Update on Dad and some questions

[mumofthree]

My Dad moved into a care home just over 3 weeks ago following almost 4 weeks in hospital. So far he seems to have accepted the move and as yet we haven't had any questions about when he's going home.

Since he went into the care home his mobility has declined - he now uses a frame rather than a stick, and that's on good days - they often use a wheelchair to move him around too. What started as night-time incontinence when he went into hospital (there were never any problems at home) has become daytime incontinence as well and he has been assessed for incontinence pads. Yesterday it took 3 carers to dress him as he had no balance and he was very sleepy and vacant when I visited in the afternoon - I looked into his eyes and got nothing back although he knew I was there and who I was. Anything he did say was incoherent. So I suppose my first question is, is this rapid decline unusual? He was only diagnosed 3 months ago although we of course knew there was a problem long before. Is it common for people with dementia to decline after going into a home? Or is Dad just generally suffering a rapid decline and his environment is immaterial?

On Friday we had a financial assessment by Social Services. It seemed that there would be one weekly cost if he contributes and the County Council loan the balance until his house is sold, and a different weekly cost if Dad was paying the whole cost directly out of private funds (he would pay £200 more in the latter). Is this common?

Finally on our calculations, Dad's funds would run out in less than 2 years (he has no savings, only equity in his house) and so a big question for us then is can the county council force us to move him to a cheaper home if they are footing the bill?

Sorry for all the questions and thanks for reading

 

[BeckyJan]

Hello.

With regard to your Dad's decline it is worth asking about any changes in medication.

I think there could be some change in mood and behaviour during the settling in period. In my husband's case once that was over he did improve slightly, although the deterioration always became more obvious after a minor stroke or infection.
I think incontinence is more likely once mobility declines and within a care home setting.

I do not know or have any experience on the different charging you mention in your third paragraph.

Whilst in theory the LA could move your Dad to a cheaper home once his funds run out, it is highly unlikely if he is fully settled and the cost is within reasonable limits. If such a thing happened to us I would be adamant that it was against my husband's best interests. Also the situation re funding for care is likely to change within the next two years.

Best wishes

 

[nicoise]

Dear Mum of Three,

Your poor Dad has just been through two big changes in his life - firstly the hospital, now the care home, either one of which would have probably set him back somewhat.

Then the chest infection also - every infection is bad news for a dementia sufferer with the consequential negative effects on an already struggling brain:

http://www.wellcome.ac.uk/News/Media-office/Press-releases/2008/WTX050472.htm

So it probably isn't really surprising that he is not very good at present, and indeed has declined quite markedly in terms of continence, cognition etc - but worrying for you naturally.

Have you checked as to whether the care home might have given him any new medications, or changed any that he was already on?

I'm sorry, I can't help with the financial side - but there are several TPers who are very good at that.

Endless things for you to worry about and try to sort out - I do feel for you with all this.

Hoping that you get some pointers, and that your dad makes some improvement.
Best wishes

 

[Nebiroth]

On Friday we had a financial assessment by Social Services. It seemed that there would be one weekly cost if he contributes and the County Council loan the balance until his house is sold, and a different weekly cost if Dad was paying the whole cost directly out of private funds (he would pay £200 more in the latter). Is this common?

This may be because if the local authority is funding all or part of the fees, even if it is actually your dad who ends up paying, then the fees will be lower. Local authorities are frequently able to negotiate lower fees than private individuals pay.

Finally on our calculations, Dad's funds would run out in less than 2 years (he has no savings, only equity in his house) and so a big question for us then is can the county council force us to move him to a cheaper home if they are footing the bill?

The local authority has to take into account the effect moving your dad would have on his wellbeing. If he is well-settled and stable in the current home then even if the charges are above what their 'ceiling' for charges is, they are unlikely to force a move purely on a financial basis. They also have to take into account other factors - for example, if the current home is the only one local enough to enable family visits. Lastly, if your dad has particular needs that are met by special facilities in this particular home then the local authority will have little choice but to pay.

You should not, however, agree to the payment of "top up" fees - families cannot be obliged to pay care fees; only the assets of the person in care can be used. Of course, some families do pay the fees voluntarily.

 

[jenniferpa]

To add to what Nebiroth said: when a person owns a home (but they don't have savings over the £23,250 upper saving limit) they are entitled to a 12 week disregard of their care home bills while the property is being sold. What this means is that for those 12 weeks the LA will pay what ever they would normally pay for a person with your father's needs but they CANNOT claim that money back. That is - it is not a loan at that point. It is only after the 12 weeks are up and/or the property is sold that they can start to call it a loan.

It is unusual to have the financial assessment laid out in the way you describe which is why it's difficult to get a handle on what they are saying. However, it is important that you remember that there are rules they have to follow, and a fair number of them are not discretionary: they have to follow them.

 

[mumofthree]

Thanks for the reassuring replies on the funding side of things. They did explain that we had a 12 week period where he pays a contribution but the balance they pay is not recoverable. After the 12 weeks his contribution increases and the balance they pay is recoverable. I feel now that even if he does run out of money we are on fairly solid ground to keep him where he is so thank you for that.

I've been back to the care home this afternoon and now the senior carer is back in after the weekend, she thinks he has an infection which would account for this weekend's particularly dramatic decline. The doctor has been out and antibiotics prescribed. Dad barely knew I was there - he opened his eyes when I said hello to him but looked very blankly at me and then went back to sleep. The carer described him as very vague today so I can only hope they are right and antibiotics improve things over the next couple of days.

Mumofthree