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What is Bad Enough?

Pusskins

Registered User
Jun 6, 2020
76
New Zealand
This confuses me. When is a PWD bad enough to go into care? Do they have to finally not recognise who you are, go wandering? What is the criteria? My husband is unable to converse in any meaningful way with me. He refuses to shave or let me wash him. He smells offensive. He does nothing each day except sleep a lot of the time. He is not incontinent but pees in all the wrong places inside the house. He sometimes goes outside to do his business out there and comes inside smelling of poo but won't let me wash and change him. He is suffering hypersexuality, he spits on the floor (carpeted). My patience is wearing thin. When or how do you decide it's time to go into a home?

As I finished typing the above, I realised the dog was nowhere close. Husband was inside, no dog. Went outside, no dog in the yard. I called her and fortunately she responded. MH had let her out the gate! I have worried this might happen for ages. It's a miracle I got her back and didn't have to go searching the neighbourhood!
 
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kindred

Registered User
Apr 8, 2018
2,492
This confuses me. When is a PWD bad enough to go into care? Do they have to finally not recognise who you are, go wandering? What is the criteria? My husband is unable to converse in any meaningful way with me. He refuses to shave or let me wash him. He smells offensive. He does nothing each day except sleep a lot of the time. He is not incontinent but pees in all the wrong places inside the house. He sometimes goes outside to do his business out there and comes inside smelling of poo but won't let me wash and change him. He is suffering hypersexuality, he spits on the floor (carpeted). My patience is wearing thin. When or how do you decide it's time to go into a home?

As I finished typing the above, I realised the dog was nowhere close. Husband was inside, no dog. Went outside, no dog in the yard. I called her and fortunately she responded. MH had let her out the gate! I have worried this might happen for ages. It's a miracle I got her back and didn't have to go searching the neighbourhood!
There are no real criteria, but frankly, this sounds bad enough to me and I am so sorry, you are having a bad time. Get social services involved now and tell them that you think you can no longer cope and are now getting ready for him to go into care. There are all the things like funding to consider, but please don’t allow that to deter you. Members will be along with more specific procedural advice but I just wanted to say all my sympathy and I think it is time now. Warmest, Geraldine aka kindred
 

margherita

Registered User
May 30, 2017
2,561
Italy, Milan and Acqui Terme
I have worried this might happen for ages. It's a miracle I got her back and didn't have to go searching the neighbourhood!
OMG! Losing my dogs is one of my worst nightmares..
Couldn't you buy your dog one of those " tracking collars"? Sorry I don't know how you call them in English, but I hope you can understand what I mean.
 

Batsue

Registered User
Nov 4, 2014
4,887
Scotland
@Pusskins
My mum is waiting to go into a care home and she is not as bad as your husband. I found that I cannot continue to care for her as she thinks I am her twin sister who she had a very tempestuous relationship with and this causes problems with care and is very stressful to live with.
 

Pusskins

Registered User
Jun 6, 2020
76
New Zealand
OMG! Losing my dogs is one of my worst nightmares..
Couldn't you buy your dog one of those " tracking collars"? Sorry I don't know how you call them in English, but I hope you can understand what I mean.
@margherita I'm not sure if we have tracking collars in NZ, but our Labrador is microchipped so she can be identified if found wandering. I have decided that from now on if I have to go out, the dog comes with me. I don't dare leave her here with MH alone. I agree with your comment. I have begun to question myself. Should I sacrifice my physical and mental health when in the end, it will not save MH anyway. of course I shouldn't. It will be a few weeks before I place him into care, but even so, I'm going to find it very hard to do. Kind of can't live with him, can't live without him. :(
 

Louise7

Registered User
Mar 25, 2016
2,373
As others have said, there is no set 'criteria' in relation to whether a care home is necessary but a carer's ability to cope and their physical/mental health is just as important when making the decision. It sounds as if your husband needs a team of people to deal with the hygiene side of things as this is not something that you can deal with on your own, so that would obviously be of benefit to him in terms of improving his health/welfare. In a previous post you mentioned that you have already placed him on the wait list for a care home so hopefully a place will become available soon. I'm not sure how different the process is in New Zealand but you need to ask for support from the social services equivalent if you haven't already done so. This factsheet may be useful as it covers making the decision about a care home - including considering whether a care home could better meet the person’s needs – and also the various emotions involved in the decision:

https://www.alzheimers.org.uk/get-support/help-dementia-care/care-homes-who-decides-when
 

Pusskins

Registered User
Jun 6, 2020
76
New Zealand
There are no real criteria, but frankly, this sounds bad enough to me and I am so sorry, you are having a bad time. Get social services involved now and tell them that you think you can no longer cope and are now getting ready for him to go into care. There are all the things like funding to consider, but please don’t allow that to deter you. Members will be along with more specific procedural advice but I just wanted to say all my sympathy and I think it is time now. Warmest, Geraldine aka kindred
Thank you, @kindred. I might have made MH sound worse than he is. He doesn't always pee in the wrong places, but has peed into the bath a few times; once he opened the vanity door and peed inside it; more than once he has peed into my bath towels hanging on the rack; and the worst was when he used my 'new' lazy boy as a urinal. He does also use the toilet though, but his toileting habits are becoming unpredictable. In some ways I could cope if only he would let me keep him clean, but I find it very hard to be near him when he looks and smells so awful and I can't get away easily as we live in a small 1 bedroomed cottage.
 

Pusskins

Registered User
Jun 6, 2020
76
New Zealand
As others have said, there is no set 'criteria' in relation to whether a care home is necessary but a carer's ability to cope and their physical/mental health is just as important when making the decision. It sounds as if your husband needs a team of people to deal with the hygiene side of things as this is not something that you can deal with on your own, so that would obviously be of benefit to him in terms of improving his health/welfare. In a previous post you mentioned that you have already placed him on the wait list for a care home so hopefully a place will become available soon. I'm not sure how different the process is in New Zealand but you need to ask for support from the social services equivalent if you haven't already done so. This factsheet may be useful as it covers making the decision about a care home - including considering whether a care home could better meet the person’s needs – and also the various emotions involved in the decision:

https://www.alzheimers.org.uk/get-support/help-dementia-care/care-homes-who-decides-when
@Louise7 Thank you for your response. I have felt for some time that he would be better off in care, but I know he would hate to go there, which makes making the decision so hard. Why I would find it hard I don't know because as I type this he is spitting at my Buddha statue!
 

Hazara8

Registered User
Apr 6, 2015
507
This confuses me. When is a PWD bad enough to go into care? Do they have to finally not recognise who you are, go wandering? What is the criteria? My husband is unable to converse in any meaningful way with me. He refuses to shave or let me wash him. He smells offensive. He does nothing each day except sleep a lot of the time. He is not incontinent but pees in all the wrong places inside the house. He sometimes goes outside to do his business out there and comes inside smelling of poo but won't let me wash and change him. He is suffering hypersexuality, he spits on the floor (carpeted). My patience is wearing thin. When or how do you decide it's time to go into a home?

As I finished typing the above, I realised the dog was nowhere close. Husband was inside, no dog. Went outside, no dog in the yard. I called her and fortunately she responded. MH had let her out the gate! I have worried this might happen for ages. It's a miracle I got her back and didn't have to go searching the neighbourhood!
Assessment is very important in order to try and ascertain the nature of the dementia or related problems. All the things you cite are familiar to the Forum community of people Caring for a loved one with dementia. The transition into Care can come about when things have reached an intolerable stage. You don't want for that because it can be debilitating or psychologically destructive for the Carer. Once the pattern of Care with all its challenges and idiosyncrasies becomes a source of such difficulty that the Care cannot truly function or the one who is Caring is themselves in genuine need of care, then to an extent the time for that transition will become apparent. The running theme of " best interests " runs through the whole process of caring for the one living with dementia. But it must also apply to the one who is Caring, especially if health - both physical and mental - deteriorates and the role of the Carer exacerbates the "dementia caring relationship " in a negative way. None of this is ever easy and every case different. Personally, l could have fun with my late mother over incontinence in the early days. Despite the inconvenience we made it something to be treated as a " norm " and not a reluctant task. But later when cognition was absent and "accidents " were accompanied by upset or hostility, the relationship became much more challenging. I think you will know in your heart of hearts when such a time comes. I am afraid there are no templates for this, other than proven ' stages ' in the progress of dementia and related symptoms. The Carer has to read their own living PWD " book" daily and learn from it. Each chapter can read much the same or suddenly surprise. But when each page does so and then each paragraph and then each sentence - that is when one knows the book might need to be placed to one side and your attention focused on your own book, because YOU matter too . And you matter fundamentally so because you are a Carer and you cannot Care when you are yourself reliant on that very same attention of care to function.