Having to choose a care home for someone else

[tobee]

Has anyone got any experience of choosing a care home for their parents or parent or other relative?

I just wanted to share worries and concerns and thoughts. I’m right in the middle of this now.

I keep worrying that I’ll choose badly and that my parents will complain and I’ll feel it’s my responsibility because of what I chose.

My mum keeps saying different things about what she wants and she says she wants to go to home but is worried about the speed. I’m trying to reassure her. My dad with dementia doesn’t want to go at all.

The house is likely to go on the market soon and that will also be difficult.

Im particularly looking to hear from others for the personal experiences but any thoughts generally would be appreciated

To clarify it’s not so much how to find a care home or the practical stuff it’s more the emotions.

Where’s the bigger picture? Why are they going into a home? Are they planning to go together / to the same home?

why do you have to choose? you can help them, sure, but it doesn’t sound like they are at the stage of needing you to do the choosing, surely.

I’m sorry this is happening to you…is there a possibility of an alternative…not already is it possible they could downsize to a small bungalow and use the rest of the money for a carer?

My mum went through about 3 years of saying she wanted to go into a home because she got lonely in the evenings and none of us lived locally. But as soon as I took her to visit one I thought she'd like she acted like I was the devil incarnate trying to force her into a home to get her money. Then a couple of weeks later it was back to wanting to go to a home The chances are whatever you do will be wrong.
In the end mum had to go to a secure section home urgently and the big thing (a nice garden to sit out in) she always said was a must wasn't possible.

In my case the decision had to be made so quickly that I paid the £22000 deposit from their account before we had even seen the place. I had viewed a lovely care home in their own town and would have been happy with them there, but DH and I viewed for one parent only and suddenly both of them needed to go in, they didn’t have any places immediately and we realised that somewhere closer to us would make a lot of sense as I am the only DC.

Read online reviews and pay careful attention to any bad ones as this will give you an idea of any main failings. One of your issues- a bit like mine - is each of your DPs have different needs, so think about levels of care on one hand - you need a place that does dementia care, and social outings on the other.
People recommend smaller privately owned ones - unfortunately we didn’t realise that. Things I like about DPs is that they have chefs and the food is all freshly made, they have some grounds to walk around and it’s a five minute drive away from our home. Things I don’t like are ever changing staff with very poor English and difficulty getting responses to communication to them about my DPs and it seems difficult to get things like eye tests and hearing tests organised for my non mobile DM.

Ultimately though nothing will be perfect but it will be much better than their current arrangement. Deep pockets needed though, very deep ones.

We've looked at loads of care homes for both sets of parents with different needs and in different areas. My most observation is that the homes run by not for profit organisations all looked nice and had decent staffing levels, the big chains all had terrible staffing levels and high turnover and those with 1/2/3 homes were either dreadful or lovely with no in-between.

Many places offer an initial trial period, and even after than you can move with usually a month's notice. So this doesn't have to be a final decision if the first choice doesn't work out.

I’m sorry, this is very hard. I’m assuming there is no alternative to residential care now.

The first thing is to let go of the idea that there is a perfect solution out there.

My mum went to three different homes. The first was an utter hellhole, recommended by a friend whose Mum had died there two years before. Lesson one: homes change fast, you need to visit now. Lesson two: it’s ok to just dislike the vibe of a home. Sometimes it’s all you have to go on.

The second was highly specialist due to Mum’s needs and it was a million times better but it was over an hour away and that was awful. Eventually the relationship with the staff broke down completely. Lesson three: being close to the main visitors is really important. Lesson four; all homes without exception seem to be dreadful at communication. They never told me ANYTHING. I couldn’t get used to it. If you are close by, you can at least eyeball things yourself.

The third one was perfectly ok. Lesson five; look for staff who stay a long time. Lesson six; go for a manager you can talk to. I think she hated me as well by the end but at least she did respond to emails and treat me professionally. The staff were kind to mum and the garden was small but very accessible and usable.

Do the best you can, go as often as you can in the early weeks, don’t be afraid to be demanding.

Oh yes; suck up relentlessly. I was a frequent user of the Employee of the Month recommendation cards, studied the staff board at length, took biscuits etc for the staff. Get to know them.

We went for one local to us and with pleasant communal areas, accessible garden (all hard surfaced but with little seating nooks and plants in tubs) decent ratings. It was friendly and you could visit at any time. No outings, but they did have activities and enrichments. We also wanted one ideally that could support nursing care if needed. MIL was well looked after but always grumpy.

Just about to start this process and with you on the emotional burden. It’s a lot of pressure to get it right, such a huge decision and I appreciate the PP’s advice that nothing will be perfect

We’ve talked to Mum a bit about what she would want, but Alzheimer’s means she often forgets the conversations

Didn't expect to be doing this yet but a fall followed by a few weeks in hospital combined with her partner’s decline in health means she would not be safe to go home - which is what she wants

She needs to be watched 24/7 so her partner would never be able to leave the house (or sleep - she fell at night and he’s still upset about that)

I think she’d hate full time carers in her house and no way partner would cope with that either

She’s started to forget what her house looks like, so maybe better to discharge from hospital to a home?

Assessments underway re medical & dementia needs and financial assessment like next week - minefield

Once they then recommend suitable places in the area we will view and see how we feel about atmosphere, how staff treat residents, what activities and outings are offered etc.
And the smell - when I visit homes to do a volunteer activity this is something I always notice!

The sniff test is very important.

I'd also - all else being equal - choose one with a silent call button system rather than bells.

Even if you pick the perfect care home (which doesn't exist) they will complain, unfortunately there is no way round that so please don't feel guilty.

When your mum says what she wants are they actually helpful suggestions or just random things she later forgets?

Bottom line is the main priority in choosing a care home is that the staff genuinely care. Everything else follows from that.

Some homes provide respite care so could you arrange a week or fortnight “holiday” so that they can try out a couple?

My stepmother was placed temporarily in a home when my father, who was her carer, went into hospital for a couple of weeks. Visiting her there made us realise that we would not consider that as a long-term option.

My mother in law and her sister also had week long stays in care homes. One they had experienced them it was easier to talk to them about what they had liked or disliked. The sister, who had dementia, went in for a week and ended up staying permanently.

That's brilliant once you are in but sounding ones can be very telling when you visit. Especially if you can see the board with the room numbers and see how long the response time is.
The trouble is once you've decided the response time is good you want them to go silent and that doesn't happen. First home mum was in was a constant din which meant I spotted how lousy the responses were. But I didn't get to choose mum's home.

Sorry to be so slow returning to this thread but various things have cropped up in the last couple of days but I will read the replies and respond as soon as possible.😊

My friend was sent to a care home by the hospital. He just stayed there.

I moved my mother to a care home but I looked at it slightly differently because I did not discuss it with her. She had dementia and it would have stressed her out to participate in the decision making.

When I visited care homes I was simply thinking "is this the right type of place for her?". She didn't need anything swanky with a cinema or hairdressing salon, she just needed kind carers who could meet her needs.

When I walked into the care home which I chose for her, I immediately knew it was right. There was a kind, calm and friendly atmosphere. The other residents seemed fairly contented, the staff were very approachable. It was an independently owned care home with about 30 residents. She was happy there for several years, and died there.

I would not pay too much attention to what your parents say because they will change their minds regularly. It needs to be you who guides the decision, and you need to trust yourself to do so. I found that hard to do at first but you do get used to it.

Ok so they are at the stage where they need a care home; they currently have a live in carer and their money is running out because it is mostly tied up in their house. I know you can do various things like equity release etc but that has drawbacks that make it not worth while. I don’t think the carer is going to be able to look after them so well if they become further incapacitated, although she’s very good. Mum has said several times that she wants a care home but I think feels her world is not in her control anymore

I don’t think my mum has the mental capacity to choose the home but I can talk to her about the homes and show her photos etc. She is physically not able to go and look because she needs to have two professional carers to take her because of her mobility issues. I have to choose and look at the care homes because I’m the only one who has the time and proximity and flexible transport ie a car.

They are past the stage of downsizing or sheltered accommodation. The financial situation is a major constraint. But if they had more money they wouldn’t be getting much at home care improvement. My mum would benefit from outside space.

I went to visit a care home this afternoon. It’s in my hometown and definitely passed the sniff test. However, there were other problems. The outside space was unattractive and urban and small and separated from the house. There were not good views that my dad would like; lovely big Victorian windows but no view. The building was a bit rabbit warren and the dining areas looked makeshift and not attractive. I’m sure we could do better further away from the urban area.

Also on the ordinary residents floor the names of residents were just felt tipped onto a stuck on piece of paper by their door. Small things but something you could easily make look more homely; similar to the dining rooms. More about thoughtfulness than money and effort.

Oh and yes they’d go together and same home.

Do you have any local carer's groups? We have just moved FIL to a home local ro us, DH is part of a carer's group who are in similar situations and asked them for recommendations and we went to view a few of those and chose one we thought would suit FIL's needs the best.
He was resistant to moving at first - even though he'd been in a dementia home as that was the only one free when he needed emergency care, and he doesn't actually have dementia!

Do they want the same bedroom? Do they currently have the same room?

ooh I hadn’t heard about carers groups before.

they were living in the same bedroom but mum’s latest hospital discharge said she had to be sleeping downstairs in a hospital type bed. She was supposed to be able to go back upstairs but the last physio said she would be not likely to be safe to go upstairs. So her world is very much restricted, to just her living room at the moment. A care home might open up her world space for her with the availability of lifts etc.

Dad had to be discharged to a downstairs hospital bed for a while but he didn’t break any bones and recovered enough to go back upstairs while being supervised. He doesn’t understand why mum is still downstairs and even suggested she preferred it recently. Which is very much not the case.

I think dad would find it hard for them to be not in the same room but I think that would be not good for mum as she would feel she needed to care for dad. He also goes to bed at about 7.30 whereas mum is a night owl and used to regularly go to bed at midnight until the last half year. She is also sociable where dad is not. Likes the telly where dad no longer does.

in an ideal world, money no object, care home they would be in interconnected suites with a separate private living room. The reality is that a lot of care homes have separate floors for dementia patients.

Have either of them had a social services care needs assessment? This is quite important. It's not the same as the discharge from hospital assessment. Even if they are paying for their own care, the care needs assessment sets the bar for what level of care they need right now and it puts them on the social services radar where they will end up anyway if they run out of money.

What's the financial situation? You say that they are paying for a live-in carer but the money is running out? How much is their house worth? If you are looking at paying for two places in a care home, that's going to be at least £3000 a week. How long will the money last?

Do you have POA for them?

It's not completely clear from your posts but...

Mum - no dementia but very limited mobility. Currently sleeping downstairs in living room. Why was she in hospital? Why is her mobility so restricted? Why don't you think she has the capacity to choose a care home?

Dad - diagnosed with dementia and also recently? out of hospital after a fall? More mobile, but clearly something caused him to fall? He's now sleeping upstairs.

What does the live-in carer do for each of them? Are either of them able to manage;:

Getting up, washed, toileted, dressed?
Cook, eat, tidy up after meals?
Medication?
Going to the toilet through the day?
Do they get out at all?
Getting ready for bed, brushing teeth etc and going to bed.

Sorry for all the questions - it's hard to advise without knowing the above, as it's quite a particular situation that they are in.

No those are good questions.

Sorry I haven’t been clearer. The live in carer does all those things. They are not able to get out at the moment because they need professional carers to help them - at least 2 for mum.

Dad was in hospital last autumn with a chest infection and diagnosed with severe heart failure. He made a good recovery considering. His carer says she’s noticed he’s less steady on his feet in the last few weeks. He has moderate dementia.

Mum was in hospital in March after a low height fall breaking her femur resulting in 3 hour operation and pining of bone. She went to rehab but hasn’t made the progress she was promised. Needs to use a zimmer to walk very short distances and has to be followed by carer with floating commode as she frequently needs to sit. Sometimes cannot walk through lack of strength. Had a mild stroke last summer and recovered well. Since the broken femur she has had to go back to hospital several times including for having a poor electrolyte balance resulting in concerning side effects. And another occasion where a Tia or stroke was suspected but doctors concluded no evidence of this clinically. Although her memory and cognition is further impaired but still moderate currently.

Both have continence issues.

I rang there local council for them to have a social services care needs assessment but haven’t heard further so need to chase it up.

Yes the money for in home care is running out which is coming out of their savings and pension income. There house is worth £500,000 but we’re realistic about the current market so we will see. Care homes around them and me and between the 2 are looking at over £1,500 per week per person for the lowest rate. I’ve frequently turned to AI to run the numbers through for different scenarios and different care homes and timescales etc.

Yes my sister and I have financial power of attorney for them. And health and wellbeing for dad. Although not for mum which we need to remedy urgently; as her health has only recently declined and she was previously dad’s carer.

Mum keeps saying she wants my sister to look at homes too which she may be able to do but has geographical/logistical/work impediments and I’m ok at dealing with most of it but occasionally have a wobble. Especially as mum sometimes says what her priorities are and then changes her mind or forgets so I’m basing my decisions/suggestions on past knowledge of them both.

Oh and why doesn’t mum have the capacity to choose a care home? It’s mostly because she can’t get out to see the homes and would rely on websites and printed literature which don’t give the full story. When I showed her some pictures from the website of two homes on my preferred list of suggestions she only briefly looked and briefly commented. But obviously I’ll keep showing her for feedback. And dad too.

I would love to be able to get mum and dad out but currently would not feel it was safe for her having a non professional helping her in and out of my car so would have to work out what we’d need for it to be feasible.