So Torn – Right time for a Care Home?

[Pheath]

We’ve recently been considering a care home for dad as looking after him has got significantly harder the last few months, he is now doubly continent and his mental functioning is very poor although still has some awareness of his surroundings. Although he walks well he can’t use his arms well anymore so needs assistance with most things.

I have been his main carer for the last 3yrs together with some additional help from outside carers, this is something I’ve done very willingly. My mum still lives with dad but she has health problems of her own, I’m only a mile away so the arrangement has worked fairly well.

Dad went for an assessment on Sunday to a care home we’ve previously viewed and they were happy to accept him and said there was a room immediately available so he could move in asap. However, I’m now feeling incredibly torn as the thought of him going so suddenly is making me feel unbearably sad and wondering if I can hang on caring for longer. Ironically he’s been a little easier to manage the last week or so, he’s just started Ebixa which is meant to help with mood control which might be kicking in a bit as previously he’d been very grumpy. Also I feel with Spring just round the corner he may be easier with the longer days. I spoke to the care home manager about if we declined this room could she guarantee the door would always be open to him and she said it was impossible to say and he’d need to be assessed again. I feel I could carrying on caring for him at home if I felt I had the safety net of the home to fall back on. This home is also the only home that I feel would be suitable for him at present (visited 12!) As well as the emotional wrench of him going there will be a big financial impact for us too.

My dilemma is whether to hold on and hope that when things get worse they’ll still be willing to take him or whether to send him now when I feel I’m still able to manage because I’m afraid they won’t accept him later down the line. It’s a residential home with quite a high density of staff-residents so we feel they could meet someone with higher needs. I’m also worried the manager will think I’m wasting her time as it’s the second time a room has come free and I’ve been hesitant to accept so feel a bit under pressure to accept this time. Guess I’m just hoping that a room will be free when we’re more desperate & they’ll still take him but know it doesn’t always work out like that.

Also in peoples’ experience is it is more or less of an upheaval sending someone to a care home earlier or later? We’re quite late down the line but am not sure how much more worse it can get and know I would kick myself if I missed this room and then when we really needed to send him somewhere ended up more in the realms of nursing homes.

Would really appreciate some advice.

Pam

 

[mellymoo]

Hi Hun,

Have you thought about him going in for a few weeks respite care ( if they would accept that ) to see how he gets on and adjusts ?

He may love it ! and if not he could go home again ?


xxxxx

 

[Chemmy]

If you feel you've found the right CH, I would be inclined to accept the place sooner rather than later as the more he can communicate (not necessarily verbally) with the staff and other residents, the better he will settle in. They need to get to know him - what he likes, doesn't like - before he loses that ability completely.

 

[Pheath]

Thanks mellymoo and Chemmy. Unfortunately for respite care I need to give our Borough six weeks notice and the room in this particular home would probably have gone by then. Dad's communication is very limited now and he's pretty much permanently confused so am not sure how much worse it will get as he can't really communicate his needs except to say he's hungry which is pretty much all the time! I do feel if I had the certainty this care home would take him when we were more ready I could care for him myself a while longer but not knowing that is making me feel in such turmoil about what to do now.

 

[ggma]

I think you have done a wonderful job of supporting your parents for so long.

It does sound as though you do need to decide if you want your dad to go in whilst he has the opportunity, as you say if he deteriorates more, it may be that he will not be accepted even if a room is available.

If you accept the room and your Dad moves in, could you view it as sharing the care and still have him home for days on a regular basis, or would that confuse him more.

I think we all struggle with the big hurdle of the right time to give up caring at home and accepting it is time for the move to care home.

Our Mum settled so well in her care home, we regretted not moving her sooner with hindsight.

All the best

 

[sussexsue]

Whatever you do it will be a huge wrench. However I think it is best to move your dad now. When there is still some of his personality there so that the CH can get to know him.

With mum going through a crisis at the moment it is so much better for both of us that she is in a CH where they are the ones keeping her clean, two people to change and bathe her, tempting her with different foods, someone able to check her every 10 to 15 minutes, etc. I can now go each day and just spend time being with her, not weighed down with the huge responsibility of physically caring for her and watching over her day and night.

I really would urge you not to leave it too long. There is never going to be a "good" time, but now might be the "right" time.

Sue

 

[Contrary Mary]

I feel I could carrying on caring for him at home if I felt I had the safety net of the home to fall back on.

The trouble is, from my experience, that there aren't really any safety nets at home. If you are happy with this home, I would be tempted to try it, rather than wait for a crisis to develop at home and anything might happen then.

I do know that it is a very tough decision to make, and only you can decide how near the end of the line you have come as a carer. (Been there)

Wishing you well
Mary
x

 

[Witzend]

I really would urge you not to leave it too long. There is never going to be a "good" time, but now might be the "right" time.

Sue

I do so agree. What so often seems to happen is that we just can't bear to do it until some sort of real crisis forces our hands. And unless we're very lucky, finding a nice, suitable home in a hurry, that happens to have a room available, can be such a headache.

 

[Pheath]

Thank you everybody for your comments, it seems to be unanimous that we send dad to the Care Home at this present time although must say I'm still in some turmoil. To further complicate things I visited a local nursing home this afternoon which I wasn't quite as happy with in the standard of care but through a spanner in the works and said what would happen if dad more complex medical needs in the future. He had a heart bypass in '97 and they felt a residential home couldn't manage this. In your experience do people always have to move from care homes to nursing homes/ hospitals once they have medical needs eg. something like heart failure or a respiratory problems or can residential homes sometimes manage these sorts of problems?

 

[bunnies]

I remember this feeling - finding a suitable care home 'too early', when I felt I wasn't quite ready to make the move, and I felt my relative didn't 'need' to move for another 6 months or so. I realised that I had to make the decision, because whenever it comes up it will not feel like quite the right time, unless it is a crisis, and then you won't be able to ensure your relative goes into the home you want.

Many people say that moving someone to a care home a bit earlier has the advantage that the person can express their needs and get to see the place as home while they are still able to express their character. I think this may be true.

Others may know better than me, but I have been unconvinced that nursing homes offer so much more than care homes anyway. My relative went into a nursing home, but the 'nursing' she received could as easily have been done by visiting district nursing. I didn't feel the nurses were able to make their own decisions so the benefit of one being on call all the time was debateable. If my relative was ill all they did was call the GP, and that was perhaps the right thing to do anyway. I found out that they would not adminster injections, so my relative had to go to hospital for these anyway. I would say if you have found a care home you like, better to stick with that. Take a deep breath, and do it.

 

[Witzend]

(

Thank you everybody for your comments, it seems to be unanimous that we send dad to the Care Home at this present time although must say I'm still in some turmoil. To further complicate things I visited a local nursing home this afternoon which I wasn't quite as happy with in the standard of care but through a spanner in the works and said what would happen if dad more complex medical needs in the future. He had a heart bypass in '97 and they felt a residential home couldn't manage this. In your experience do people always have to move from care homes to nursing homes/ hospitals once they have medical needs eg. something like heart failure or a respiratory problems or can residential homes sometimes manage these sorts of problems?

TBH it can be quite stressful enough finding a CH that will meet someone's current needs without worrying about what they might be in future. Though that's all too easy to say, I know.

From exp. if people need actual nursing procedures they will have to move to a nursing, rather than a residential, home. My fil had to move after a few yrs at his res. home, but by then he'd deteriorated so much both mentally and physically that he wasn't apparently upset by it. The first CH was perfect for him at the time he first had to go, and managed his often very difficult behaviour brilliantly.

Similarly a couple of residents from my mother's CH have had to be moved to actual nursing homes, but again they were pretty bad by then.

All the best, anyway - it's such a horrible and worrying time. (2 worn-out T shirts here)

 

[Pheath]

You have all been so helpful & can't thank you enough. Also the fact you're all without exception saying the same thing is helping me decide what best to do.
Tonight has been exceptionally difficult getting dad to bed which is always a flashpoint, even though he's been largely calm during the day he went totally beserk tonight and tried to hit me which he's never done before and kept saying he'd call the police if I went near him. Think everything now is pointing us in the direction of what to do next but am still terribly sad it's come to this, I'd always wanted him to be at home right until the end but can see it's no longer possible. Of all the illnesses this has got to be one of the worst. Pam