Hi I am writing my first post although I have been "lurking" for some time learning and gaining knowledge of what is in front of me. My mother aged 87 (today) has vascular dementia. Diagnosed about 6 months ago she has been unable to hide symptoms for about 2 years. In the last year things have taken a decided downturn , along with increased confusion a general quietness , continued desire to go home even when at home she has had a great number of falls. These resulted in 2 brain bleeds, broken wrist broken pelvis broken foot . All separate falls. In November she fell against my father and this resulted in him being hospitalised for a revision and replacement of his hip replacement. He is now faecally incontinent and wheelchair mobile with the ability to transfer from chair to bed with assistance. During his hospital stay mum came to stay with me. I was unable to leave her alone in the house, we slept in the same bed as I needed to help her to toilet. She needs personal care and companionship. Dad was hospitalised for over 2 months. On discharge we realised as a family they could not go back to living independently with my support 2 days a week and carers as they had previously done. I live about 2 hrs drive away. I looked around at care homes in my location, I hoped that I could have them in safety and care together but close enough for me both to visit and bring them to my home. As I looked at the different homes I became sadder and sadder. Everything was so impersonal small student type single rooms, residents sitting but not watching the tv or interacting. I didn't want this and neither did they. They have not descended to this level yet. Dad is an avid bridge player and mum is till capable of conversation but no longer initiates it. Finally I found a home that appears so much more than the others. Superficially so better presented with excellent facilities , a spa bath an activities programme etc etc. I grasped this hope. Here I thought maybe I had found it. Mum and dad have been here for 3 weeks or so. The staff themselves are generally lovely. I know there can never be enough of them but really there aren't. Mum is desperately tired and sleeps most of the afternoon on her bed and wants to go to bed at 6pm. Unfortunately no one is available to do that so on a number of occasions she has been found wandering naked along the corridor because no one has come to her buzzer and she cant find a nightdress. Dad asks to go to bed at about 8 but it has sometimes been approaching midnight before the staff can get round to getting him to bed. because both are in a wheelchair they are taken to the dining room early and leave up to an hour after the meal because they need assistance. The lack of independence and their distress makes me visit daily. I would love for them to have more care and here is the question I am really wanting to ask. This is a residential home and although they have taken my parents in I feel their needs exceed what they can or do provide. The staff /patient ratio is ok( maybe) if these were independently mobile or non dementia sufferers but the vast majority are and the girls acknowledge they are restricted in how much time they can give to an individual. My parents could afford to pay more but if I arrange to transfer them to a nursing home is this just the same ration of staff just with some of them being qualified nurses.This really is the home with the best local reputation and yet I can see they struggle. My parents do not need qualified staff they need time with an individual. To this end I have been going in from 12 pm till 6 to ensure they can get away from mealtimes without too much of a wait to ensure mum goes to bed and that dad has someone to vent his frustrations. Now the home are quite happy for me to do this, I can also engage a private physio to work with dad for his mobility but how would they react if I asked to employ someone to help with my parents personal care in the mornings and at night when I cant. I am wanting to pay someone to do the job I am doing for them to allow me respite etc. I feel at the moment without my support they would struggle and be even more unhappy. I cant find a better home but the best is not good enough. Has anyone ever tried this. How do you broach it without seeming critical of their care. Where do I go from here. Sorry for the long post. when I read it through I don't think it demonstrates the absolute anguish and sadness I feel. How do I help apart from doing it myself?