Care Home Advice

[leigh]

My mother has Alzheimer's, probably what most people would call mid-stage. She is currently still able to live alone in her little bungalow as my sister lives a couple of roads away and is her carer. She helps her every day and for the time being I think this arrangement will be fine.

However we have noticed mum's problems seem to be getting worse quite steadily. At some point we realise we will have to face looking at more full time care. She is currently housed by the local council and only recieves her state pension and disability living allowance and pension credit. Needless to say I dont think we will be able to afford a top notch private care home.

Can anyone please tell me the different options and where I can find more information on the net maybe. I've have found the addresses of some homes in her area but would just like to know from someone how it works?

Thanks for reading.

Leigh

 

[blue sea]

I'm sure others will be able to offer more advice - but here's some to get started. Social services will be able to give you a list of ones in your area, though this will not include all those available. You can read inspection reports on all care homes be accessing csci.org.uk - well worth a look at any you are considering. Obviously not much to beat personal visits, though. If funding is needed you have to have an assessment of needs and financial assessment done by social services. This can be requested at any time , even if not at stage where home being considered, as it is the route for community support too. The Alzheimer's web site and Help the Aged both have excellent fact sheets on care homes and funding. I think it is an excellent idea to do all the research now, so that if it does become necessary you are prepared with the facts.
Blue sea

 

[noelphobic]

Hi Leigh

As far as paying for care homes fees goes, this link should take you to the AS factsheet which will explain it fairly well. If your mum's assets are very limited then her fees should be paid by the council, although most of her income will go towards it. It's a bit more complex than that, but hope that gives you some idea

http://www.alzheimers.org.uk/Caring...idential_and_nursing_care/info_payingfees.htm

Assuming you are in England then the following link will take you to the website of CSCI (Commission for Social Care Inspection). They visit residential homes and produce reports and you can access all the reports from their website.

http://www.csci.org.uk/registeredservicesdirectory/rsquicksearch.asp

If you look at the top left of the Talking Point webpage there is a link that says 'Factsheets'. This will take you to a page listing all the factsheets that AS produces, some of which may answer some of your questions.

I am sure you will get lots more advice but hope this is of some help.

 

[Grannie G]

Hi Leigh,

From personal experience, the only way to choose a care home is to visit unannounced, and have a list of questions ready to ask.

 

[noelphobic]

Hi Leigh,

From personal experience, the only way to choose a care home is to visit unannounced, and have a list of questions ready to ask.

Yes, I meant to say this. I am a big fan of arriving unannounced but it can be helpful to read the CSCI reports first just in case there is anything really awful in them. Also, to give you some idea if they are likely to be able to meet the needs of your loved one.

 

[Natashalou]

waiting lists

Ive noticed before on a few threads that there seems to be a belief that relatives can actually "choose" a care home. Im sure if the situation isnt an urgent one this might very well be the case and I assume homes run waiting lists..but certainly in my area it isnt a case of choosing , it was a case of gratefully grabbing the one vacancy in the many homes I contacted before somebody else did.
Our situation was possibly slightly unusual in that mum was in hospital and waiting to be discharged, but the hospital had made it clear if I didnt find somewhere sharpish, the social work dept there would just send her anywhere in the west sussex area (I wanted her in London)
Mum pays privately, but again it is my understanding that when her money runs out, the council will only meet the fees to a certain level, which falls a fair bit below the fee the home actually charges, and unless there is a relative to make up the top up she will have to move somewhere cheaper.
Sorry to paint such a bleak picture, but from my own experience it certainly wasnt visiting homes and choosing the best/nicest/most suited, it was getting what was available and being thankful!

 

[jenniferpa]

Natashalou: I think you're essentially correct in how the system works in practice. The only thing I would say, is don't automatically assume that the council won't pick up the full tab since councils often get reduced rates. For example my mother pays £600 while residents placed by the council pay £450: exact same home and facilities. If my mother's money runs out, she won't have to move, but the council will still only pay £450 and the home will happy with that (I've checked). So you can't always assume the price you're quoted will be the price the council has to pay.

 

[Natashalou]

so

in fact then the private residents subsidize the others?

 

[jenniferpa]

The party line is "councils bulk buy beds therefore they get a discount". You draw your own conclusions! Actually, it's not an entirely specious argument: the nursing home (any nursing home) knows they have so much money from council contracts coming in, even if the beds aren't filled.

 

[noelphobic]

in fact then the private residents subsidize the others?

the nursing home my mum is in charges £125 per week more for self funded residents than they do for local authority funded residents.

Some homes also have 'top up' fees. This generally means that they charge more than the local authority is prepared to pay. Therefore, in order to stay in that home, the resident or their family will pay the difference. In my mum's first home the difference was £50 per week.

 

[Margarita]

noelphobic

the nursing home my mum is in charges £125 per week more for self funded residents than they do for local authority funded residents.

How do they , In what way does SS or government say that someone needs are nursing care, when not self funded ?

As My SW say my mother needs are not nursing care, so will not put her in a nursing care home that I like near me.

That my mother went into last year for emergence respite, its part privet and part local authority. I got to know someone that was fully funded by social services, of course yes they state pension.

So Leigh could not look for Nurseing care home , Just residential care home as her mother is just mid-stage. is this right ?

 

[noelphobic]

How do they , In what way does SS or government say that someone needs are nursing care.

As My SW say my mother needs are not nursing care, so will not put her in a nursing care home that I like near me.

That my mother went into last year for emergence respite, its part run privet and part local authority. I got to know someone that was fully funned by social services, of course yes they basic pension.

So Leigh could not look for Nurseing care home , Just normal care home as her mother is just mid-stage.

I don't think two tier charging is necessarily restricted to nursing homes. It may well also happen in 'normal' care homes also. I know top up fees are sometimes charged in care homes because they were charged in the first home my mum was in, which wasn't a nursing home.

I'm not really sure what you are saying or asking Margarita

 

[Margarita]

Oh sorry How do they assess my mother as needing nursing care


Ps as in why would your mother need nursing care , because she like my mother has AZ and my mother would not
need N C

 

[noelphobic]

Oh sorry How do they assess my mother as needing nursing care

Oh right, I see now, sorry! I'm not sure of the exact criteria, and they may vary from area to area. My mum was only classed as needing nursing care after she broke her hip and became wheelchair bound. So, for her, the over riding factor was her mobility, or rather lack of it. For others it may be that they are on oxygen or peg fed or a number of other factors. For someone like my mum who is self funding, being classed as needing nursing care means that she gets a contribution to her nursing home fees. However, that's not as good as it sounds because nursing homes generally cost more than care homes so she still pays just as much. For someone who is local authority funded then the finances are less relevant but, as you say, will dictate which homes the person can be admitted to for respite care or permanently.

I would think the best person to ask about how the assessment is done would be your mother's Social Worker or CPN. If I can find anything else out I will get back to you.

 

[noelphobic]

Ps as in why would your mother need nursing care , because she like my mother has AZ and my mother would not
need N C

Because my mother is in a wheelchair and care homes don't generally accept people who are not reasonably mobile.

From one of the AS factsheets

Nursing homes always have a trained nurse on duty and can offer 24-hour nursing care in addition to personal care. Nursing care may need to be considered if the person with dementia is very confused and frail, has difficulties walking, has other illnesses or disabilities or is doubly incontinent, for example.

http://www.alzheimers.org.uk/Caring...ntial_and_nursing_care/info_choicesincare.htm

 

[Margarita]

Thank-you for that.

Hope I do not sound a pain but , is it because your mother can’t walk even without a Zimmer frame ?

What I find is that my mother needs a wheelchair, has got one , but will not use it , can only get about with a Zimmer frame, she had a fall last year and has not forgotten it , so is scared in get into the wheelchair.


I want to take her to the park to the shops , but she can’t walk outside more then 1min then is staggering wanting to stop her legs are hurting her she says, we have tried all tricks to get her in wheelchair , but she won’t she just happy to stay sitting in chair , laying in bed following me around the house , then if I go out panicking when am I getting back, if it was not for AZ day center picking her up for day center she would not go out of the house

 

[noelphobic]

Thank-you for that.

Hope I do not sound a pain but , is it because your mother can’t walk even without a Zimmer frame ?

What I find is that my mother needs a wheelchair, has got one , but will not use it , can only get about with a Zimmer frame, she had a fall last year and has not forgotten it , so is scared in get into the wheelchair

No, she can't walk at all now. She could walk following the hip replacement surgery but got very little physio so I think she almost 'forgot' how to walk. She had trouble getting the hang of using a zimmer frame.

 

[Margarita]

OIC , just gets a bit confusing how the system work, when they asses (sp?) nursing care for people with AZ , and funding them in nursing care home

 

[noelphobic]

OIC , just gets a bit confusing how the system work, when they asses (sp?) nursing care for people with AZ , and funding them in nursing care home

yes, I agree Margarita. The whole system is very confusing. I forgot to mention that my mum also has Parkinson's disease and epilepsy, although she did have these when she was in the first home, which wasn't a nursing home.

 

[leigh]

Thank you to everyone who has posted advice, it is a little confusing reading all the messages in one sitting but I will have a good look at everything over the weekend and make some calls on Monday morning.

I just want to be prepared, hopefully it will be afew years before we will really need to take steps into moving mum but its easier for me to sleep at night if I can have an idea of what the process is. I don't want to think of her ending up in a care home where she will be ignored by the world, we are still getting used to the new person this disease is making her. Its like a slow grieving process in many ways.

Has anyone else found huge personality differences in a AZ relative? For example, mum has never been green fingered, in fact the only time I've ever seen in her in a garden is family bbq's or lounging in the sun occasionally. She used to have her nails manicured bi-weekly and would never dream of dealing with plants hands on. These days she spends hours and hours in her garden, picking up leaves, pulling weeds, trimming grass (with a kitchen knife.....dont ask!), it's very out of her character, but hey as long as she's happy I'm certainly not complaining, I just find it hard to understand why AZ affects her in this way.

Does anyone know what I mean?