• Expert Q&A: Rare dementias - Tues 3 March, 3-4pm

    Our next expert Q&A will be on the topic of rare dementias. It will be hosted by Nikki and Seb from Rare Dementia Support. If you have any questions about rare dementias, they will be here to answer them on Tuesday 3 March between 3-4pm.

    You can either post your question >here< or email them to us at talkingpoint@alzheimers.org.uk and we'll be happy to ask them on your behalf.

Nursing home or care home? Advice, please........

helen forshaw

Registered User
Hello. I am sure this has been asked many times before and I have read through the information sheets and still am not clear..........
Dad went into a lovely care home a couple of months ago but unfortunately after a week they said that he needed more specialised care. He was diagnosed with Alzheimers about seven years ago, is still quite fit, eats well and is continent. The main problem was that he was wandering into the other residents rooms day and night whch was distressing for them.
I brought dad back home but now want to explore care for him in a suitable home. I cannot get my head round whether I should be looking at nursing homes or care homes. I don't want to have to move dad again in a year but at the same time, I want him to have the opportunity to live with other people who are mobile and still able and willing to chat and take part in activities.
At the moment I employ a carer who comes in to look after dad when I am at work. She is great and takes dad out for a walk, helps him with personal care and chats with him. Basically she just lets him decide what he feels like doing and does it with him/for him.
I am finding the evenings and weekends very difficult as dad is very dependent on me even though he forgets that I am his daughter and doesn't remember my name.
I really want to keep him at home as long as possible but I want to make plans and put him on a waiting list if I find a home which feels right for him.
Could anyone, please, advise me whether it is more sensible to explore homes which are called "nursing" homes rather than residential "care" homes which cater for dementia?
Many thanks.
Helen
 

laura1957

Registered User
Aug 26, 2011
12
hi helen if i was you i would keep him with you for as long as possible as it sounds as though you have an excellent carer and he seems quite able to do things for himself as you say he is continent,i wish i could have found a decent carer for my husband as he is only 67 and because i was ill myself i had to put him into a nursing home due to the fact he became incontinent because he missed me,he is in a lovely home and i suppose the moral of the story is don't put him in a home of any kind while he is able to do things for himself, obviously its your decision ,love laura :)
 

FifiMo

Registered User
Feb 10, 2010
4,710
Wiltshire
Helen

The decision on whether my mother needed residential or nursing care came from the local authority's application for funding of care. As part of the application a doctor's and social work assessment had to be carried out that this determined what kind of care was necessary. In the case of my mother this was deemed to be nursing care. Having had this assessment carried out I could not then put my mother into residential care - only a nursing home. This is for legal reasons and also because the terms of a licence dictate the services and levels of care that a particular home can provide.

We did however find, what I was told, was a new approach to care for dementia patients and it is a home which provides holistic care so that the resident does not have to move to another establishment as the dementia develops. Obviously if there were issues which were beyond their ability to cope with - say - extreme violence or something then another place may have to be found. Other than that, my mother can stay there as long as is necessary. The home is structured such that the more able clients are on the ground floor and they have access to the secure gardens and can come and go as they want within the confines of the unit. The first floor is for those who need a bit more looking after and who might be at risk of falls if they were to go out rambling round the garden. They, as an alternative, have a huge balcony area overlooking the garden where they can enjoy watching everyone coming and going. The second floor is for those who are less mobile still and more often bedridden and approaching end of life. The benefit of this home, aside from the holistic care, is that it is only for people with dementia and therefore everyone is experienced in caring for those with dementia. All the activities they do are also with the dementia client in mind. Perhaps something like this would be suitable for you dad in the longer term?

If you are self-funding then please be aware that there can be a considerable cost difference between residential and nursing care. The more nursing staff that are employed the higher the costs seem to be.

Fiona
 

Jo1958

Registered User
Mar 31, 2010
3,724
Yorkshire
Helen, hi
I'm sorry to hear that the care home didn't work out and you are now so tied. If you are self funding then I think it's up to you to ask around the homes in your area to see if there are some that will welcome your Dad and give him a good home, lots of leg work for you but I guess the sooner you start to gather the information the better. Social Services will make the decisions for assessment and which homes they are happy to finance so if you give them a call then that will start the ball rolling there.

In the meantime if you are finding the evenings and weekends hard why don't you use the hunt for a permanent home for your Dad to try long weekend respite visits, there is something really good about knowing that you have a break maybe every month when you know that your Dad will be well looked after and you can have a real break from caring, it can make the difference between permanent home care and residential care much easier. Again the route for this is different depending on the funding but it would be a lot cheaper for you than permanent nursing care.

I look forward to hearing how you get on, with best wishes from Jo
 
Last edited:

Bristolbelle

Registered User
Aug 18, 2006
1,847
Bristol
All in the name.....

I made the huge mistake of putting Mum in a home which did not have nursing cy over.
Then when she was ill and they needed to use hoists her personl possessions were removed from her room to allow access as the rooms residentail care homes are usually smalller than those in nursing establichments which have to allow for specialisit equipment etc.
Many homes actually accept clients as residential clients and then upgrade thier care as their condition progresses. I would certainly reccomend this kind of establishment because it prevents the person having to be moved twice.
Good luck
 

Jancis

Registered User
Jun 30, 2010
2,567
66
Hampshire
Hi Helen,
I know exactly what you mean about the confusion regarding different homes and levels of care. I don't understand why care homes cannot be classified in a standard way that clearly defines what they do or do not offer.

Your experience with your dad being turned out of the home after only a week must have been truly dreadful for you especially after it sounded so promising and befiting. Did the manager not offer any alternative recommendations?

But on the positive side, now you are aware how your dad behaved in terms of wandering into other residents rooms then you can at least explain this to a prospective manager when you enquire about the suitability of their home. It sounds like your dad may need staff who are trained in mental health care specialising in dementia. It really depends on your dad's physical health as to whether you think he may need nursing care in the near future.

My relative was very challenging (suffering from severe depression and dementia) and because he had been in a psychiatric hospital, his care team elected to place him in an EMI Nursing Home (I've read here that the term elderly mentally infirm is no longer used but I note social services still use the term) where they had staff to cope with many other 'challenging' residents. Everyone was far worse than my relative and it was terribly depressing and he hated it. He was mobile, able to communicate and enjoyed his food. He did have incontinence problems and resisted personal care and medication but his physical health was fine. He certainly needed mental nursing care but not physical nursing care. In this home there were people who needed both and these were in the majority. Fotunately we managed to move him to a home that has identical status but it is not depressing at all - more of a balance of residents with different levels of needs and he has improved dramatically.

I'm sorry you're having so much problem trying to help your dad, I've read your other threads and it seems that everything is working against you. I hope you can find a solution.
 

HelenMG

Registered User
May 1, 2008
194
Dublin, Ireland
Hi Helen,
My advice is to look well and hard for a good place for your Dad - one that specialises in dementia care, and is bright and roomy, with dementia trained staff and with a good spectrum of activities for dementia of all stages. We moved my Dad from his first home back home for a while as it was not suitable. We then moved him into a place near home which let us visit every day and that seemed suitable - Dad was continent and mobile but prone to wandering. But a year on the second home wanted us to find somewhere else as they couldnt handle dads aggression - and he had become incontinent - and less mobile and needing - but totally rejecting any help with his personal care. I think our first search was not thorough enough - as when we started looking for a third place we found some places that were so completely dementia - focussed.

It is a very hard job to find a good place but best advice is go and visit as many as possible so you can see the differences for yourself.
Take care,
HelenMG
 

helen forshaw

Registered User
Thank you for your responses today........

I really appreciate your thoughtful and helpful replies to my post.
I think from your comments and experiences that I will need to take time to explore as many care/nursing homes as possible to find the right one for dad.
I also think I will ask my excellent AS Dementia Support Worker to call round for a chat as there are so many things to think about.
I like your idea, Jo, of the option of weekend breaks/respite which will also give me an idea of what the homes are like as well as giving me chance to recharge my batteries.
I am so lucky to have found such a fantastic (private) carer who I can totally rely on. Dad really likes her and I think it makes sense to keep her as long as possible with some short breaks for me.
I have been really disappointed with the approach taken by Adult Social Care - I know budgets are restricted but the "Social Care Assessor" I met with was pretty clueless and after three weeks has still not sent the information I asked for about local care/nursing homes.
As dad is self-funding, (for the time-being!) I prefer not to get involved with council assessments until absolutely necessary so there is no point in paying nursing home fees until dad really needs this level of care.
Anyway, your thoughts and experiences have given me lots to think about and I appreciate you taking the time to share them.
Ma ny thanks.
Helen
 

gjold

Registered User
Oct 25, 2011
2
It might not seem like it but help is out there...

Hi Helen,
My Mum's situation is slightly different but today (yesterday as it is now) we as a family after nearly five years of home caring agreed that Mum's needs would be best met in a nursing home. Mum is just 63 years young, hasn't spoken in a little over three years, is wheelchair bound and incontinent. However, laughs lots which I put down to my silly songs, rhymes and continued attempts to make her smile and laugh! - endorphins et al.
As so many of the previous post have mentioned funding always comes into the equation, whether it be 'self' or 'local authority' but putting that aside. In our experience so far and hearing what you've said about your Dad and your desire for him to be engaged and to have as much freedom as possible. I would suggest you consider looking at a form of specialist 'dementia care home' over nursing and/or 'standard' care home. They appear at least to be more in tune with an individuals needs in providing personal care if/when required, engaging in activities as well as having nursing elements to hand if god forbid needed. Obviously this all depends on the home and what they can/have to offer. The majority of 'care homes' that we have been to see deal with a mix and match of residents (for want of a better phrase) and short of going along a separate EMI route can't cope with such a mix for similar reasons as you mention. Nursing homes (that we've visited) on the other hand would appear to be more geared up for excellent palliative care but don't seem to offer the same sort of interactive activities as a result. I've not had a chance to research these yet but if your Dad served in the Armed Forces there are also homes in association with the Royal British Legion and other alternatives such as the Masons which may be able to offer something that suits... (I'll do a global repost once I know more details).
This is one of my first posts so I don't know now if it helps but hope so? In any event I would like wish you all the very best of luck in your endeavours and remind you that its everyone's mental health and well-being that need to be thought of when making any decisions...
Kind regards
Gary :)
 

Eikenella

Registered User
Oct 13, 2008
9
North London
Hi Helen,

after years of my dad looking after mum at home, with the help of carers (2, 3 times a day because she is unable to walk), she went into a nursing home for 'respite' because dad needed emergency surgery. Putting her into a home had not previously crossed our minds. We were determined to keep her at home.
The 'respite' became 'short stay' and then as it became clear that dad's situation was only going to deteriorate the home was able to offer her a permanent place. It was the best thing that could have happened. She gets very good care and the family are 'looked after' too. They listen to our concerns and consult us at every stage. Most importantly the medical care is very much better. We used to have battles over the phone to get the GP to make home visits when mum had chest problems or needed blood tests etc. Now, the home manager calls and 'he runs'.
She has been there just over 2 years and has no sores, no bruising, and 24 hour care. Her 'social life' is also very much better than it was at home. She was self funding and that was a worry because the money would eventually run out but she has recently been awarded continuing health care funding so we are now assured that mum will be able to stay on at this wonderful and caring home.
Dad was also in a nursing home post surgery, but was able to make it home for a little while. With my limited experience I would opt for a nursing home that specialises in dementia care. Ask if you could go for a look around of any you like the look of and have a chat with any relatives of residents and any residents able to talk to you. Ask what activities etc they offer the residents.
Nursing homes have received a lot of bad press but there are good ones out there. We came across ours by chance but are very grateful that we did.
I am confident that you will find somewhere for your dad.

Good luck
 

scatterbrain

Registered User
Jan 10, 2008
25
Berkshire
Finding a care home

I totally agree with the advice given about looking long and hard for a home that will provide the type of care you want for your Dad. I found the inspection reports very useful when I was looking for somewhere for my Mum - http://www.cqc.org.uk - but there is no substitute for going there in person! My advice would be to follow your instincts once you have narrowed the choice down to a few likely places. If it feels like the right place, it probably is.

Wherever you decide on, they will want to do their own assessment to make sure that they can indeed provide what is needed but in my experience that was not difficult because I had already told them everything they needed to know.

It might be helpful to go with a friend to visit the homes, before you try to take your Dad to see them. Someone from outside the immediate family can be more objective and offer valuable moral support, as well as reminding you of the questions you want to ask but can't quite bring to mind in the heat of the moment.

I hope you find the perfect place soon.
 

grove

Registered User
Aug 24, 2010
7,723
North Yorkshire
Hello Helen , It is hard looking for a Home is 'int ? & it can be so :confused: etc what to do for the best for " Our Loved Ones " , i agree with Fiona try & find a Home with all "round care " so if & when your Dad require's more "Special Help "
etc you will not have to move him again & therfore not causing any more upset &
:( to yourself & your Dad . Also agree to find a Home where the Staff are trained / focused on Dementia Care ( a friend who lives near me made the mistake it was a emergency & she had no help from S Worker etc ....... moved her Mum into a "general N Home " & then sadly there was a small "Incident " :eek: with her Mum , Judith then moved her Mum into a N Home that provides good all round Care for people with Dementia / Altz )

I work in the Kitchen of a N Home so have a bit of "insight " into all types Homes etc , tho of course the rules change all the time as to what type of Home is suitable etc . If & when you do to visit ask about the Menu / Diet etc & will your Dad be able to eat in his Room if he wants to etc ? . Most god Homes are very relaxed about that sort of thing as they like to give Resident's a choice & ask to look at a daily Menu etc ( we have a 4 Week Menu Rota :) ) & are snacks / drinks available even when the Chef has gone "off Duty " ? ...... Have heard the "Charity Homes " are very good as they spend the money on the Residents & Home :) rather than make BIG FAT PROFITS ! at the end of each Month ( sadly the Firm i work for is like that :( )

You seem to be coping well & its good the Carer is lovely :) / hard working with your Dad , restpite is needed / important for you tho Helen ( my friend would not be with out it she Cares for her Mum all the time / her Mum has V Dementia )

Sorry for the long Post ! ! & just sending much Love & Support to you in the days & weeks to come in your decision's looking at Homes & what to do for the best for your Dad ....... ( many thanks for your reply on my Phone Thread have replied back ! ! ! )

Take Care

Love & Hugs Love Grove x x
 

PurpleJay

Registered User
Nov 2, 2011
169
Derbyshire
I have recently been visiting lots of potential homes for my mum who has recently been diagnosed with vascular dementia and needs 'nursing dementia' care. That seems to mean a nursing home which is registered for dementia.

I have come across homes who offer 'residential dementia/emi care' and this may be what you need. My local authority (mum's social worker) gave me a directory of all the local care homes and then I rang round to ask what they offered. It has been a bit of a learning curve.
 
Last edited:

helen forshaw

Registered User
Thanks again for all your support and advice. I am visiting a Care Home which specialises in dementia care tomorrow, 20 resident capacity, in the countryside about five miles from where I live.
Also new Social Care Assessor is visiting next week to discuss the range of options, including some respite for me and dad - (I am sure he needs a break from me as well!)

Thanks again everyone for your experiences and ideas.
Love Helen x
 

Forum statistics

Threads
112,777
Messages
1,651,913
Members
63,151
Latest member
Wishing20