When is it time for a care home?

[Rosie72]

Hello - I'm new to the forum and wanted to ask advice. My mum lives on her own in sheltered housing in a second floor flat. She has carers going in for half an hour morning and evening and has meals on wheels at lunch time. She goes to a day centre one day a week, but it is becoming increasingly difficult to get her there as she says she doesn't like it. She is becoming very isolated and basically just sits in her chair all day watching TV.

More recently she is having delusions and imagining all kinds of horrible things such as me having my throat cut or my niece being kidnapped and killed. When she has these thoughts she becomes very distressed and agitated. Last week she was found wandering outside in a distressed state because she thought her brother had died (in fact he died 20 years ago). This is the first time I know of that she has wandered out of the flat and negotiated the stairs on her own.

I worry about her constantly as she has now lost the ability to use the phone and I hate to think of her alone feeling upset. She keeps saying she wants to live with me or with someone who will care for her and asks me not to leave her alone. I have spoken with social services and they said they would aim to keep her at home for as long as possible but will up her care package. My main concern is if she wandered again as she lives right by a main road and by a level crossing.

I never thought I would want my mum to go into a care home, but now feel this would be the best option - I could ask for her to be moved closer to me so that I could see her every day and I would at least know she was not alone and that she was safe.

Any thought or words of wisdom?

 

[jenniferpa]

Hi Rosie and welcome to Talking Point.

There isn't (of course) a hard and fast rule but there are some pointers. Is the person still safe? And by safe I mean not only not likely to fall etc but are they able to recognise danger (say fire) and exit the property or call for help. Are they frightened to be left alone? Is their life worse (as in quality) now than it would be in a good home? Have you (as the carer) reached the point where you can't give more?

Some of those might be contradictory, and I suspect there are others that I can't think of at the moment. I'm afraid that social services idea of upping the care package is probably not going to solve the fear or safety issues.

 

[Dibs]

Hi Rosie

My experience with my mum was similar to yours. My mum lived in a retirement apartment had 4 visits a day from carers and myself popping in and out. Like your mum mine lost the ability to use the phone, was extremely lonely and didn't like being left on her own. She too started wandering at night within the the apartment complex knocking on neighbours doors. My biggest fear was that mum would end up wandering out of the building. I kept a list of everything mum did to show how she was deteriorating and social services agreed that the time was right for my mum to go into care as we all agreed it was better to do so when we did than wait until an emergency happened. My gut instinct also told me it was the right time. It is an extremely hard thing to do but my mum has now been in her carehome for 17 months and is well looked after and cared for and I know she is safe and I spend quality time with her without all the stresses that we hd before. It isn't an easy decision to make but it can work out for the best.
Take care Dibs (Deborah)

 

[Mariondb]

I think SW's rule of thumb i.e. their set of rules is to up the care to a maximum of 4 visits per day, if that doesn't work then the next stage is a Care Home. That should handle their "care" of course while the carers are there, but and it is a big but, it does not take account of their vulnerability in the "in between" times when they are on their own, i.e. if they are mobile and wander then that is a danger to them and a severe worry to you.

Their welfare and safety comes first rather than any broad based guidelines set by SW's. If you feel your Mum's best safety needs are that she goes to a Care Home - and from what you say she does not seem opposed to that idea - then perhaps that is the best route for all concerned.

I would speak to the SW again and tell her that whilst 4 visits a day may well cover her care needs, it really isn't the upping of care that is the issue, it is actually her safety and welfare and see what they say. Make sure they are well aware of exactly what you have said here. They have to take account of it, because of "accountability".

It is difficult of course, and everyone would prefer to stay in their own home, but I really do feel it is our job to look after the safety of our parents as they used to do for us.

 

[Grannie G]

Hello Rosie

Social Services are not taking into account your mother`s feelings and loss of skills.

She is afraid and has expressed the wish to live with others.

She has been found wandering, no care package will cover that.

She is unable to contact someone for help now she has lost the ability to use the phone.

She is at risk.

 

[Katie.white]

I was in the same position up to about 2 months ago although my mother wasn't in sheltered housing. She too had started going for "walks", was unable to use the phone, cooker, washing machine or anything else, was very lonely and had become virtually incoherent. Just as I was going to up her care again and the AS had arranged for another extra day at the day centre my brother found her upstairs on the floor, we still don't know what happened and never will but I had no choice but to put her in a care home when she was discharged from hospital. Fortunately, I'd found a nice one for respite care.

It's not just the fact that mum was alone a lot of the time especially during the night and she didn't sleep either it's also the fact that anyone could have knocked on the door and she would have opened it and she was so vulnerable.

My heart goes out to you if you read my posts you will see that even now I am racked with guilt about doing it but I know I've done the right thing.

 

[sussexsue]

Social Services are not taking into account your mother`s feelings and loss of skills.
She is afraid and has expressed the wish to live with others.
She has been found wandering, no care package will cover that.
She is unable to contact someone for help now she has lost the ability to use the phone.
She is at risk.

Totally agree. Your poor mum is frightened, nothing makes sense any more, and worse still there is no one there she can turn to for help. Many of us who care for people will tell you that they want to keep us in their sight at all time, and this probably what your mum wants. Someone to tell her what to do, to make all the decisions for her, to keep her safe. Think you should be pushing for a Care home.

 

[allend100]

Hi

I have just found a care home for mum, she has been cared for at home by her partner and has carers every morning to get her up and dressed. He is due to go in hospital next week for a procedure on his back which will need some recovery time. We've coped so far with a mixture of family chipping in but none of us feel we can adequately care for mum when he goes into hospital. We reached the decision by considering what was safest for her and that was care home. We've visited 5 or 6 homes and have made a choice with the help of social services. Convincing her partner was tricky but he has come round when we said it would be better for us to have input into choosing the carehome than wait for a crisis. I'm crsooing everything that she settles.


Denise

 

[FifiMo]

There is a lot to be said for someone going into a care home at a stage when they are able to benefit and gain quality of life by being there and can get involved in the various activities etc. All too often admission to care homes happens as a result of a crisis or an accident or some drastic deterioration happening and I think that this is unfortunate as the nature of this kind of admission can also lead to greater confusion and a harder time settling in.

My mother, who would have boarded up her house in order to stay in it, went into a nursing home a couple of weeks ago and she is absolutely loving it. The person who sat at home watching the tv is now in the day room till all hours chatting with everyone. She goes off to the hairdressers, goes to the reminiscing group, has taken up knitting, but has yet to be persuaded to go to Bingo ! hahaha When I left her last weekend she was sitting with her new friends waiting for Strictly come Dancing to come on the tv! So, it could be that your mum, despite all her protests, could end up like mine and enjoy the company and have a new lease of life.

Would it be possible perhaps for you to find a nice home and maybe book her in for a week's respite as a trial to see how she gets on? Some homes do offer trial periods.

Fiona

 

[Rosie72]

Hello and thank you all for your kind words. Mum has been very distressed again today and imagining that there is a man in her flat who is assaulting her. She was also found wandering outside her flat again (having negotiated the stairs on her own).

I think one of the issues for social services is the financial cost, as mum has very little by way of savings so would have to be fully funded. My concern is that if she continues to wander, they will consider her an emergency and move her into somewhere that I would not have chosen. I would ideally like her to be close to me.

Can anyone tell me what normally happens in this situation - do I get any choice about where she goes, or does it all come down to cost? There is a place near me which is a specialised dementia care home but is quite expensive, so I guess that would be out of the question.

Thanks again for all the advice.