How do I tell my mum she had to move to a care home?

[whatsthepointinwasps]

My mum has Alzheimer’s, lives alone but has 4 visits a day from a care at home company.
These visits cover basic needs but she now needs 24 hr care as she can do virtually nothing herself.

She herself said she feels ‘useless’ and safer when I’m around but I work full time and apart from spending my days off with her when I do her housework, shopping and laundry I’m not around that much.
She agreed it would be better to be living where there is someone there 24/7 but doesn’t want to leave her flat.
I’m not sure how much of this discussion she took in as she seems to have limited capacity (I have POA) but historically she always said ‘I don’t want to end up in a home’

There is a place locally who can take her next week.....I’m just not sure how to tell her????

@pointythings

It's incredibly hard, but you're doing the right thing. My Dsis and I were in this situation with our DM, but without POA. She refused to consent, and legally all we could do was wait for her to deteriorate far enough that she was sectionable (not UK). She fell down the stairs in the family home and broke her neck 4 days before the assessment for section was due to take place and was found by one of her carers. That's the kind of awful end you are preventing here.

Yes my Mother's doctor said the alternative to persuasion was to have her made a Ward of Court . It was going to be awful .Everyone should have a POA.

Hi OP. Sorry you have reached this point. I was in your shoes 2.5 years ago. My mam wasn’t safe to be left alone and we had to make the decision to put her in care.

We told her that some work needed done to her house so it was just for a couple of weeks or so and just obviously kept her there.

You’ll probably go through all sorts of emotions. Guilt being one. Try not to. We promised her when she was first diagnosed that she wouldn’t go in a home. It was an impossible promise to keep. I had to keep telling myself that I would be more guilty should she seriously injure herself whilst on her own. Being there 24/7 is nigh on impossible though we did try. I also work full time.

I feel for you having to do this during COVID but hopefully we’ll be able to visit indoors soon.

Good luck x

My friend has just gone through this with her DM. She has Alzheimer’s and although my friend spent a lot of time with her mum she couldn’t be there 24/7. She had carers coming in 3 times a day but it got to the point where when they went in in the morning she had fallen in the night and been there several hours unable to move. This happened a few times, she was also becoming incontinent. It got to the point my friend was really struggling with it so she told her DM she was going to the care home for a holiday. She’s been there 2 months now and loves it. She’s clean and well fed and looked after 24/7 and hasn’t once asked to go back home. Your DM might enjoy the reassurance of having someone there and also my friends DM is eating much better as previously the carers who came in to her home only had time to heat up ready meals. It’s a very emotional decision though.

For my FIL he went to the day centre at the care home a few times. One time he just stayed - this was what the care home recommended.

No way would he have understood or made the decision that he was going to live there, he just couldn't consent.

When MIL visited she would be careful never to say 'Good-bye' as it distressed him but to leave the room as if she was just going to get something.

He was really happy there and very well looked after.

You may not get your mum to explicitly consent, or even if you do, she may forget again.
Telling some white lies, glossing over the big picture will be the key here.
Respite, just for a few days, etc focussing on the positives.
I know it's hard, but thank goodness you have LPOA. We didn't. World of pain (still continuing).
Think of it in terms of needs, not wants (this is how the council assess care needs). Sure your mum mum wouldn't want to go into a care home, but she needs to. You're keeping her safe. Good luck.

I think a care home is essential- however, my mum has just left rehab and is on 6 calls per day and 2 per night so 4x is not the maximum. My mum has to pay but due to the cap on maximum payable per week it’s no more expensive. I was recently told care managers have to try and maintain folk at home unless they’re self funding for a care home and sort it themselves - not sure why this is.
I do feel for you and expect this conversation with my own mum soon - she’s immobile and the care company left grill on yesterday with door closed nearly burning house down but most worryingly my mum thought it was her phone going off not the smoke alarms. She is not diagnosed with dementia though has some but is in the main competent enough to make her own decisions. I’m applying for LPOA as the 7 weeks in a care home made managing her affairs far too difficult- on the other hand I don’t want to have to use it to insist she goes into a home, but suppose it’s our responsibility that we always thought only applied to our kids.
It’s so hard and I hope you sort it OP - you know what’s best for her safety and wellbeing so don’t feel guilty about it - she will be fine - hopefully enjoy it.

This is so hard for you, but you are definitely doing the right thing. I have been in a similar situation and my advice is to tell them on the day of the move and not before. Lie as much as you need to. It is better to lie and protect their feelings than to overload them with the distressing truth. Promise them they will go home soon, its only temporary, etc.

And get support for yourself. You need to have someone to talk to so you can offload.

Good luck

You are very lucky that the council are funding this as usually dementia , Alzheimers etc will not be funded

Everyone is funded if they can’t pay themselves and have less than £23,250 in savings. The OP has said her mum doesn’t have any money.

Your relatives paid because they did have savings/a house etc., not because they had dementia.

I had to do this 4 years ago. My mum too had carers going in 4 times a day as well as me . I have osteoarthritis so couldn’t lift her etc. Pre Covid I was able to visit the homes. I looked at 10 but read the reports on many more but just discounted some on the report alone. I am an only child so all the responsibility was mine. I eventually told her she was going in temporarily until she was able to make herself a cup of tea or take herself to the toilet ie look after herself. She accepted that. Obviously I knew she was never going home again but she didn’t and didn’t need to. It took her about 2 months to settle in. I sorted out her room with her favourite chair from home, her normal bedspread and loads and loads of pictures I had to rent out her house out as she was fee paying. She was there for 2 years before she passed away. It was the hardest thing I’ve done but absolutely the right thing

Don’t tell her it’s permanent. Tell her she’s going for a rest.

My BIL has early onset alzheimers. (57)

He’s not needing live in care yet - but can’t be left.

My sister has had some help and advice, mainly about the future, from Age Concern. Facetime chat, they reply to emails, given her a mobile number for help.

They’ve been a beacon of light in a dark situation.

They may be able to offer you advice and help in your situation.

@BoxitUp

Does it really gave to he a residential care home. Our council have Extra Care accommodation which means it's a step down from res care but with a warden 24/7 and a domiciliary care package in place. The accommodation is 1 or 2 bedroomed flats with accessible bathroom, walk in shower, bed rails if needed, etc. Some EC accommodation have good social hubs.

This type of accommodation is not normally suitable for people with advanced dementia.

My friend got her DB to take their mum out for a day trip, and spent the day moving her belongings to the new care home and carefully arranging everything as close as possible to how it had been at home. They'd had conversations about the move, but her mum didn't really understand. They then told her she was going "home" to the new place, and apparently she settled in very well and wasn't really any more confused about where things were in the new place than she had been in her old home.

We were in this exact situation 3 months ago. Over her dead body was she going into residential care.
We decided to create an ‘issue’ with her house - the electrics were dangerous and she had to move into temporary accommodation whilst it was fixed.
We literally turned up, told her this ( all bags pre packed and in the car already) got her in the car and into the home. It all happened so quickly she didn’t really have time to process it.
We were absolutely dreading it but it went without a hitch.
3 months later, she’s safe, cared for and hasn’t got a clue where she is, and has forgotten about her house.
I feel for you, I really do.

I worked in a care home & was given the job of bathing a new resident with dementia who was disoriented & wanted to go home... well within days she'd made firm friends with another lady who also had dementia & forgot all about 'home'.
They would sit together at mealtimes & in front of the tv.
So it was nice to see her happy after all.

Hopefully it will be similar for your mum x

I think you need to plan for the future. Supported living will be a temporary arrangement.
Don’t settle for a care home because it’s the nearest.
Get local authority full assessment of needs and funding before she moves.

As someone says, she may forget the flat very quickly. She might actually enjoy the greater social contact and activities living in a good care home brings.

Maybe let her try one for a few days. Certainly opt for one that allows her to take furniture and personal possessions.

Fear of care homes rarely bears much resemblance to reality. There certainly comes a point when safety and the balance of risk means moving to a higher level of care.

When lockdown eases, she can go for a few days trial. Then the good suggestion of not letting her see her flat being packed up but arrive at the care home for tea, with a nice bunch of flowers to find a vase for and a new cardigan to hang in her new wardrobe. If the care home don’t offer it, do a large picture of something familiar for her bedroom door, so that she can identify it easily.

Make a ‘this is me’ photo montage for her wall so there are things for people to talk about- photos of her wedding with her husband’s name, photos taken on holiday with location labelled, pictures of her children with names.

Don’t feel guilty. You wouldn’t expect to care for her at home if she had an advanced motor neurone disease or end stage brain tumour. Dementia also needs proper care that can’t be managed by one person at home. It is a healthcare need as much as any physical disease process. Your responsibility as LPA is to act courageously in her best interest. That sometimes means making tough decisions but also means you can continue being a daughter and not a carer.

My nan was 'tricked' too, she'd been living 'independently' in a supported living environment but needed more. She fell and broke her hip so we used this opportunity to sort it. She went into a hone 'temporarily' whilst her hip healed, 18 months later she loves it there, can't remember before and has made friends.

I need to have a conversation with the home as Covid Restrictions have made the move in process trickier. I am not sure how much access I will have prior to actual move.
From speaking to senior nurse she seemed to say bring mum and her stuff on day room available and that’s it. I may have gotten that wrong though as I was a bit upset during the call and mot 100% thinking straight.
I felt happier initially as I thought mum was going into different unit, that I’d seen and liked. However Social Work have said she will be going elsewhere as doesn’t require secure placement.
I don’t want to get her settled in one place just to have to move her into a locked unit once she’s deteriorated.......which she inevitably will.
I will be phoning both SW and home manager tomorrow morning for further clarification and discussion

Thanks for all the supportive suggestions, some of them i have already done- photos etc, I will decide on the actual approach to use one I have more info from the home

I faced a similar situation and i agree definitely make sure you are kind to yourself. My mother said she wanted to leave on every visit I had for over 18 months which was heartbreaking. It is worth being prepared for this but after a while I realised this was just her saying she wanted her old life back not that she actually wanted to leave. I think there is a lot negativity about care homes and that somehow you have failed if a relative goes into a home. But when I look back my mum had a much greater quality of life in the care home that when she was living at home, lonely, wandering, falling and ending up in A&E. Hope it goes well.

I know covid makes things trickier. But if it's any consolation I tried to "settle in" my mum on moving day (before covid) and it was totally the wrong thing to do.
The staff told me to drop and leave and give her time to adjust but I wouldn't listen! Made things much harder.
It didn't take long for her to settle in.
Unfortunately, what you imagine would ease a situation normally doesn't work when someone has dementia and can't understand.

Re: your mum requiring another move in the future - you can't prepare for every eventuality. Sometimes you have to make the right decision for now, then see what happens.

My DM went into residential care on Monday. We weren't allowed in and she is having to quarantine. She was in tears when we left so just prepare for everyone to be upset and obviously there is no visitors allowed at the moment but remember this is the best place for her. We are lucky that we know the home and staff as another relative was there last year and DM is familiar with the surroundings. Even so she's already tried to escape 3 times! Better now though thank goodness. Could you tell her it's respite care for 4 weeks? Book the room first then present it to her as something her GP recommends, a change of scene, more company, anything you can think of that she's lacking at the moment. Or, the carers are going on holiday, that might work?
Name and prepare everything she's likely to need including toiletries, towels etc and favourite things, snacks, photos, alarm clock etc.
Glad that the council will fund it for you, makes economic sense sometimes. My DM's 2 carers 4 times a day cost more than the home she's in. Madness. Good luck.

@MrsFezziwig

You are very lucky that the council are funding this as usually dementia , Alzheimers etc will not be funded

Everyone is funded if they can’t pay themselves and have less than £23,250 in savings. The OP has said her mum doesn’t have any money.

Your relatives paid because they did have savings/a house etc., not because they had dementia.

For the sake of clarity the OP only said that after I had made my comment .

As regards your final statement , certain things ARE covered eg cancer and you are given care REGARDLESS of your property however Alzheimers patients are deemed to be only needing "personal care " and not "medical care " . The distinction between the two is appalling . There has been work afoot for many many years on this matter but no change .

Is there a way to do it on a trial for maybe 6 months? Then if you can see if your mum likes it. I know there's still the expense of her current house.