Care homes make me think people never die

[rockrollerpud]

Recently I was given the news that someone I know died suddenly. Classic late seventies, living life totally normally, seemingly slim, fit and healthy, then gone within 24 hours from heart attack. This was surreal to me. And here is why.

I visit a relative in a care home weekly. And for want of better words, I’ve been visiting so long that I honestly feel like some people can’t die. Or at least, their bodies are just designed to trundle on like a diesel engine car with 200,000 miles on the clock.

Most of them are 80-100 years old. Many sit there all day asleep with their mouths open. Many are overweight, have multiple health conditions, yet they just don’t ever change from that. They go on for years/decades.

I have to say, there are far more women than men in the care home.

Quite regularly, I’ll read on here, that someone struggled at home but then went in a care home and only lasted 1-2 years. Yet I see the majority seem to live forever in the care homes.

Before I knew what I know now about elderly disease and decline, I’d always assumed that by the time I got to a care home, I’d be so spent, I’d only last a few years too. But now it’s freaking me out that I, like many others, could spend 15% of my life in one.

Anyone else a long term visitor to a care home and be shocked at this?

My Nan went into a care home at 96 after living independently until then.
She died at 102. It was no fun for her, she was never happy there but needed to be looked after to be safe.
She just died of old age really. She didn’t have any serious illness in her whole life, no heart problems, no high blood pressure, took no medication and only had surgery once for a knee replacement at the age of 80.
I used to think how amazing, but now I know I wouldn’t want to live as she did for her last couple of years.

Are care homes raking it in as you say? from what I’ve heard many are closing down regulations make it impossible to keep afloat

Please ignore the yess that was meant for somewhere else.

I'm not sure, some are, some aren't. Some are closing because they can't make it work - this puts the onus on to richer care homes to pick up the flak, with the local authority having to make up the money difference.

With this in mind, you could argue the CQC and Council's Social Services don't care to look to closely, to regulate much, for fear of care homes closing.

Yes they are raking it in. One home abused my DM by deliberately making her sign contracts in retrospect without me present after they lied about fees. Two managers cornered her alone in her room and made her sign the paperwork pretending it was for something else then they lied through their teeth and denied it saying she was confused. CQC are not fit for purpose is 100% correct. I made a complaint - nothing happened to the owners of the home. They own multiple care homes, care only about profit, and their accounts show millions.

CQC are a joke. Care homes are told when they're going to be inspected and pull out all the stops - extra cleaning, painting, paperwork completed, extra staff, fancy activities and nicer food. The inspections that are unannounced are usually the ones that catch them at it.

What you can't legislate for is intelligence and genuine kindness. Emotional intelligence is a particularly rare thing amongst staff and most just aren't switched on or bright enough to know that it's inappropriate to patronise the elderly, have blaring radios, put on toddler games as activities, not talk about their relationship problems with another staff member whilst resident is having a bath, forget to put someone's glasses on, not close the door when they're having a pad change, be slow with pain relief and not give them choices about how they want to be cared for. Mil never came to terms with the fact that the staff looking after her weren't naice young ladies and she couldn't interact with them at all or ask for things she needed doing.

Maybe. But if not I won't just sit there day after day and let my body waste away when I can do something about it.

My Mum spent three months in a care home in the final stages of Alzheimer’s following a protracted admission to a mental health ward. In hospital she was wrapped in cotton wool and even placed on 1-1 observations because she kept wandering. She died very suddenly in the care home although I suspect this was due to poor care. I didn’t pursue it as I was thankful she was no longer suffering. Dad was living independently at home and suffered a major stroke. The doctors agreed there was little hope of a meaningful recovery I requested palliative care only. He died in a hospice a couple of weeks later. I miss my parents but I’m relieved they didn’t linger for years in care homes.

My dad is 92, and has forgotten most of his life before the last few days. But recalls bits of childhood, he thinks his wife is his daughter. But actually, I think in a very odd way, this might be the happiest he has ever been. He has mellowed and softened, he is in his happy place with a great view to enjoy over a harbour with boats moving, and his wife still adores him and spoils him. He enjoys his food, requires no medication, and while he has periodic crises after which she has to wrestle him back to decent health (because the NHS doesn't really care for very old people well, in Dorset) they rub along. I think it comes at a high price for her health though.

My aunt took a cup of tea up to my grandad and found him dead in bed. A heart attack in his sleep at 78. A bit young these days but the best way to go.

I agree. How a young fit person die suddenly and an elderly person has to suffer sometimes decades in a care home?

Falls are an accelerator, one way or another. There have been a number of celebrity deaths in the last few years that came quickly after a fall - Des O'Conner, Barry Humphries, Nicolas Parsons I think, Christopher Plummer, Bobby Robson, very possibly the Queen I would have thought, and Jilly Cooper.

Most of these were mentally lively until that time, some actually still working.

Some were quite tall and I have a theory they're more likely to stumble and hit the ground hard in that case. As most were still active, that is a factor - the brain wants to do a certain thing but the body doesn't follow suit and - bang! My mother was in a wheelchair and used a hoist for her last few years; it is unlikely she would have had a fall (but don't rule it out; make sure the seat belt is fixed on the wheelchair or going along at speed, you can hit a dive and they can go flying as the wheelchair stays where it is...)

But both did had falls of a kind; my mother had early Parkinson's and was walking and stumbled a bit. It broke her hip but it didn't show for a while, she had brittle bones and it doesn't hurt immediately, she wound up with a hip replacement while the pain killers interfered with her drugs and drove her mad, she thought people had entered the house.

Dad had a fall because he went nuts - this can happen with a urinary tract infection, easily cured with antibiotics, or low sodium levels, which may well require an overnight stint in hospital. He tried to get to the loo and fell, so my advice is to have a piss pot by the bed - an empty beetroot jar will do it - to avoid unnecessary nocturnal trips to the loo.

Dad broke a leg but it was near the top of it, on the pivot, so didn't require plaster and it healed by itself, this was around lockdown lifting. He didn't really walk again however - in a way I regret that, but he had a touch of dementia and I could just see him haring off and falling again.

I more regret not getting Mum walking again on a wheelie zimmer, it would have made all the difference, the act of walking keeps the mind going. But once the care home had her leg contracted, stiffened up from its use in bed, that was the end of that.

My point is that it's the fall that gets you, though it may not be immediate, there's no way of telling. Have to say in the documentary showing Jilly Cooper inching her way up the stairs of her house, plus 80, I would also advise relocating the bed to the ground floor if possible.

Exactly what my stepfather is going through.
Now 94 and 'benefitting' from all the physical activity he engaged in over the decades. He used to 'jog' before the word was invented 😂.
But his brain started to deteriorate when he was in his mid 70's and he's been 'away with the fairies' for many years (I don't mean that rudely just how he is) and it just got worse and worse.

He has taken a cocktail of drugs for years to keep his blood thin and has had several stents so the body is ticking over nicely.
After aged 80 he had a hip replacement but now struggles to walk any distance as the mini strokes he keeps having affect his balance.
He has plenty of muscle on his legs and was always a tall slim man (still is) but it's his brain that's f**d so he's prone to falls.

He's been in a care home 3 years now and he'll go on for years. Despite his children not wanting life extending treatment, the care home sent him to A&E after another TIA. Afterwards he couldn't eat or drink so they were spoon feeding him and doing the thickened liquid. So he's still there (@8k pcm private funding so cross subsidises others) and just exists.

Sadly my mother died from a rare illness at 76 and she was super fit for her age. But she developed a rare disease affecting the liver and was dead after a year. We were devastated at the time but looking at them both now I wonder if she actually had the 'better death' .

Mel Shilling comes to mind. Beautiful soul. How is she gone, yet both my relatives’ bodies that have been battling multiple health problems for over a decade, can still happily chug along. One of my relative’s had a brain scan recently and the consultant basically said my relative shouldn’t be here going off the extent of the damage to their small blood vessels. I know!!! It’s just incredible how some people, no matter their health battles, keep on going.

I am absolutely terrified of old age and the idea that I might spend years in a care home is horrifying to me. What makes it worse is that I will have absolutely nobody to keep an eye out for me as I am an only child and can't have children. I used to take some comfort in the fact that safe guarding bodies like the CQC existed, but now people are saying they aren't for for purpose? What a tragic way to end my life. Completely alone and probably neglected and abused.

I'm not unsympathetic to this thread with all its different views but I take it some would have been quite happy to be with Boris Johnson's 'let the bodies pile high' strategy during lockdown. It's almost like it's building a narrative.

It's far from inevitable that you will end up that way though, only a small percentage of people go into care homes and an even smaller percentage last for many years in them. Plus many can have quite a good quality of life or at least be getting some enjoyment from life when they get good care. As people have said, if you are gifted with good health to start with then trying to look after yourself so you have as long as possible healthy is a good idea.

My dad only ended up in a home for end of life care as they could provide the round the clock care he needed and make sure he was peaceful and as pain free as possible. My mum died peacefully at home having been pretty healthy up to the age of 85 and only unwell for a few months. I'm not scared of old age, I'm scared of not getting there as one's 50s are like sniper alley. PIL are 82 and doing very well. I release from my own parents who were slightly older that it can change quickly so we will appreciate them while we can.

@NewspaperTaxis Yes, falls are the thing!

I used to work in a hospital and didn't understand why there was a Working Group on fall prevention in the elderly. Well, now I do...

It's such a chicken-and-egg situation though. Sometimes there can be mini strokes that contribute to the fall and are never detected. But falls seem to precipitate mental decline, often dramatically.

Now in my 60s, I'm pursuing functional fitness in a way that I never did when younger! The motivation is strong 🫣

My elderly relative has spent years looking after their physical health but none looking after their mental health. Think extra screening, obsessive with exercise, statins, blood pressure medication etc etc.
The problem is that years of untreated severe anxiety have undoubtedly contributed to cognitive decline.
They express a wish to die suddenly of a heart attack rather than end up in a home, but have done everything in their power to prevent that happening.
It’s a bizarre mismatch.

My DPs were relatively independent until DM had a fairly minor fall aged 86 and the wheels came off the bus spectacularly with DF age 91 as her assigned carer who has significant memory loss and 4 random carers a day. We are lucky to live in Scotland so that care was free, but social care insisted they were fine to live at home until we forced the issue when DF went into hospital after yet another fall.

They are now in a care home near us. Surprisingly DF 92 is really enjoying it and now that his diabetes is being managed and he is well fed, is looking well. We visit them 2-3 times a week and often take DF out for walks or lunch. His memory is shot and he couldn’t have lived alone.

DM is in a sad state with progressive dementia. Her mind is sort of working but hyper focused on minor complaints and she is barely able to speak or see. It is hard to predict what will happen to someone. She hasn’t had intensive medical treatment apart from a breast cancer lump removal aged 80 followed by 5 years of tamoxifen. With the benefit of hindsight certainly the tamoxifen seems ill thought out as it seemed to plunge her into a depression from which she never really lifted even after stopping it. But at 80 she was reasonably hale and hearty so it would have seemed cruel to deny her the operation.

In the nursing wing of the care home which they are in, most of the residents spend their days semi conscious in front of the TV being spoon fed mush by foreign born carers. It doesn’t look fun.

For those who say they would rather stay at home even if they are wandering the streets, please don’t do this to your poor DCs. You may think you’re independent and able to make your own decisions but sadly the world feels differently. Funnily enough every single old person I have come across who wants to retain their independence seems quite happy for that to be at the cost of their middle aged DCs lives.

Are care homes perfect and do they perhaps extend lives further than they need to - no and possibly, but I don’t know what the alternative is.

I agree that in general, society is broken. However, it's impossible to care for the elderly at home nowadays. A century ago, old people would die within days or weeks of a serious illness or a fall where they broke their hip. Immobility carries an extremely high risk of pneumonia for the elderly, which meant that a few days in bed could be enough to carry them off. Nowadays, people are kept alive for years, but they need extremely high levels of care, and how are their relatives supposed to manage that?

Yes, the idea of years ago feeding tubes being placed to keep bed ridden dementia patients alive would not have been on the radar. Nor would antibiotics for inhalation pneumonia as they are a relatively new drug in the history of medicine.
Years ago 1 wage kept a family, so caring for a relative at home was also easier.

I don’t think society is broken or people are less caring it’s more that modern medicine can treat all the diseases that used to bump people off. And unfortunately controls them so that only a dr has any say. A family member was on a morphine drip (controlled by an electric pump that couldn’t be tampered with) until he starved or was dehydrated to death as he couldn’t eat or drink.
It might have been better to let him eat or drink weeks before, develop pneumonia as it had gone down the wrong way and not be given antibiotics.

Caring for relatives at home is a red herring in our current medicalised society. Countries that care for their elderly so not have them surviving for years on a cocktail of drugs and medical interventions - they would die of infections or accidents that we now prevent. We artificially prolong human life. My mum's husband is in a care home because he kept wandering and being picked up by police - for being on a busy road/in someones garden etc. Mum locked the doors but a minute's inattention and he would get away, plus he was turning on electric appliances overnight and setting off fire alarms. He was assessed as unsafe and put in a home. Left to his own devices/cared for by my mum, he would have died on a road/in an accident or wandered off in winter and got hypothermia - in many ways a natural end. He has been in a care home for over 4 years with no natural end in sight - doubly incontinent, progressively losing mobility and spoon fed. Allowing him to die would have been a kindness and would doubtless have happened in one of the countries lauded for caring for elderly relatives. But as a society we don't allow that.

Yes, those ends would have been "natural" but the trauma for the person whose car hits him, or the guilt for the wife or family member who accidentally lets him out and when he is found dead would be horrendous.