Tell me about the care your parent(s) buy in

[Hergest]

My Mum is 93 and has poor mobility and very little strength/energy after a hospital stay last summer, but is still able to get to the loo, make a cup of tea, do an online shop. Just tires too qucikly to cook, and can't reach/bend enough to use appliances or dress and undress. She is definitely better than she was but now seems to have 'plateaud'.

Her current care package (2x2 hr) now seems to be more than is needed and the carers often leave early.

I would love to hear what your EPs carers do and how long it takes them (and also if you don't mind sharing, what you pay, wehre you are, and what sort of 'rotation'.

I think there are quite a few of us on these boards who would value this kind of information exchange. ( I will make another post to share what my Mum's do in the less-than-2 hours!)

🙂🙂

Mum's carers tend not to stay for the full two hours (even though they are paid, albeit at £30 / hr which I know is not bad for the SE where she is)
In the morning they bring her tea, deal with the commode (only wee) prep her breakfast (she likes fruit etc on her cereal) unmake her bed (sleeps in riser recliner), help her wash and dress, prep her lunch and leave it on the side, clear and tidy the kitchen.

In the evening similar, with a heated ready meal plus maybe some fresh veg.

Approx weekly she will have a hairwash, there will be an online food delivery to unpack and put away, parcels or milk might need bringing in or bins emptying. Also help with eg re-ordering meds, making GP appointments on the dreaded NHS app. They also do a load of laundry approx weekly.

They are very good and reliable in that they report to us if they have concerns eg with her swollen legs, cracked skin etc.

Muym does have a cleaner (£15/hr) who isn't needed very often but might be able to take over some eg the laundry if she was available more.

If it was realistic to do all this in an hour Mum might be able to eke out her savings for a bit longer. But I'm not sure how realistic that is, and 1.5 hours of the more flexible agencies is very close to what we pay for two hours with this one.

Just interested to know what carers can actually do in an hour!

My mum has 1hr morning visits. They get mum washed, shower&hair wash if wanted, cream on legs, dressed, downstairs on stairlift, make her a cup of tea. Sometimes put a wash on. Could be done in 45mins but mum needs to keep stopping to rest

Thanks Teen - that's really helpful. I think my Mum needs a bit more as she needs both breakfast and lunch made as she can't get down into the fridge any more (and there isn't room for a higher-up one) . But I think it would probably still fir within an hour. The agency I spoke to suggested if we swapped to them, to try 1 hr x 2 and then extend if it really wasn't enough.

My Mum sounds in a similar situation to yours but she is 77. She spent 3 months in hospital last summer after a fall and suffered from delusion while there. This has improved but physically she hasn't.
She is restricted to the lounge due to very poor mobility, sometimes she can make it to the commode 6 foot away but it takes everything out of her.
She has carers for virtually everything, she has two carers 4 times a day for about half an hour, so breakfast, lunch, dinner and bedtime.
In half an hour one makes a meal and a drink and the other tends to her personal needs, i.e. in the morning they might get her to the shower or strip wash, get water to clean her teeth, put on various creams, make sure she takes her meds, changes clothes etc. At lunch one does food & drink and one might wash up, put washing on, change the bin etc.
I do cook two dinners a week for her as she prefers my cooking! When I do, the carers usually cut short their visit.
At the bedtime visit, they make sure she has everything she needs overnight, clean teeth & face etc and they make her a hot chocolate, clean the commode etc.
If there is time my Mum likes a good natter, she really likes her carers and she knows their shift patterns so knows who will be arriving.
I would say she probably has a little too much care time a day, but it would be hard to reduce really.
She is also provided with a cleaner for 1 hour a week, but she also has a family member for a further 2 hours a week to clean as she is very house proud!
She also has a chiropodist once a month.
I do a lot for Mum too, washing, cooking, putting her shopping away (she does an online shop), ordering her meds and other supplies, organise birthday cards and gifts for family, I cut her hair, do gardening, go to the shops to load her gas/electric meter, go to the bank, chemist, post office etc).
We are in Sussex, Mum pays towards her care (about £500 as far as I know) I'm not sure what the overall cost is as Mum is quite guarded about money, but I know that it must be only a fraction of the actual cost.

Mum's care currently costs £240 weekly for her 7hrs (home counties) but is going up in March.
We are lucky that my DF (96) does most of mum's care with DB and I supporting on visits.

Thanks @UnderThePressure - I m interested that your Mum gets her care part paid for. Do you think this is because her savings are under £23,000 but she is topping up what she receives? I realise you may not know. Or is it NHS "continuing care"because of your Mum's medical condition(s)? Again I realise you may not know.

And that sounds roughly the same rate my Mum would pay for 1 hr visits @TeenToTwenties , but unfortunately nether me nor my sib live near enough to fill in to that extent, so she would need 2 per day.

The other thing to consider OP, is when do care visits tip into being cheaper to have live in?
Probably not at 2x2hrs daily but it is worth enquiring about as with live in you have the care on tap to run to your own schedule not the carer's schedule, and you have the companionship and someone on hand for emergencies.

My dad is 80 and has multiple health issues including poor mobility. He gets around (slowly) with a wheeled walker. He has 4 x care visits every day - 4 x 30 mins.

In the morning they help him get washed, dressed and make his breakfast. 2nd and 3rd call they make his meals and usually do a couple of light jobs, either stacking/ emptying the dishwasher or pushing the vacuum around. The last call is to help him get dressed for bed (he goes himself much later) and again do any extra bits like putting a load of washing in.

He has a cleaner once a month who does a big deep clean and in between times, I’ll keep on top of the cleaning/tidying. As there’s continence issues, he uses a washing and ironing service and they pick up and drop off his cleaning. He doesn’t pay fully for the carers (State funded) as he only has a state pension and savings under the threshold but he pays for the cleaning services from his attendance allowance. One of my relatives had significant savings but once it was nearly used up from carers, she was reassessed and the Social Services stepped in. Many local SS no longer pay their own carers - they often outsource to agencies so you should typically get the same type of care.

In your case, if the carers don’t have enough to do, you could trial dropping to 2 x 45 minutes or splitting into 3 x 30 minute calls a day. My dad has been with a couple of agencies and all have offered 30 mins, 45 and 60 min length of visits, depending on need.

from experience I would look at an hour in the morning to shower and dress plus breakfast, a 30 minutes evening dinner call, a 30 minute help to get ready for bed call then an hour lunchtime call by someone willing to do household chores as well as lunch prep plus crucially talks to her. Could be the same person but a lunchtime home help call could be completely separate booking, perhaps a local housekeeping service, my friend does two of these calls each day, 2 hours in morning and 2 lunchtime/early afternoon before picking her kids up and only charges £18/hour

OK, so our experience is quite different as the carers were only coming in the last two weeks of dad's life, when he was on his end of life path (all treatment withdrawn apart from palliative care) and were fully state funded. (We could have paid for additional support and did look into it but didn't end up using it in the end). However, I felt it was worth adding this here because the may be other people reading in a similar position who are not currently getting any form of care for their relatives. We didn't realise we were entitled until the GP asked the District Nurse (the head one, not sure what her official title is) to call, and when mom described dad's situation she immediately arranged for carers to start coming.

The care was initially given by district nurses, then outsourced to a private care company. The private carers were not always brilliant, but to be fair I think they were quite out of their depth, dealing with a man who had severe dementia and was very close to death..... They were all without exception lovely people who were doing their best - I think anyone who works in this industry is an unsung hero, and deserves a lot more than they earn!

We had three visits a day, morning, afternoon and evening. They would change dad's pad if needed (he was doubly incontinent), wash him if needed, apply cream etc. They lasted as long as they lasted, usually only about 15 minutes.

If we had wanted overnight care (which we did consider) from what I remember it was £350 a night. We are in the West Midlands.

We cared for dad at home with no additional support until the last couple of weeks, and if I had that time over I would have bought in additional support sooner. We of course didn't mind doing personal care for him, but it did take its toll, and I would prefer it if my memories of his final few months had been more to do with enjoying the time with him, if that makes sense? And it took a lot out of my mom, who is herself in her 80s.....

Can I hijack and ask about carers and meds?
Do agencies have particularly stipulations?

@limetrees32 I'm a home carer and I am assessed twice a year for medication administration.
Our company uses a MAR sheet, each dose given is signed for. It's relatively clear if there's been an error.

Our carers can only give things if prescribed and in original packaging and on the tasks list. They are not even meant to pass medicines otherwise.

They can however 'prompt' so my DPs can remember to take their own that I put into pill boxes for them.

We recently had to ask for a basic moisturising cream to be prescribed so the carers could apply it, even though you can buy it over the counter.

Thank you, that's very helpful🙂

@TeenToTwenties are prescription dossett boxes helpful?
Or make no difference?

They could be, we haven't really investigated, partly because one of the pills goes up and down quite a lot, plus Dad has eye drops too which also go in there. So I load up when I visit 2-3 weeks in advance, collect new prescriptions etc.

Is there anything that your mum’s carers could do with her? I’m only at the very beginning of this journey so have little experience of this but have noticed in our village that one older man is taken in a wheelchair to the village shop each morning and then home again. Or is there anything companionable that the carer could do with your mum like a jigsaw (if she is able to sit) or something?

Prescription dosettes are good if your tablets are basically the same every month. They don't work if the doses need to change or your condition means your tablets are constantly changing.

Pharmacies often will only do them if you have absolutely no-one to fill a box for you as making up the boxes isn't cost effective for them.

This is all so helpful. To respond to a few points - Mum has settled into a rhythm of two visits a day and she's mobile enough to go through to the kitchen to make coffee/collect her plate of lunch etc between times. I think she quite likes to set the rhythm of her day across the middle of it - it usually includes several naps!

She is just aware that the carers don't need the full two hours and in fact often leave a bit early. But she also feels 1 hrx2 would be a bit rushed.

The agency she's with is not in the immediate area and the carers won't do shorter visits as none live in her neighborhood (rural albeit not remote)

However their hourly rate kind of corresponds to a about 45 mins from the local Home Instead office, for example - so although this would be an option, if ahe wanted to save a useful amount of money she'd need to have a lot less time iyswim. Im not sure it makes much commercial sense to offer shorter ones because of the travel time in her area

Talking to Mum again tonight I have a feeling that she is going to decide to carry on as she is . She hates the idea of any kind of change. And her main carer is absolutely great, can't fault her really, and v flexible/gives lifts to gp if needed etc. And taking the longer view, Mums savings probably will run down in the next 18 months or so anyway, compressing her hours might buy another 8 months till social services will very probably kick in anyway. Then she'll still have the £23k left to top it up if she wants. Which takes us through the next 3-4 years at least. I don't think she can really see further forward than that - which is fair enough I think! She is amazed to be still alive and tbh after the health issues she has had over the past 10-15 years it is amazing!! 😃

If she sticks with the current people, I think as per pp we need to be more proactive about asking the carers to do more with mum - her physio for example, or cooking a few times per week from scratch and fewer pappy ready meals,so she gets a slightly better diet .

This has been really useful to me to help think through the options, including for 'down the line' so I'm very very grateful 🙏🙏

PS fwiw the carers she has are happy to bring mum her box of prescribed meds, the only exception was the (very low dose!) opiate she came home from hospital with (that she stopped taking quite quickly anyway).

Just checking - she does claim Attendance Allowance, doesn't she?

Yes she has less than the threshold in savings. She had to an incomings and outgoings assessment and basically she pays her disposable income to her care costs, which is where the £500 a month is calculated. The council then pays the rest.

Wow so it's still.means tested below £23,000! I don't actually think my Mum's pension leaves anything to spare beyond what she needs for food, bills etc - but I suppose if someone has a bui occupational pension they'll still be paying out then?

Thanks, yes, the application has gone in as her '6 months needing care' comes around soon 👍🤞

If your carers are happy to drive, I wonder if it might be worth them doing 2x2hr visits most days but once a week or so could they do 1 x 3hr and 1x 1hr and take her out somewhere in the 3hr visit? We got my gran’s carer to take her out once a week. Sometimes it would be just around the local countryside, stopping somewhere scenic with a view for a sandwich & a flask of tea; sometimes it would be a slow drive around the village she grew up with a cup of tea at the cafe there if she was up to it; sometimes to a local garden centre where they had wheel chairs and it was all quite spacious and quiet. The garden centre sold everything imaginable and my gran liked to go there to buy birthday presents or perhaps some bedding plants for her window box (which her carer would then pot up for her) and that sort of thing. She really enjoyed her outings. The carer was a wonderful lady who we were so fortunate to find as she was more of a companion who would turn her hand to anything whilst also managing to keep clear boundaries of what she would & wouldn’t do.