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Employing 24hour Care at Home

Bunty2410

Registered User
Apr 28, 2020
65
Hello
Has anybody got experience of implementing and having 24hr home carers for their relative please?
 

Rosettastone57

Registered User
Oct 27, 2016
1,399
I looked into live in carers for my mother in law with the care agency she was using for short visits. She was self funding, but her pockets were simply not deep enough to sustain live in care on a long-term basis. The agency were charging over £1000 a week for 24 hour care. She went into a care home for £1300 per week, which was more economically viable, where there was a whole team looking after her. I'm sure others will be along soon with better advice, but it simply wouldn't have been suitable in our situation. My mother in law would simply not have tolerated the same person with her all the time
 

Bunty2410

Registered User
Apr 28, 2020
65
I looked into live in carers for my mother in law with the care agency she was using for short visits. She was self funding, but her pockets were simply not deep enough to sustain live in care on a long-term basis. The agency were charging over £1000 a week for 24 hour care. She went into a care home for £1300 per week, which was more economically viable, where there was a whole team looking after her. I'm sure others will be along soon with better advice, but it simply wouldn't have been suitable in our situation. My mother in law would simply not have tolerated the same person with her all the time
Things are progressively getting worse for my mum, but she’s refusing all interventions. While a more supportive environment would be the ideal, with Covid we wouldn’t be able to see her and as a result this would have a detrimental effect on her. She has multi system failures so I don’t anticipate she has many years if months left. It is such a sad state of affairs what ever we choose. We have the Neighbourhood Team involved but they are still at the assessment stage so nothing put in place as yet. We thought that live in care would be a compromise although we are not that keen and like your MIL my mother would find it irritating to have someone watching over her 24/7.
 

Bod

Registered User
Aug 30, 2013
1,351
Our neighbour had 24/7 live in care, but not for dementia.
The carers did 4 weeks "on" then a week "off" before going on to a different job.
Some carers fitted in well, others did not, as night care wasn't needed, only 1 carer was needed. But if night problems happened then the cost rocketed, and if 24 hr waking care was needed, the cost was prohibitive.
At this stage a full time Care Home placement, will be the better position.

Bod.
 

Jessbow

Registered User
Mar 1, 2013
3,128
West Hertfordshire
Consider all the side bit- you'll become an employer- tax & Ni payable.Pension contributions?
Holiday pay and cover No one person can work 24/7..you'd need a team, especially for holiday/illness etc cover.

My neighbour has a disabled dau who has 1:1 Care at home. Cost a fortune!
2 carers 7am- 4.30pm
a Carer 4.30- 10pm
then a night carer

They have odd shift cover via an agency, but most of it , S is the employer
 

MartinWL

Registered User
Jun 12, 2020
407
I looked into this as an option for my mother but I discovered that live-in care has limitations:
-It does not include any night duty, the carer is expected to be asleep at night.
-The carer expects a break during the day, perhaps two hours
This wouldn't have worked for my mother, she was inclined to get up during the night regularly and indeed when she broke her hip in a fall it was at about 3 in the morning. She needed someone available genuinely around the clock.
 

Champers

Registered User
Jan 3, 2019
239
Very sensible replies already, but I’m going to add my experience too.

My late MIL lived alone but 5 minutes down the road from us and was slowly going down hill but refused any help apart from a friend of hers, who wasn’t in a much better state than MIL. To cut a long story short, MIL ended up in hospital early last year for three weeks and it was clear her mental and physical condition was deteriorating quicker than ever. The OT at the hospital approached us and said that she must receive full time care upon discharge, which we totally agreed with.

We believed a CH - even short term to see how she settled - was the way to go. Her home was totally unsuited to her living requirements, she was incontinent and needed to have a full body wash regularly and the flooring levels made movement totally unsafe. However, the hospital SW stepped in and said, because MIL had said she wanted to go home, her wishes must be respected. He was adamant she had full mental capacity, even though she couldn’t recall a conversation or process information to make an informed decision.

I think it was unethical because the SW’s first question was whether MIL was self funding? I regret to this day telling him she was as he took over and insisted she had care in her home. Within 6 weeks, just as we suspected, it went pear shaped. Her needs were far more than the care agency and carer could cope with. she kept the carer up all night, wouldn’t let her take her break and despite all the equipment, still kept falling and having accidents.. The cost was around £6500 PM.

Luckily, we found a far more realistic SW who saw that her quality of life was so poor and agreed that residential care was far more suitable. We believed MIL was also clinically depressed as all she did was sit on her living room in front of the TV crying and talking about dying. Once she was in the CH, her remaining year was so much better. She had company of her own age, regular activities and trips and her personal hygiene was so much better cared for. She became more interested in what was going on around her and the crying stopped.

The support on TP was amazing and kept me sane. We had so much flak from the SW and made to feel like we were exploiting MIL. He insinuated that we wanted her in a CH because it was the cheaper option! ironic really, because virtually all her saving went in CH fees eventually but we genuinely didn’t care about the money, we wanted her remaining time to be happy - and it was.
 

Bunty2410

Registered User
Apr 28, 2020
65
Very sensible replies already, but I’m going to add my experience too.

My late MIL lived alone but 5 minutes down the road from us and was slowly going down hill but refused any help apart from a friend of hers, who wasn’t in a much better state than MIL. To cut a long story short, MIL ended up in hospital early last year for three weeks and it was clear her mental and physical condition was deteriorating quicker than ever. The OT at the hospital approached us and said that she must receive full time care upon discharge, which we totally agreed with.

We believed a CH - even short term to see how she settled - was the way to go. Her home was totally unsuited to her living requirements, she was incontinent and needed to have a full body wash regularly and the flooring levels made movement totally unsafe. However, the hospital SW stepped in and said, because MIL had said she wanted to go home, her wishes must be respected. He was adamant she had full mental capacity, even though she couldn’t recall a conversation or process information to make an informed decision.

I think it was unethical because the SW’s first question was whether MIL was self funding? I regret to this day telling him she was as he took over and insisted she had care in her home. Within 6 weeks, just as we suspected, it went pear shaped. Her needs were far more than the care agency and carer could cope with. she kept the carer up all night, wouldn’t let her take her break and despite all the equipment, still kept falling and having accidents.. The cost was around £6500 PM.

Luckily, we found a far more realistic SW who saw that her quality of life was so poor and agreed that residential care was far more suitable. We believed MIL was also clinically depressed as all she did was sit on her living room in front of the TV crying and talking about dying. Once she was in the CH, her remaining year was so much better. She had company of her own age, regular activities and trips and her personal hygiene was so much better cared for. She became more interested in what was going on around her and the crying stopped.

The support on TP was amazing and kept me sane. We had so much flak from the SW and made to feel like we were exploiting MIL. He insinuated that we wanted her in a CH because it was the cheaper option! ironic really, because virtually all her saving went in CH fees eventually but we genuinely didn’t care about the money, we wanted her remaining time to be happy - and it was.
 

MartinWL

Registered User
Jun 12, 2020
407
Very sensible replies already, but I’m going to add my experience too.

My late MIL lived alone but 5 minutes down the road from us and was slowly going down hill but refused any help apart from a friend of hers, who wasn’t in a much better state than MIL. To cut a long story short, MIL ended up in hospital early last year for three weeks and it was clear her mental and physical condition was deteriorating quicker than ever. The OT at the hospital approached us and said that she must receive full time care upon discharge, which we totally agreed with.

We believed a CH - even short term to see how she settled - was the way to go. Her home was totally unsuited to her living requirements, she was incontinent and needed to have a full body wash regularly and the flooring levels made movement totally unsafe. However, the hospital SW stepped in and said, because MIL had said she wanted to go home, her wishes must be respected. He was adamant she had full mental capacity, even though she couldn’t recall a conversation or process information to make an informed decision.

I think it was unethical because the SW’s first question was whether MIL was self funding? I regret to this day telling him she was as he took over and insisted she had care in her home. Within 6 weeks, just as we suspected, it went pear shaped. Her needs were far more than the care agency and carer could cope with. she kept the carer up all night, wouldn’t let her take her break and despite all the equipment, still kept falling and having accidents.. The cost was around £6500 PM.

Luckily, we found a far more realistic SW who saw that her quality of life was so poor and agreed that residential care was far more suitable. We believed MIL was also clinically depressed as all she did was sit on her living room in front of the TV crying and talking about dying. Once she was in the CH, her remaining year was so much better. She had company of her own age, regular activities and trips and her personal hygiene was so much better cared for. She became more interested in what was going on around her and the crying stopped.

The support on TP was amazing and kept me sane. We had so much flak from the SW and made to feel like we were exploiting MIL. He insinuated that we wanted her in a CH because it was the cheaper option! ironic really, because virtually all her saving went in CH fees eventually but we genuinely didn’t care about the money, we wanted her remaining time to be happy - and it was.
It seems to me that medical and social work professionals are all too keen on deciding that people have mental capacity. They may not have sufficient understanding of the law. It is important for relatives to stand up to them. If the person can't understand all the facts, remember them, weigh up the pros and cons, they don't have capacity for the decision. In the context of where to live they need to be able to understand the dangers of living at home. They may decide to take the risk, but they can only do so if they understand it. Ability to talk a good talk isn't a criterion in law!!
 

Bunty2410

Registered User
Apr 28, 2020
65
My mother lives 2 hours away from both my sister and I. She has 4 care episodes a day but no night cover. She fell twice last week but was not seriously injured. When I saw her on Friday she was laughing at her inability to string a sentence together but her laughter was somewhat maniacal.
while writing this at 11pm I got a call from Careline to say my mothers Vibby has been activated and an ambulance has been called. I didn’t go I waited for some contact, none. Rang the house no answer, rang A/E twice she’d not been admitted.
03.45 got a call from Careline to say she’d stayed at home. This isn’t sustainable. We’d hoped to get to after Xmas then admit her to a Nursing Home but events are beginning to dictate otherwise. I’m floundering. She wouldn’t let the medic examine her last week and refused respite. I will try and get her night care to bide us time while we organise a Nursing home. Time to put my brave pants on.
Sorry if I’m rambling on.
 

Jessbow

Registered User
Mar 1, 2013
3,128
West Hertfordshire
Bunty. get the care home wheels in motion now, it can take time.

Granted, this year , with all the covid stuff going on, things maybe different, but the christmas my mum spent in a care home was probably the best christmas she'd had for years- not that she particually liked christmas, but they really made an effort, and she enjoyed it.
 

Sarasa

Registered User
Apr 13, 2018
2,011
Hi @Bunty2410 , we are having very similar problems with my mother in law, and I feel like I'm watching a slow motion car crash as problems pile up but the family feel they have to respect their mother's wishes so no decisions are made that could possibly upset her,
I agree start looking at suitable places now, specially as you can't get there quickly if there is a crisis. This site Care Home UK is useful for helping you draw up a possible shortlist.
 

Athlemea

Registered User
Sep 25, 2016
3
Hello
Has anybody got experience of implementing and having 24hr home carers for their relative please?
Hi and best wishes, tough times.

My father has live in care and it is currently a good arrangement for his health and happiness. It is also reassuring for me, 110 miles away.

He's only had two different carers this year and both know him well and respond to his changing needs as Alzheimer's progresses.

The cost is the only major downside.
 

Bunty2410

Registered User
Apr 28, 2020
65
Hi @Bunty2410 , we are having very similar problems with my mother in law, and I feel like I'm watching a slow motion car crash as problems pile up but the family feel they have to respect their mother's wishes so no decisions are made that could possibly upset her,
I agree start looking at suitable places now, specially as you can't get there quickly if there is a crisis. This site Care Home UK is useful for helping you draw up a possible shortlist.
Hi
We have got to the stage that if we respect her wishes we will not be fulfilling our responsibilities as POAs as her capacity is diminishing
 

Bunty2410

Registered User
Apr 28, 2020
65
Hi and best wishes, tough times.

My father has live in care and it is currently a good arrangement for his health and happiness. It is also reassuring for me, 110 miles away.

He's only had two different carers this year and both know him well and respond to his changing needs as Alzheimer's progresses.

The cost is the only major downside.
Hi
We are considering increased home care as a stop gap while we organise residential care near us, but Im dreading moving her as she still says she doesn’t want residential care, but she lacks insight and judgement.
 

MrsV

Registered User
Apr 16, 2018
194
Northamptonshire
Hi there,
If the PWD needs 24/4 care, as my mum does, they need a team of people working in shifts 24/7 to cope. It would be cheaper for them to go into a care hone I think. My mum pays just over £1,000 a week For Her care home. Everyone in our family works full time, and non of us can afford to give up our job to provide the level of care that’s required to deliver safe care at home. You would be burnt out within months trying to cope, not to mention the mental anguish
 

Sarasa

Registered User
Apr 13, 2018
2,011
I think 24 hour care at home depends a lot on what the person with dementia is like. I can see that it might work well for my mother in law as she sleeps through the night (at least at the moment) and is usually pretty amenable to suggestions during the day. In her case it would be a case of getting used to who ever it was, so she'd need a limited number of carers. With my mum it would have been a disaster. She'd have insisted on going out by herself, resented any help on offer and probably verbally if not physically abused them. In a care home with lots of people about they can manage her, one person at home wouldn't be able to.
 

Champers

Registered User
Jan 3, 2019
239
It seems to me that medical and social work professionals are all too keen on deciding that people have mental capacity. They may not have sufficient understanding of the law. It is important for relatives to stand up to them. If the person can't understand all the facts, remember them, weigh up the pros and cons, they don't have capacity for the decision. In the context of where to live they need to be able to understand the dangers of living at home. They may decide to take the risk, but they can only do so if they understand it. Ability to talk a good talk isn't a criterion in law!!
Absolutely spot on.

We couldn’t get the SW to appreciate that MIL was incapable of making decisions as she couldn’t even hold, let alone process any information. He then moved the goal posts and said that she clearly had ‘fluctuating’ capacity. You could argue that even the most advanced cases of dementia have ‘fluctuating’ capacity as the suffer still occasionally has fleeting moments of lucidity! And if that’s the case, there would be no point in having POAs.

The whole experience was sadly made very unpleasant by this man. Subsequently, whenever we visited MIL in hospital, two nurses would position themselves within earshot to listen in on our conversations. Initially, I thought I was being paranoid, but when I asked MIL something one day, one of them jumped into the conversation and answered for her!
 

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