Care Home Conversations.

Discussion in 'I care for a person with dementia' started by MrsMoose, Sep 14, 2017.

  1. MrsMoose

    MrsMoose Registered User

    Oct 1, 2014
    152
    Can people tell me how they have broached this subject when a partner or parent has dementia.

    My father in law cannot care for himself properly any more, so the sheltered accommodation he is is no longer appropriate - even though he has a morning care visit, a cleaner, someone doing laundry, a communal cooked lunch.

    His dementia is becoming more severe and there are particular issues over him being unable to clean himself appropriately after using the toilet. The bathroom and living room floor are getting soiled. (We don't know quite how.)

    He is in denial about the very regular 'accidents' which take place. And or he says they will never happen again

    We have found a care home near where we live - where a friend's mother was very well looked after. They have a place and would like us to take him for an informal cup of coffee type visit in a few days time. On Monday. (The next stage would be for him to spend part of the day there for a more in depth assessment of his needs.)

    My husband is really unsure how to broach this.

    Scenario 1.
    Husband: 'Would you like to go and visit a possible care home.
    Father in law: No.

    Scenario 2.
    Husband: Would you like to go and visit somewhere that you might go for a few weeks - a sort of holiday - where they can look after you? The warden and I think you're not quite so well at the moment, and it would really do you good.
    Father-in-law? No.

    Scenario 3
    Husband: You're not able to cope any more and though your carer is mopping up your regular accidents, we're going to have you move you to a care home. We're visiting one today.
    Father in law: I'm not going.

    As luck would - or would not - have it, the warden of my father in law's sheltered accommodation is away till Monday, so we can't get a steer from her.

    The person in charge of the care home has made some suggestions as to how we might deal with this, but I wondered what other people had done.

    NB My husband has power of attorney.
     
  2. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,624
    USA
    Mrs Moose, sorry to hear of the ongoing issues with your FIL. I'm not where I can respond in full, but didn't want to read and run. I'll return later with a better response, although my own experience was that we didn't ask or tell my mother what was going on-we just moved her into the care home. That was straight after a hospice discharge, though, so very different to your situation, of course.

    Let me think on this and I'll be back. I hope you will get some good advice in the meantime. Best wishes; this is not easy.
     
  3. MrsMoose

    MrsMoose Registered User

    Oct 1, 2014
    152
    Thanks so much for your reply Amy...
     
  4. Rosettastone57

    Rosettastone57 Registered User

    Oct 27, 2016
    905
    I haven't quite reached the scenario you're facing and I'm sure others on here can give better advice.
    But in my experience with MIL asking her if she wants something simply doesn't work she will always refuse. There comes a point of not giving choices you just have to take control. I'll be equally as interested in the response on here as to how to approach this.
     
  5. Lavender45

    Lavender45 Registered User

    Jun 7, 2015
    1,598
    Liverpool
    My mum moves from a secure hospital to a nursing home on Monday. I've introduced the idea as being a convalescence home as she needs a few weeks of being looked after to get the strength back in her wobbly legs. I'm not saying mum will be very happy when Monday comes around, but wobbly legs are something physical she can understand.

    Hope you find a way forward and that the home you have found out works out well for you. X
     
  6. DMac

    DMac Registered User

    Jul 18, 2015
    537
    Female
    Surrey, UK
    Hello Mrs Moose,

    I guess your approach will depend upon how far along your FIL is in his dementia journey, and how easy it will be to 'trick' him (for want of a better expression - sorry, I don't mean to be disrespectful).

    If you search for 'love lies' on this forum, you will see the various ways in which people have 'persuaded' their loved ones. In essence, your best approach is likely to be some variant of scenario 2. Much as it feels wrong to tell deliberate untruths, sometimes it's the only way.

    My approach was to tell my MIL we were going out for a coffee. Her care home has a lovely garden which we were able to sit in, just like a nice garden centre. In her case, her dementia was already well advanced to the stage where she simply did not recognise the care home for what it was. To be fair, it does look very homely. After getting her there under false pretences, I then sneaked out so she could not see me leave. Thankfully for me, she had absolutely no recollection of the day of her admission, so it wasn't a problem for me to visit her later (I did leave it for a week, though).

    Good luck, and let us know how you get on. xx
     
  7. nitram

    nitram Registered User

    Apr 6, 2011
    18,827
    Male
    North Manchester
    You could explain to FIL that the government are allowing older people to have a free holiday - something free from the government is always attractive.

    If he accepts this and goes for a short free holiday the rest is up to you, the free holiday could be extended for various reasons.
     
  8. Malalie

    Malalie Registered User

    Sep 1, 2016
    307
    Female
    Must admit that we did exactly the same as DMac, although we had been to visit twice before, as MIL wanted to go into a home when she grew old.

    Of course, with the dementia, she was totally unaware that she couldn't cope, so after each visit she would say "What a lovely place - I wouldn't mind being there when I get old....." She was 88 but believed she was 40 and married to her son at the time....

    We did exactly the same - sat with her in the coffee bar for a drink, and then a carer took her off to look around the gardens and we just legged it to be honest. You can imagine how awful we felt - we didn't visit her for some time either. She had no recollection of what we had done, no memory of her own home afterwards.

    It was very traumatic for us, and Mum was still confused and agitated, but no more so than when she was in her own home. She was clean and warm, surrounded by people, and started to put on weight, so I don't really have any regrets.

    It does really depend on how far gone FIL is and I suppose that only you know that. The idea of the Doctor wanting him to go into a convalescent home to put on weight or something is good.

    It's just awful not being able to discuss things logically with a person with dementia, and bringing up 'accidents, you can't cope on your own" etc would achieve nothing apart from making him feel more stressed and scared about the situation he finds himself in.

    I hope you can find a way round this.
     
  9. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,293
    SW London
    It's very difficult. I have to say that we didn't discuss it with my mother at all. According to her there was nothing wrong with her but her Alz. was very bad by then, zero short term memory, having 'accidents', refusing to wash, etc. Since she would simply have refused to go - and it could be hard enough getting her out of the house at all anyway - we knew there was no point in asking her.

    We had to get her there by stealth, I'm afraid. It was all planned like a military operation, and although I was dreading the day like nothing else in my life before, it went rather better than we'd dared to hope.
    We took her 'out for lunch', since the CH had asked us to arrive shortly before lunchtime, and left her there an hour or two afterwards.

    It's a measure of how bad her dementia was that she didn't even realise it was a care home we'd come to. She thought it was a restaurant and offered to pay for us all, which made us all feel dreadful, though since she hadn't been able to manage money or credit cards for some time - siblings had P of A - she couldn't have paid anyway.

    I do hope you find a way that works for you. It's such a stressful and worrying time.
     
  10. JigJog

    JigJog Registered User

    Nov 6, 2013
    241
    The consultant told me that I had to find a place for my husband.

    I looked around and found a suitable care home without him knowing

    Once it was set up I told him that the doctor needed him to have his medication monitored. He either had to go into hospital (which I knew he would hate) or he could go into this posh hotel for a while on a free holiday and have his medication monitored there. I told him there was no other option. White lies but it worked.

    I took him to see the posh hotel making sure that he didn't see the care home sign at the entrance. He looked around and said, 'It's really quite special here isn't it?' He agreed to go.

    I dreaded taking him but he has settled much better than I thought. He doesn't ask to come home and is very happy.

    The quality of our lives has improved for each of us separately and together. I get to spend quality time with him instead of being totally engulfed by the battle of his personal care.

    I should have done it sooner. I pushed myself too far. If I'd asked him about going into a care home he would have never agreed because folks with Dementia are fearful of change.

    But he liked the idea of a 'free' holiday - he was an accountant!

    It took the white lies to achieve the happier outcome for us both.

    Good luck.

    JigJog.
     
  11. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,565
    Female
    Auckland...... New Zealand
    #11 Linbrusco, Sep 15, 2017
    Last edited: Sep 15, 2017
    At the beginning of Mums dementia I had a conversation with M about Rest Homes/Care Homesas one of Mums friends DH had just gone into a Nursing home due to heart issues and a stroke. Mum had said at the time she had no problem going into care if she ever needed it as she wouldnt trust Dad to look after her. That part proved right.

    As it happens just 3 yrs later my DH required major surgery, and I had booked Mum in for 2 weeks respite. I didnt feel I could cope with both, Mums dementia had worsened and I had already had had shingles.
    My sister asked why I wasnt telling Mum.
    1. She would have refused to go
    2. She would have asked 50 questions over & over
    3. It would have increased her anxiety

    On the actual morning I just told her, that our family GP had phoned and he wanted her to go to a private nursing home for a complete checkup and a few days rest, as she had had quite a few UTI's recently (true)
    I stayed about 3 hrs to get her settled and left her with the nurse and watching a musical.
    We were told not to visit for at least a week, but I just couldnt do it and saw her the next day. She was quite confused of course, but had slept & eaten well.
    As it turns out Mum was placed permanently, now a year gone in a July.
    We have always just said she was there for her health & a rest. Now, she doesnt even ask.
     
  12. MrsMoose

    MrsMoose Registered User

    Oct 1, 2014
    152
    Thanks to everyone for their replies. All these stories/experiences are useful.
     
  13. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,078
    Kent
    My husband was losing weight and losing mobility. I told him the doctor wanted him to go to a convalescent home to build up his strength.

    He accepted this readily, poor man, he dearly wanted to get better.

    Once he was in and asked when he was coming home, I always put the onus on the doctor.
     
  14. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,624
    USA
    Mrs Moose, I've been thinking about how to respond to you.

    I am not clear if you have trouble getting FIL to "go out" with you. If you do, that's one issue to deal with, and in that case there is no way I would mention incontinence, dementia, a care home, anything of that nature. I'd just say whatever it takes to get him out the door.

    If I read this correctly, it's more an issue of figuring out what approach to take in terms of having a conversation about a care home.

    If I am correct, and forgive me if I'm not, and also please forgive me for what I'm about to suggest, then I would not try to have a conversation about it at all.

    What I mean is, I wouldn't open up any line of dialogue that gives FIL an opportunity to refuse. I wouldn't ask him if he wants to live in a care home, or about the incontinence and soiling of his flat and inability to keep himself clean, or frankly even mention anything about dementia at all. I would especially not bring up the incontinence/hygiene issues as those can be very upsetting and likely won't steer the conversation anywhere good. While he may be in denial, and may be stubborn (my mother was an expert at both pre-dementia, and her Alzheimer's has not improved this!), it's also possible that the dementia has affected his brain in such a way that he cannot remember and/or understand that there is a problem. The fancy medical term is anosognosia; it affects many persons with dementia, and can be very challenging to deal with.

    I'd be more inclined to just show up and state, we are going for coffee and cake (or tea and biscuits or lunch or whatever it is that might appeal to him), get him in the car, and take him to the care home, and see what happens.

    I'd be careful to be pleasant and upbeat and just enjoy the coffee and maybe a tour or a walk in the garden or whatever the staff suggest, and see what happens.

    Like Witzend's mum, my mother was confused about the care home itself. When we initially arrived, she seemed to understand it was a care home/convalescent centre/some sort of facility, but we went to the dining room and had a meal with her, and she was sure it was a restaurant, tried to pay for our meals, and then waved us off without much of a second glance.

    I am sorry to say it, but I don't see the benefit for your FIL, of trying to have a rational conversation about his dementia, his symptoms, his care, and so forth. Dementia and logic just don't go well together! Of course it depends on the person, where they are in the disease, and the moment, but generally speaking, you simply cannot expect to have a reasoned conversation.

    I know we would all like our loved ones or persons with dementia to turn to us and say, I know I can't cope any longer, I know I need help, let's go find me a nice care home and move me in. Sadly, that doesn't happen for most of us.

    I hope I haven't upset you. Your FIL is clearly in need of more care, help with hygiene and personal care, and likely needing 24/7 supervision, and you are very clearly concerned for his well being. All your posts are very clear about that. I don't think your or your OH are terrible people, just concerned for FIL's safety and welfare.

    Very best wishes and please do let us know how you get on.
     
  15. MrsMoose

    MrsMoose Registered User

    Oct 1, 2014
    152
    Update. My father-in-law has agreed to move into a well-run care home near us that has a vacant place.

    I feel shattered, and we haven't even started doing the things we now have to do!
     
  16. Kjn

    Kjn Registered User

    Jul 27, 2013
    5,835
    Mrs. moose that's at a good start , good luck .
     

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