SS assessment of needs, will his LA do it and share it with our local people? Or how does that work?

If he were in hospital where he lives and needed to be discharged into a care home, but near us, how would that work practically...would we be responsible for transporting him etc. Any problems with admin you could forsee?

There are probably things around this I haven't even thought of so any other advice is warmly welcomed.

Just trying to get ahead of the game. I am exceedingly tired of the whole set up, I never thought I'd be 65 and still having to deal with all this, it feels like it will never end.
Thank you.

First of all, I am sorry that you are dealing with this, I have got similar but not over different local authorities, and I hope someone will be along soon to give you more precise guidance. It is good that you have LPAO. It is probably obvious, but I would focus on getting answers from the LA you are in, and have a "scenario based" set of situations so they can answer the questions without giving personal advice on your exact situation. So it would be "general guidance" rather than "advice" per se. Explore all possibilities, for example, include the situation where he moves in with you (even for a week) and then you move into care home, or the hospital scenarios you talk about. You could probably also talk to a couple of local care home managers and see what their pov is, but I would be a bit wary as treating this as advice, you would still need to check with the LA. It is all hard work, but it is one of those things that you should probably pro-actively do, just so you know your options and the curve balls. Finally, I think he won't want to move, and this is something else to overcome. My Dad (86) is extremely difficult if he has even the slightest change now, spends most of the time repeating himself, obsessing fearfully about the same thing, and cannot do anything that he used to enjoy (even watch the TV). My mum (same age, no alzheimers but disabled herself) insists he must be kept at home and she is happy to look after him, and we are local, so just about managing, but "incidents" are increasing (some are just messy (incontinence) or physical (refusing to eat ) some are mobility related, some are completely psychotic and scary (suddenly decides to leave house, or put cooker on, sees family members in the house that are not there, does not recognise any of us when there etc.). A very cruel disease. Hope someone else comes on to help but I feel for you xxx

He had 2 relatives who lived to be 103 so this scenario is a real possibility ( I am trying not to consider this! )

I am exceedingly tired of the whole set up, I never thought I'd be 65 and still having to deal with all this, it feels like it will never end.

Wow.....just wow.

Hello Ada, are you new to the Elderly Parents board? Maybe start your own thread if you have things to say.

I have no concrete advice regarding the LA funding, and @avignon1234 has covered it well.

Just wanted to wish you well, and say I completely understand your feelings of ‘will it ever end’

Dementia is a cruel disease. It was an absolute blessing when my MIL died, as all semblance of her younger self had gone.

Hope it goes well Op.

Hi @TesterPotQueen

I went through this scenario with my mother and had all the same questions, it was a logistical nightmare.

But once she was in the care home it was absolutely fine.

My mother had several years worth of money to self-fund (I initially thought 3 years, but she had a bit more than that). I chose a care home near me, and made all the arrangements myself. She was still mobile enough to get into a car for the journey at that point.

The one point where you may have an issue is the needs assessment, which is done by the manager of the care home. They would normally visit the person, but obviously that wasn't possible as she was too far away. They agreed to accept the needs assessment and care plan from the agency she was using at home.

I did not involve Social Services or the LA. They are not interested if the person is self funding.

My mother had been living in the care home for several years when her funds ran out. At that point I contacted Social Services in my area, a financial assessment was done, and the LA (i.e. my LA where she currently lived) funded the remainder of her life.

As I say it was logistically difficult and a bit traumatic, but once she was in the care home everything was so much easier.

Yes, thinking about it @catofglory situation makes perfect sense - if you simply moved to an area as a young person (no dementia or anything) and subsequently needed social services or some other intervention, the LA would not say "aha ! but because we think you used to live in Kent, so it is up to them to sort". Given there will be a period of self funding then his address will be a local one, albeit the care home. I think the other questions are still maybe worth chatting through (we are not quite at care home stage yet, so did not know what assessments they needed before they accepted a person on a self-funded basis). Definitely be worth asking the care home. Similarly with the hospital one, if they discharge, I think it is usually the family that collects, or possible Patient Transport Service (but I don't think they would countenance a 5 hour journey) - although it is a scenario that could happen - i.e. elderly person goes into hospital while away on holiday, and then needs to be discharged (to their home) In this instance, probably a high percentage where family comes for them, and maybe most of the time, if they were "OK to be on holiday" (and I realise this is relative !) before the incident, then maybe they would be expected to be OK enough afterwards (i.e. to get a taxi or something). Again, hope you get your questions answered, it is hard to work out what to do and know all of the rules x

It is absolutely fine to proceed as you suggest. By the time your dad's money runs out (if he lives that long) he will have been a resident in the local area for a number of years. Being in a care home that is near one's family is an obvious and logical choice and it won't be questioned. My granny still had all her marbles when she had to go into a home as no longer able to care for herself and she chose one near to one of her sons in an area she'd never lived in, and self-funded for 18 months then the LA took over with no significant problems we just had to show that her assets were now depleted to the level at which the LA needed to pay and show there had been no sneaky business hiding assets away.

The vital thing is that you need to make contact with the new LA months before his funds run out. Do not wait until his assets hit the limit. Keep his financial records up to date including projections of anticipated future bills and start the ball rolling for LA funding when you can see that he will hit the assets threshold within the next 4 months. The only other thing you'll need to prove is evidence that he definitely needs to be in a care home at all, if the decision is made without LA involvement when he starts as self-funded. From your descriptions in the OP this doesn't sound like you'll have any trouble with that but make sure you keep some evidence so that you can demonstrate the need if they query it (most likely this won't be necessary as the care home will by then be able to confirm that he has significant care needs)

Thanks for replies, I will read later, have to go to work now.

I would absolutely not have your dad move in with you, even for a week as someone suggested. You would probably find it impossible to get him into a care home thereafter.

The advice from all the above is spot on. One extra point: choose a home with a stable manager and senior team — good leadership and proper staff training matter. Also, make sure it’s easy for staff to get there by public transport. Recruitment is tough in the sector, and if staff have to rely on taxis, retention suffers and residents feel the impact. Essentially you are looking for staff with twinkling eyes and smiles rather than flashy facilities that are not required.

@TesterPotQueen sending sympathy and so sorry you are in the position many of us find our selves in. Same language is used so often on these boards; difficult and stubborn regarding the EP and utterly tired and exhausted from those of us in the middle of it all. Well said @PermanentTemporary calling out @AdaDex . These threads are a lifeline for many of us and we are genuinely tired and exhausted in our mid 60s. Another ten years of it is mind boggling but also something we have to consider. If we cannot vent here then we’d be lost.

I do hope the OP finds some solace on here. The post was clear and very much a sensible one. 💐

My dad was in the same position. When I investigated I was told that if his money ran out within 2 years, his old local authority would be billed for the care home fees by the new authority, but that it was not a complex process. He didn't need it in the end, but I was told that it was not unusual and they were used to dealing with it.

Thank you to everyone who replied, there are some really good points made, some of which I hadn't thought of at all, and I appreciate the solidarity from many posters. I think if and when the time comes we will move him nearer to us and then just deal with the funding situation should it be necessary, but I will write down all your points in my notebook to refer to. Thank you.

There's no way he will be moving in with either of us even for a few days or a week, he would not manage stairs plus he gets totally bewildered if you take him anywhere new now so it would be too disrupting to then have to put him somewhere else new to him soon after.

Finally I would like to especially thank @PermanentTemporary and @BlueLegume for standing up for me, and for understanding where I'm coming from.