Should I move my mother to a different care home

[hangingplant742]

Hi there.

My DM has advanced Parkinson’s and mixed dementia (Alzheimer’s and vascular). She is still mobile when her Parkinson’s medications have just kicked in but is often stuck and frozen in a Parkinson’s freeze.She’s been in a home for just over a year. She could live for another 10 years or could die tomorrow type scenario.

I’ve never fully liked the care home she is in but we had to find something quickly nearby to me.

Last night I went to visit her (I go weekly) and was appalled at some of the things I saw. When I arrived she was shuffling around her room with her zimmer. She asked me to help her to the bed which I did. I removed her shoes and found her feet in this state. I was/am devastated. She’s always had excellent feet. She’s only 78 but has always had great foot and toe nail health. I asked her if she knew her nails needed cutting and bless her she just sort of nodded but didn’t seem too bothered. Her dementia has really ramped up in the last six months so she needs a lot more checking and prompting with things.

i went to find a care worker and asked them to check when was the last time my DM saw the chiropodist. They checked in the computer system and there was nothing logged since April. I showed them the photos of the feet and said I was upset. At this point they got a clipboard and checked a written list and said they asked my DM in June and July if she wanted to see the chiropodist and she said no. They said they can’t make her say yes.

i went back to my DM and asked her if she said no, and she said she just said no because she thought they meant do it there and then. She clearly didn’t really understand. I think the care staff don’t check her feet at all and didn’t know they were bad. The care staff are trotting out the ‘we can’t make a resident agree to nail cutting’

When I asked if a resident says no continually to nail cutting, do they just let the nails grow forever and they didn’t really reply. Just kept repeating that my DM said no.

My mum is increasingly in dirty clothes. I wanted to help change her into pyjamas and could not find anything suitable for her to wear. A care worker appeared and pulled out three pairs of pyjama pants from the wardrobe suggesting I put a pair of those on her. I refused because all three were stained yellow with wee at the crotch.

Her room has a basic ensuite with no window. It’s a bit basic but last night it was dirty. i asked for some nail clippers to attempt to improve her nails myself. They said I had to do it as they weren’t allowed to. I was crying and wretching whilst doing her nails. I could hardly get through the nails they are now so bad.

Then I wanted to wash my hands but there was no soap in her en suite and no toilet roll.

A few months ago she was found wandering in the steeets outside and had escaped without them knowing.

Last month they told me she made another resident fall over from encouraging the resident to walk faster (my DM is still fast when her medications make her mobile). They said they knew what happened because they saw it on the CCTV. I have had concerns for a while that they are understaffed. They told me they have 6 staff to 28 residents. I’m not sure if they include the care home manager in that ratio but evening and weekends particularly seem bad.

My dilemma is that my DM has very little money. She has about £160,000 left from the sale of her tiny house. Because there is no cap, she will pay almost all of her assets in fees. But when I have looked at other nicer places, even though she has enough money to self fund for about 2.5 years, they won’t let her move in if I don’t sign a financial contract to say I will pay the top up fees once her money runs out. I don’t have the money to pay top up fees indefinitely. I have two young children at home still and it will be a miracle if I can find money to find them through university and pay my own mortgage.

I’m working class and in a senior professional job - but I’m the typical squeezed middle now. My salary, although decent, does not go far.

My DMIL is also in a home and she also has only a bit of money. The state is going to ensure I have zero inheritance left, and I will definitely have to work full time until I’m very late sixties to afford a basic lifestyle myself. So top up fees are never going to be an option.

My DH and I have been single handily caring for our mothers for over a decade. We are exhausted and broken.

My question is - should I move my DM? Are my expectations of her foot care reasonable? Do other more expensive homes have better staff ratios?

I have a good neighbour whose husband went in one of the expensive posh homes and she said the care there was dreadful and she removed him after a week. So I’m also aware that even if I gamble, hope her money lasts her, and try to find her a place in a ‘posh’ home - it could still be lacking.

I am distraught.

That is shocking. I am sorry your mother's care is so poor. You need to make an official complaint. I suggest you contact AgeUK for advice about how to navigate this. It sounds as if the care home she is in is not suitable for her needs.

Thank you for your reply. I feel gaslit. They kept repeating they can’t make her have them cut. But she is gentle and compliant with almost everything. She just said the word no and I feel like they happily ticked no in the box and carried on their day. I suspect they don’t have time to spend cajoling every resident but I honestly think they didn’t even know. I also told them I expected to be informed if my mum refused basic treatment. And I know she didn’t refuse as such. She was confused. She’s not aggressive or violent with her dementia.

I have lots of experience of care homes. Some are good, some are dreadful. I could write a very long post, but I really recommend AgeUK as a starting point for getting advice. It is so difficult to navigate the system. Document everything. The home your mum is in sounds very poor.

Perhaps she needs a nursing home rather than a care home.

When my grandma was in a nursing home (MH unit for the elderly), when this was available in the 90s, my mother or grandad visited daily. The nursing care was excellent but mother did her laundry, ensured everything was ironed, did her hair, fed her, etc.

How old is your mum, as you say you have young children, which must be hard.

My mother is 90, and has Parkinsons, a meningioma, has had silent strokes, etc. Is at home because ahe has step (84) but if anything happens to him, she will not cope.

If my mother were facing that care or lack of it, I'd raise merry hell, but have choices. In your shoes, I'd read the contract and make an appointment with the csre home manager and potentially escalate to someone more senior. But I'd be looking for alternatives as they aren't meeting her care needs and she is reliant on medication.

Have you explored CHC Funding

Totally depends on where you are whether the care is any better or not. No home is going to force her to have her nails cut if she’s refusing though.

I would be more concerned about the lack of soap and toilet paper and lack of clean clothes.

That is appalling .. I am devastated for you and your Mum.
The care home sounds utterly dreadful.. they have not been checking her feet. To ask an unwell, elderly person to consent to a podiatrist is dreadful.
No soap and toilet paper sounds like lack basic hygiene and care.
I would complain.. not to management but to official authority.. I am sorry I am not in UK so I don’t know exactly who.
I would send photos.

So upsetting. Thank you for caring. I hope you are able to move her.

They’re right that they cannot do anything that your Dm doesn't agree to, including cutting her nails. Imagine they forced her to have her nails cut and she lashed out? Both the carer and herself could easily be injured. My stepfather would fight against anyone touching his feet so most of the time his nails were like talons - but he was fine with this, it just looked a bit gross.
Regarding clothes, your DM will likely require far more clothes than you’d think, especially if she’s incontinent. However, if she IS incontinent she should be using pads that you’d need to provide. My biggest concern would be that she was able to get out and wander - this should have been reported as a safeguarding risk. Generally speaking, moving a person with dementia is not a good idea as they are used to their environment and staff - a change of these could be very unsettling.

Complain to the current home

• going missing from the home is a safeguarding issue - if she can’t remember to tell them that she’s popping out and if she’s not safe out on her own then they need to review how and why it happened and make sure it doesn't happen again (this may be done and dusted by now)
• basic hygiene substandard - no soap, no toilet paper, dirty bathroom, dressed in dirty clothes
• no clean clothing/poor laundry (although I did do a fair bit of mum’s laundry myself to stop clothes getting lost/boiled to death)
• they should have raised the chiropody issue with you - it sounds as if she doesn’t have capacity to make that decision for herself any more and you need to intervene to book it with her and find a way of them ensuring it gets done (eg book chiropodist and you phone her on the day to remind her it is pedicure day today)
• another resident falling is, sadly, probably just an everyday hazard in a care home for people with dementia
• what will her current home do when her money runs out?

Regarding moving her - don’t rush to do this, it’s a serious decision

• moving her is a risk: it may make things better for her but the change may accelerate her decline
• of course you can’t guarantee her fees when her money runs out. Either you look to move her to somewhere knowing she is likely to be moved again when the council takes over her care, or you find somewhere that will accept council funding when the time comes. Both are difficult decisions.
• More expensive homes may have more staff, nicer rooms etc but won’t necessarily have better care. The best dementia care home round here is a grotty-looking mess mostly with council funded residents but the quality of care is phenomenal. You need to do your research - inspection reports, personal recommendations, unannounced visits.

I’m sorry, this is really difficult for you.

I think you should move her if at all possible. My mum is in a care home with mixed dementia and foot care is on the list of her requirements. They should be informing you if she is refusing. Like your mum, mine is mostly compliant and gentle but she will occasionally refuse something for reasons now sadly she can't communicate to us. Totally sympathise with you about the financial aspects - same story here - we just want the best for her and to ensure she is physically comfortable and as contented as possible, it shouldn't be too much to ask.

I think you should move her if you can. It doesn’t have to be somewhere posh, just somewhere that has a great reputation. There’s a care home near me that’s quite basic but their reputation is brilliant, particularly in how much they genuinely care for and look after their residents.

The other alternative is that you keep her there but step in to take on more of the load yourself - washing clothes, making podiatrist appointments etc. It’s a lot though!

I'd contact ageuk and the cqc, you can also call social,services safeguarding team qnd the GP, the toenails need cutting but dirty clothes, no soap or loo roll is just awful, it sounds very neglectful. Is it a nursing home with registered nurses, their website should tell you who the registered manager is so start with a meeting with them, her managing to leave unsupervised should have been reported, ask to see what action was taken and her safety assessments. Do you have power of attorney. I'd put in a vulnerable person concern to social services, they can visit, she can have another care needs assessment and they can arrange a move if her safety is at risk.