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Too early for care home?

Sky1

Registered User
Aug 30, 2020
34
Hi All.
First post and apologies for posting what i know is a common question (i've been reading), but i'm struggling with, well, everything.
Mum has recently been diagnosed with dementia. Lives alone. Siblings and I live some distance away from her. Mum is experiencing hallucinations. She is lonely. She is having memory and reasoning problems (TV etc etc is 'broken'), as expected I know. She takes care of her own personal care and is still going shopping, alone. Her ability to judge and reason means she is at risk from scams and will open the door and answer the phone to whoever. Sibling and I are unable to have her live with us, for range of reasons. Is she 'too well' for a care home? If residential accommodation. She will not be keen on this, but i'm wondering if it will keep her as well as possible, and as safe as possible, for as long as possible. I'm thinking increased social interaction, improved diet (she's lost weight, as she's eating buffet type food now), reduction of loneliness etc.
Thanks for reading. Best, Sky1
 

Banjomansmate

Registered User
Jan 13, 2019
2,337
Dorset
Your first “problem” would be whether or not she would be self funding? If reliant on Local Authority funding it is doubtful she would be considered needy enough.
Do you have Lasting Powers of Attorney in place yet? If not that is the first thing to get organised.
 

Sky1

Registered User
Aug 30, 2020
34
Thank you for replying Banjomansmate. She would be self funding. LPA is in place.
I've been looking around at the alternatives, sheltered housing and others, and I can see that they would appear more suitable. But they would still mean her being on her own all day and i'm worried about her low level of social interaction, poor eating habits and general unhappiness. Thanks again.
 

Sarasa

Registered User
Apr 13, 2018
2,002
Hi @Sky1 and welcome to Dementia Talking Point. You'll get lots of help and support here.
My mother was similar to yours in that, in some ways, she seemed to be managing to live independently. She went out for coffee and a scone in Marks everyday, did a bit of food shopping while she was there, went to the hairdressers and a keep fit club etc. She managed personal care at home and a bit of cleaning too. The downside was that she became convinced her new neighbours were stealing from her, she got confused about medication (none critical fortunately) and got into muddles about when things such as hair appointments were due. None of this was helped by her being partially sighted. I lived two trains and a bus away and went over every few days to read post, check on food and generally keep her company. The crunch came when she started going to the local pub drinking with random men, one of whom at least she invited back. We'd already agreed with her that she would be moving nearer my brother and her flat was on the market. By the time we got a buyer for it my brother was seriously ill, and the place we thought she could move to near him was no longer suitable so I moved her to a care home near me.
A few things. Do you have Lasting Power of Attorney for finance and health and welfare? A good thing to get sorted now if you haven't, as it will make taking over managing bank accounts etc easier. We got it sorted while mum was still at home. It meant I could check what she was doing with her money, but she still had access to it. It's often suggested here that you scratch the three numbers off the back of her cards so she can't be scammed into giving cold callers her details but can still get money out.
It's tricky at the moment with care homes, but maybe look at this site and contact a few to get your eye in as to what is available.
I'm sure others will be along with more suggestions soon.
 

Sky1

Registered User
Aug 30, 2020
34
Thank you Sarasa for your welcome and reply. LPAs are in place. Mum is less sociable than yours but does shop a few times a week. Mum has hallucinations and is convinced that there is another family living in the house with her. She is very confused and unhappy. Although when i read other posts on TP, i know that she is very lucky and very well. I know this is the best its going to be. How did your mum feel about moving into a care home, if you dont mind me asking? If she needed convincing how did you do it? Thanks again. Sky1
 

Sarasa

Registered User
Apr 13, 2018
2,002
Mum was very unhappy about the move @Sky1 as she thought there was nothing wrong with her and it was a plot by my 'nasty boyfriend'* to steal her money. I didn't tell her it was a Care Home, just said she was moving near me for a while until she could move near my brother. She's been there well over a year now and I haven't seen her since March, due to Covid restrictions. She is far more settled, and content if not exactly happy, but then she wasn't happy at home either

*I don't have one, just a nice husband.
 

Sirena

Registered User
Feb 27, 2018
2,294
I think in your position I would first of all aim to get her daily care at home via a care agency. My mother was in a similar situation (although no hallucinations I'm aware of) and I arranged for care at home. I chose to start with 4 hours a day , 9am till lunchtime. That meant they had a good block of time and could give her breakfast and lunch, and supervise to ensure she ate it. They also had time to accompany her to the shops, the park, and any appointments (whether for a haircut or to the doctors). They also did all the necessary housework, laundry etc. After a while they also helped her to wash and choose clothing. And of course they chatted to her and kept her company. They were brilliant and would help with absolutely anything she needed.

When I started this, I didn't know how well it would work, I thought it might be a short term thing for a few months, but it worked very well for 18 months. After a few months I added an hour's evening visit so they could check on her and keep her company.

She then started wandering, and despite having 5 hours company a day she reached the point where she was still lonely, because within minutes of the carer leaving she didn't remember they had been there. That was the point when I moved her to a care home. She took a few weeks to settle in but since then she's been very happy there (she moved there in Feb 2018).

She would never have agreed either to have carers in, or to move to a care home, so I arranged it without discussion. The day before the first carer visit I said a nice lady was coming to help her carry the shopping and do a bit of cleaning. When it was presented as a fait accompli she accepted it - fortunately she really liked her main carer. I never used the word carer!
 

Sky1

Registered User
Aug 30, 2020
34
Thanks Sarasa. Your reply has sparked an idea. I appreciate that your situation was a Plan B, but I can see stating that she would be moving into older person's accommodation near us, as a temporary measure, until we can sell her house and buy her somewhere permanent might work. Altho the deceit is , not sure of the word.

Thanks too Sirena. I would agree with you totally, except. She's not keen on staying in her current home or even village, but this point varies depending on when the question is asked. Thanks for the advice on terminology and arranging etc. too. So very helpful.
 

Sky1

Registered User
Aug 30, 2020
34
I mentioned moving into older person's accommodation to Mum and she wasn't having any of it. No way. No way. I think she answered my question, for sure.

Although, her hallucinations have escalated and she's now starting to become paranoid - accusing me of talking to person a and person b about her.

I have read that hallucinations and paranoia are often worse in the afternoon / evening, but Mum seems to have them all day. How do you deal with them? I'm not joining in, pretending I see them too. Is this best, in you experience?

Also, beyond being kind in the face of paranoia / accusations, has anyone got any tactics to convince or is that not possible given the nature of the condition?
 

canary

Registered User
Feb 25, 2014
13,893
South coast
One of the things with dementia is that they reach a stage where they enter a sort of alternative reality. Their memory becomes so poor that their subconscious brain fills in the gaps with false memories (called confabulations). This is not under their control and seems like real memories to them. They also get delusions because their brain is trying to make sense of things that it can no longer understand.

Once they reach this stage you cannot bring them back into reality as they are certain that their memories are correct and they are unable to follow reasoned ideas. So, unfortunately, you will never be able to convince them that they are wrong. In order to reach them you have to enter their world and give reasons/reassurance that make sense to their skewed view of the world

I dont think think anyone has posted a link to Compassionate Communication, which I think you might find helpful to give you some pointers
 

Bod

Registered User
Aug 30, 2013
1,349
I fear that a move is closer than you think.
Would one move to a Care Home near you, be better than a move to supported living, followed fairly shortly to a Care Home, which might be a rushed job, into somewhere/anywhere that has space, out of an area you can visit easily.
Care Homes aren't all bad, my father flourished in his, and was very happy, took a while to settle, but seeing him enjoy the activities, I knew he was in the best place.

Bod.
 

Sirena

Registered User
Feb 27, 2018
2,294
I agree with Bod. Your mother may not want to move to a care home, but she needs to (or will do in the very near future).

As I said, I never discussed it with my mother, I arranged it and moved her there - I told her she was going for a short break. As Attorney you have to act in their best interests, and unfortunately by that stage it is almost always a decision which you have to make alone, as they are unable to participate in any rational way. I am sure if I had waited until my mother agreed, I'd still be waiting 2 and a half years later. She's very happy there, but she didn't have the ability to grasp the fact she needed to go.
 

Jan L

Registered User
Mar 26, 2020
54
Thank you for replying Banjomansmate. She would be self funding. LPA is in place.
I've been looking around at the alternatives, sheltered housing and others, and I can see that they would appear more suitable. But they would still mean her being on her own all day and i'm worried about her low level of social interaction, poor eating habits and general unhappiness. Thanks again.
@sky 1 some of the retirement accommodation have communal areas and activities organised for the occupants, with their own private apartment to maintain their Independence but there is always someone looking out for them and places to eat and socialise. We have had such a place recently open in the town where I live.

One of the problems in the early stages is that they are not aware that they have a problem so it makes it difficult to persuade to accept help.
 

Rosettastone57

Registered User
Oct 27, 2016
1,395
I agree with other posters . I think a care home is just around the corner . If you wait for a person with dementia to see your point of view or agree with you, you will wait forever. I never discussed the care home with my mother in law, I just arranged it. She was self funding and refused point blank to go into a home. So we waited for a crisis. She became ill and went into hospital and we arranged full time care for her. She went straight into the care home from hospital and never returned to her own home.
 

Sky1

Registered User
Aug 30, 2020
34
One of the things with dementia is that they reach a stage where they enter a sort of alternative reality. Their memory becomes so poor that their subconscious brain fills in the gaps with false memories (called confabulations). This is not under their control and seems like real memories to them. They also get delusions because their brain is trying to make sense of things that it can no longer understand.

Once they reach this stage you cannot bring them back into reality as they are certain that their memories are correct and they are unable to follow reasoned ideas. So, unfortunately, you will never be able to convince them that they are wrong. In order to reach them you have to enter their world and give reasons/reassurance that make sense to their skewed view of the world

I dont think think anyone has posted a link to Compassionate Communication, which I think you might find helpful to give you some pointers
Thank you so much for this response - confabulations, that's a term I've never heard of.

The Consultant has suggested Olanzapine for Mum. I've googled and have read of the side effects. But the low dosage may limit or stop? the hallucinations.

Thanks for the link too.
 

Sky1

Registered User
Aug 30, 2020
34
I fear that a move is closer than you think.
Would one move to a Care Home near you, be better than a move to supported living, followed fairly shortly to a Care Home, which might be a rushed job, into somewhere/anywhere that has space, out of an area you can visit easily.
Care Homes aren't all bad, my father flourished in his, and was very happy, took a while to settle, but seeing him enjoy the activities, I knew he was in the best place.

Bod.
Thanks Bod.

Sorry if this is a stupid question, but what is it about my description that makes you think the move to residential care is coming soon.?

Appreciate your views. Sky1
 

Sky1

Registered User
Aug 30, 2020
34
@sky 1 some of the retirement accommodation have communal areas and activities organised for the occupants, with their own private apartment to maintain their Independence but there is always someone looking out for them and places to eat and socialise. We have had such a place recently open in the town where I live.

One of the problems in the early stages is that they are not aware that they have a problem so it makes it difficult to persuade to accept help.
Thanks Jan L.

i've been looking at all options over the past few weeks. I think this is what i'd 'like' for Mum. Some of the residential care homes i've viewed on line seem a little like this, but with a room of own instead of apartment. I hoped this arrangement would give Mum company, support and so on. But, as i said, she's really against the idea and yet doesn't know what else is preferable.
 

Sky1

Registered User
Aug 30, 2020
34
I agree with other posters . I think a care home is just around the corner . If you wait for a person with dementia to see your point of view or agree with you, you will wait forever. I never discussed the care home with my mother in law, I just arranged it. She was self funding and refused point blank to go into a home. So we waited for a crisis. She became ill and went into hospital and we arranged full time care for her. She went straight into the care home from hospital and never returned to her own home.
Hi. thanks. Can i ask the same question i asked another poster please and sorry if its a stupid one. but what is it about the content of my post that makes the care home just around the corner.
 

Bod

Registered User
Aug 30, 2013
1,349
Thanks Bod.

Sorry if this is a stupid question, but what is it about my description that makes you think the move to residential care is coming soon.?

Appreciate your views. Sky1
Frequently when the move to Supported Living is finally thought of, by the family, the real situation is much worse than is realised.
The costs of moving a person away from "their" home, both financial and mentally is high, only to have to repeat the process often, less than 6 months later, into emergency care, is best avoided.
Once Care needs, become obvious, it is better to arrange proper long term care that can be adapted as the persons needs change.
To find the correct Care placement, both for the persons needs, and family convenience, takes time.
Usually a Care home place has to wait untill a room becomes available, so many months can go by before the room becomes vacant. But once the person is there then it's a home for life, with no need to move again.
Emergency Care placements will be where there is space, which could be many miles away, and could mean later moves to better place.
In your first post, it is clear that loneiness is the main problem, along with the clear inability to manage house hold tasks. This will only get worse, such is dementia.
Supported Living works well for those who are mentally fit, but just need a little physical help. Generally these places cannot cope with residents that disturb the peace and quiet, of other residents, as Dementia sufferers often do, with getting lost, banging on doors at any hour of the night, because they are frightened, wandering into other residents apartment's.

Bod.
 

Ruth1974

Registered User
Dec 26, 2018
112
Hi All.
First post and apologies for posting what i know is a common question (i've been reading), but i'm struggling with, well, everything.
Mum has recently been diagnosed with dementia. Lives alone. Siblings and I live some distance away from her. Mum is experiencing hallucinations. She is lonely. She is having memory and reasoning problems (TV etc etc is 'broken'), as expected I know. She takes care of her own personal care and is still going shopping, alone. Her ability to judge and reason means she is at risk from scams and will open the door and answer the phone to whoever. Sibling and I are unable to have her live with us, for range of reasons. Is she 'too well' for a care home? If residential accommodation. She will not be keen on this, but i'm wondering if it will keep her as well as possible, and as safe as possible, for as long as possible. I'm thinking increased social interaction, improved diet (she's lost weight, as she's eating buffet type food now), reduction of loneliness etc.
Thanks for reading. Best, Sky1
There are different levels of care in different places. My friend works in one where everyone has their own flat but theres a warden and communal areas, food can be provided etc . That would maybe be ok for a few years, she would have company and people keeping an eye on her.