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How is the best way to approach the subject of care homes with a person with dementia

Discussion in 'Middle - later stages of dementia' started by BigDecision, Jan 18, 2015.

  1. BigDecision

    BigDecision Registered User

    Jan 18, 2015
    1
    Hello I am new to the forum and I am hoping that someone can help. My mother in law is fiercely independent and does not want to go into a care home, she overheard a telephone conversation with one of my relatives and a care home making an appointment and came out really cross and saying she was not going to one.

    The problem is, she needs the 24 hour care, currently in her own home, she has started going out, not locking the house, last time she was found wandering out, early in the morning, not dressed for the weather. Despite home carers and frequent family visits, I am really concerned for her safety and security. She is no longer capable of looking after herself, and it is desperately sad and difficult.

    Please can anyone give any advice on how is best to encourage her to accept the idea of care home and how to get her there, we can't physically force her there against her will. I don't even know that even if we could get her there, that she would go in. She needs to be protected and safe that has to be our primary consideration and this just isn't possible in her own home, despite the enormous emotional distress knowing she doesn't want to go is having on us all.
     
  2. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    15,983
    Toronto, Canada
    I do not think there is any way that you can approach your mother on this subject. I did not tell my mother she was going into a retirement home, but I had very different circumstances as she was being moved from a hospital.

    You may have no choice but to simply move her there without telling her. Talk about going out for lunch. It will be very difficult.
     
  3. Katrine

    Katrine Registered User

    Jan 20, 2011
    2,852
    England
    Hi there and well come to TP. I don't think I can offer much practical advice and hope you'll get some tomorrow.

    Your forum name gives the clue that you already know that this won't be your MIL's decision, but that of her family. You won't be able to persuade her. There are very few people in her position who can recognise that someone else needs to take over, especially when they have made it to the age of 90 and still live in their own home.

    A number of possible things could happen.

    She could get ill, or have a fall, or have an accident while wandering outside. This could result in a hospital admission and a reassessment of her care needs. This is what happened to my MIL. She was in hospital and then transferred to residential care because she was assessed as needing 24/7 care.

    You could ask Social Services to reassess her, putting in writing details of her safety problems, especially at night when she is not receiving care support. If the police have been involved, they should forward a report to SS.

    You could contact her GP and or Community Mental Health team, to get an urgent assessment of her mental capacity. If she does not have capacity to decide on her care then if someone has welfare Power of Attorney they can start arranging residential care without her approval.

    In some circumstances she could be sectioned on a temporary basis, under the Mental Health Act. This usually happens only if someone is clearly a danger to themself or others. Thus, she would have to do something dangerous, it wouldn't be sufficient for you to say that she might do it. We were in that frustrating situation with MIL until the inevitable happened and she had a fall in the street while wandering at night. She wasn't aggressive so sectioning wouldn't have been likely, but she was increasingly a danger to herself so it is still a possible avenue to get someone to a place of safety where their needs can be assessed in a secure environment.

    If it is generally agreed that your MIL is not safe to live alone any more, then much depends on whether she can fund herself in residential care. If you aren't dependent on local authority funding it is obviously much easier to make private arrangements and to have a wider choice of CH.

    I think that's enough blether from me for now. I hope I have given you some ideas to consider. Best wishes, Katrine.
     
  4. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,282
    SW London
    Some of us on here have had to get our loved ones to their care homes by stealth, taking them 'out to lunch' etc., since we have known they would never agree to go, and could not understand that they were no longer safe to be left at all. My own mother firmly believed there was nothing wrong with her, even when she was so bad that she would not wash, had zero short term memory, and could no longer even make herself a cup of tea.

    Other people manage by persuasion to a 'hotel' for a few days, while probably fictitious plumbers/decorators are making the house 'uninhabitable'. Or they say the doctor needs them to go, just while their medication is sorted out. Basically anything they think might work. It is usually advised not to tell the person it is forever - it is likely to cause pointless distress. Nobody likes fibbing, but sometimes there is no choice, unless we want to wait for a real crisis, and end up with having the person sectioned. To me, a well meant fib has to be better than that.

    All this is of course easier to manage if the person will be self funded. It is sadly not infrequently the case that no matter how urgent the need is seen to be by relatives, social workers will say they cannot put anyone in a home if they don't want to go, since of course it is expensive and they are all anxious to save money.

    Having been through all this twice, I do feel for you at such a worrying time and hope you find a way that is not too stressful all round. It is not at all uncommon for people who have vehemently said they will never go into a care home, to settle very well and think they are in a hotel, or even in their own home, with 'staff'. Fingers crossed.
     
  5. CJW

    CJW Registered User

    Sep 22, 2013
    213
    Do you have a health and welfare POA.? I didn't and so was powerless to get mum into a CH. The SS have to decide together with the GP that she cannot decide for herself and is a danger to herself and/or others before they will act and they are very reluctant to make the decision. My mother was finally hospitalised, 6 months after she should have been in care in my opinion,and then released to a CH after being found delerious wandering the streets. Good luck and my thoughts are with you.
     
  6. catbells

    catbells Registered User

    Jun 14, 2010
    384
    Cambridgeshire
    Hi Bigdecision
    4 years ago I had to move my Mum without her permission. She had started going out at night (lived on a sheltered scheme complex at the time), change in behaviour - shop lifting, local shops telling me she was offering too much money/or her purse - so very vulnerable. I tried talking to her, but she wouldn`t have it, she wasn`t moving unless in her box, so as an only child, no other family support, I just had to contact adult social care and get on with it. Luckily I found a EMI unit nearby where we both lived. She lived bingo, so we introduced her slowly by going to bingo, she thought it was for me, but on the day I had to have a carer take her out, whilst I put post-its on furniture I needed, and 1/2 hr later the van came. She had her own flat, front door albeit it led to the corridor, staffed by carers, so she would have meals and supervised medication. I couldn`t reason with her, nor did she understand, although I think she had tried for a long time to hide her memory loss. She was most indignant for about 10days asking for the van. It tore at my heat to do this, but I had to make her safe. The carers were more worried about me, I was in such a state. However, 1 year almost to the day she started walking 24hrs and had to moved her again into a secure dementia unit. It was difficult, but the right decision and I`m sure she will thank me. We have to do what we think is right as tough as it is. Don`t beat yourself up, in time you will heal and accept.
    Heather xx
     
  7. Wookie

    Wookie Registered User

    Feb 19, 2015
    1
    Thanks this is helpful - new user

    My mum is 300 miles away and I visited her in the last two days and whilst there she thought I was someone else and since returning home, she is insistent I have not visited! My husband and I spent a lot of time cleaning and throwing away mouldy food etc. We have broached the subject of her moving nearer to us and almost succeeded once but it fell apart at the last minute and she threatened to call the police! It's hard to know how to handle the phone calls I have where she is adament I haven't visited; ii can't keep travelling the distance and I work in a school which means school hols are the best time to see her. She has a friend, who takes her out most days but he is in his 80's ands he won't let him do anything else. We have tried having carers in and even a live-in carer, as she doesn't want to leave her home, but they all get short shrift eventually and it falls apart. I was relieved to see from other posts I am not alone in having a 'stubborn' mother who 'will not be moved'. Perhaps I should leave her where she is whilst she is safe? Or do I try and move her with the idea of a 'trial period in a care home' in the hope it improves her quality of life and I get to see her more frequently but less intense. There are lots of books about how to bring up children but nothing about how to care for your older relatives!
     

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