Can you just put someone in a care home?

[elderlyparentone]

Blunt title. But DM (not elderly) is caring for DF (in 80s - big age gap). He has Parkinson’s plus many other things, including mild dementia. But he is mobile, can mostly go to the toilet by himself but does have some accidents. This seems to be the main problem. He doesn’t speak much, which is partly the condition, partly he’s always been a bit of a silent miserable bastard. He has previously had carers short term when he had an accident and broke a bone. DM has suddenly decided she can’t cope and wants to put him in a care home. I feel like maybe carers is a good middle step. But she feels this won’t help her, because carers won’t be predictable and she can’t leave him sitting in mess if he’s had a toilet accident.

Is it even possible to just put someone in a home? I feel that might be the worst place for him and we should at least try carers for a while.

They own their house, she has more savings, he has a small amount (around 10k). He has a pension they both live off. I understand half of his pension will be used to fund care, but they can’t fully self fund a full time care home. So will that mean he’s in a shitty home? Would they even take him when he doesn’t really seem to need it? What if she just refuses to help him anymore?

Struggling with how to navigate this. It seems like a sudden reaction, but I know she finds it hard and it’s all on her. I am an hour away, full time job, kids (toddler and primary school aged). Brother fucked off overseas. Apologies if this all sounds hard hearted, it’s a lot harder to deal with this stage than I’d anticipated.

The whole adult social care situation is a shit show tbh.
Even if DF does have a care needs assessment he will be allocated the minimum needed. The care company as a private enterprise will expect the maximum work for the least wage from their staff. DF will have to contribute to this care.
If DM genuinely will not care for him in any capacity she will have the battle of the life on her hands overseeing the care is as per the care plan, liaising with the care company, making official complaints to ASC when the standard falls short etc etc.
She will need to go away on a regular basis ideally to make sure his care needs are being met independently of her input.
Either which way she won't be fully off the hook.
And staff turnover can be rapid, resulting in many inexperienced carers.
I'm really sorry but this is my honest pov

Wishing you lots of luck for this, hopefully it can be sorted where no one is left unhappy,

State pensions are not transferable - so no, she won’t get his. In addition, any pensions he receives will be used to pay for his care. The one thing that she can rely on is that their home cannot be counted in the financial assessment if she is over 60.

Thank you. Yes I suspected it wouldn’t be that easy.

I am hoping I can get everyone to rally round a bit to give her a break and see if that helps.

the facts may be relevant. The "why" "normality" or "fairness" is not.

He has a state pension and a private pension. Others have suggested she may be able to keep half of the private one. It seems unclear at present

Have a look at this factsheet, from skimming through she would be able to keep half his occupational pension but your mum would need proper advice. There are so many women dependent on their husbands pensions because historically they were far less likely to have one or it would be smaller due to time out of the workplace caring for family, there has to be provision for this. Of course it could apply the other way round but it is mainly women affected.

www.ageuk.org.uk/siteassets/documents/factsheets/fs10_paying_for_permanent_residential_care_fcs.pdf

And I agree with pp, if she really has hit burn out and cannot cope any more, her only real option is to leave/ divorce.
She will always be the fill in carer otherwise unless he's in residential care which I 100% think will not happen unless he agrees and pays - then when his funds run out I assume the council will assess whether they will continue to fund his care.

The mum can’t have it both ways though - keep his pension and force him out of his own home. She can end the marriage and do what she likes.

I don't know if anyone else has suggested this, but there are lovely sheltered housing/ retirement villages, where you have your own apartment, but that also have care packages you can but into. So, care is provided by on site staff, and you pay extra for. Might be worth a look 😊

But that is undoubtedly easier said than done.
If you have been with someone a long time it is hard to walk away when they are so vulnerable, however difficult life is.
I really really feel for her.
She's between a rock and a hard place.

That’s not the case OP.

The house they live in will not be part of the assessment if someone lives there who is over 60, which I presume your DM is.

All of his income is assessed together with half of any joint savings. Your DM might be eligible for benefits herself, she needs advice on this.

It is achievable but you need the help of a social worker to negotiate him a funded bed when he qualifies for one.

It’s really not fair to expect your DM to be his carer. Dementia is a game changer and you should be helping her make plans now.

Really hard for her. They’ve been married 40 years. I really hope I don’t have to come back asking how to support them both through divorce 😩

In our authority we tend to do it automatically when carrying out financial assessment - in some authority’s you need to make clear you intend to give 50% of the income from your private pension to your spouse. Wouldn’t matter if spouse had their own large income as we don’t means test that! If they then moved into a care home themselves we would go back to taking 100% of the income into account.

well it sounds as though there is a possibllity that she can retain half of his occupational pension? I don't know and you don't know..... but my statement stands...the why, fairness or normality is not relevant. Social Services and the pension will have rules about what happens in such circumstances. Neither of them will be concerned with making judgements about reasons, normality or fairness.

SS assess him first. But DM needs a break - ask them for resource care options too. They should be free.

I can’t comment on the pension split situation, but I do know that the system will exhaust all other options before funding/part funding a care home l I also know that 4 x per day carers can do very little and yes if the person needs a poo when they aren’t there, either the other person in the house deals with it or they sit in their own shit until the carer comes again.

I would also say that whilst it’s sad your DF declined in respite, it’s not just about him, your DM is a person too. Sadly your DF will continue to decline wherever he is and literally nobody apart from paid carers are going to rally round and clean up excrement, probably more so if they’re related.

I am sorry if I am being too blunt, but please you need to be aware of what it is you’re actually expecting your DM to do.

His whole pension won’t pay for a care home and he won’t be funded so it’s a non issue

It is so unfair.
In the situation I am thinking of there is the maximum care package but the carers do as little as possible and leave as quickly as possible. The entire private pension goes to care costs.
The person needing care is adamant that they will not go in to residential and despite having cognitive impairment is judged to have capacity. They are housebound, unable to walk unaided, both urinary and faecally incontinent, unable to cook, feed, wash, or dress themselves, or manage their own affairs.
Quite clearly the spouse is forced to be unpaid carer, even if working themselves, unless they leave.

Continence is the biggest reason people are moved from community to care homes.

From what I have learnt about capacity assessments through work; it doesn’t sound as if OP’s Dad is at a stage where he will agree to live in a care home.

In fact there are many people who are in a much worse state health wise who would be so much better off in a care home, yet who when asked will not give consent to be moved to one, and as they are deemed to have capacity ‘at that time’ then they are kept at home with an often complex care package… quite often an individual bounces back to hospital several times before they finally decide that a care home is their best option, or the decision is actually made for them because they’ve been deemed to have lost capacity.

Sometimes an individual can be hospitalised and their partner decides to refuse to care for them or to even accept them at their home - this happened recently at work where a wife didn’t want to take her husband home; but as I went onto annual leave I just never found out what happened in the end. I know he needed help with his care needs but he had capacity & was mentally well, however their marriage had broken down and she didn’t want to look after him. So yes it definitely happens more often than you’d think!

My Nan was actually sectioned at 91 in 2017 as she had psychosis with her dementia and was deemed a risk to herself and others - so clearly she did not have capacity. As she had been under a section she was entitled to a year of free dementia home care iirc so we were given a choice of 2 homes. She had no choice in the matter.
In her case it was obvious she could be put in a home without her permission as she clearly lacked capacity; the same happened to a friend of my Dad’s who’d developed Lewy body dementia with his Parkinson’s & had become violent towards his partner and had started wandering for miles at night. Again he was a risk to himself & others.

But someone who has capacity like OP’s Dad can’t just be ‘put in a home’, unless he actively chose to go and live there.

Even frequent emergency hospital admissions don't really make any difference if a person with capacity chose to remain at home rather than go into residential.

I don’t know the actual requirements, but my mother was much younger than her last husband and she tried putting him in a care home and wasn’t successful as he wanted to stay at home. He had mild dementia and mobility problems after a stroke. Even when she was providing inadequate care they didn’t step in despite complaints from family members.

The only other factor that needs taking into consideration potentially is, with a diagnosis of Parkinson’s, the medications can be really tricky to manage as there can be a lot of them at ever increasing amounts during the day but also need to be taken at exact timings (and some not with each other) which can be really hard to manage on carers visiting at only 4 times a day.

Weve tried to get the meds simplified as much as possible for my ER with Parkys but it's still 6/7 different medication times durinf the day coupled with declining dexterity (blister packs are now too tricky for them) declining coordination and cognition and behaviour changes. Even with paid carers we've had to put extra family support in.

It really is a terrible disease.

Di you mean “we should try carers” or that she should?