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When is the right time for a care home?

Discussion in 'I care for a person with dementia' started by Nick71, Sep 9, 2015.

  1. Nick71

    Nick71 Registered User

    Sep 9, 2015
    I'm caring for my Aunt who has vascular dementia; she's widowed and lives alone. She never had children of her own.
    Her symptoms started around 3 years ago following a TIA; if I'm honest it was probably there before that event, you just put it down to them being old and absent minded.
    Gradually she has become more than forgetful. She still waits for her husband to come home and believes her mother is still alive. She hears "men in the kitchen" at night and imagines she's had visitors during the day but doesn't know who they were. She's even forgetting who I am on occasion.
    We buy her food occasionally as we're certain she isn't buying much in the way of food; we check her cupboards and fridge while we visit to make sure she's got something.
    Her medications, even though they are provided by Boots in daily burst capsules, we still have to decant these into something familiar to her - otherwise she takes too many on the wrong day.
    She's increasingly distressed when the slightest mishap occurs; a cupboard handle comes off and it's the end of the world!
    She's conscious that something is wrong and gets worked up about it, telling me she "..never used to be like this" and "..why is this happening now?".

    Yesterday I had the big talk with her about her condition, (instead of just sugar coating it) and, at the time, she took it in and realised it wasn't going to get better. She herself brought up the care home question. She recognises she can't cope well and, and although we have talked about it in the past (and she promptly forgot about it). This time there was a hint of acceptance. We talked about what furniture she could take with her and what facilities there would be at the care home. We also discussed what other arrangements we'd need; power of attorney etc..
    That being said, this morning when I called her to see how she was, she had forgotten about it all together (no surprises there), but we're going to have another talk tonight after work.

    So my big question is - is it too early to be moving my aunt to a care home?
  2. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    North West
    Some people have found that if someone goes, more or less willingly, into a care home before it becomes absolutely necessary, they often settle in very well. But as with anything to do with dementia, there are no hard and fast rules.

    Welcome to TP.
  3. Beate

    Beate Registered User

    May 21, 2014
    No it isn't too early. Especially when someone lives alone and has problems like wandering or not taking medication properly, it is often the best solution. But get LPAs sorted!
  4. arielsmelody

    arielsmelody Registered User

    Jul 16, 2015
    Is finance in place? At this stage, it sounds as if your Aunt would probably have to be self-funding, and have you looked into the cost of a home long term?

    Have you looked at the option of care visits a few times a day? My MIL has problems with taking pills and eating, and she has carers coming in to help (with limited success, but at least it is something, and she is someone who is determined to stay in her own home).
  5. Nick71

    Nick71 Registered User

    Sep 9, 2015
    We've looked into care homes in the local area; there are a few, not all are suitable.
    We're planning on taking her around a few of them so she can make a decision; I want this to be down to her and not for it to seem like we're shoving her in a home to get rid of the problem.

    She will be self funding and selling her home will be a necessity, and I've made an appointment to sort out the LPAs for next week. The solicitors were very understanding.
    Right now the it's a massive weight on my shoulders; I can't help feeling guilty about the care home decision, somehow it feels like I am taking her independence away and locking her up just for my own wellbeing.
  6. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    North West
    #6 stanleypj, Sep 10, 2015
    Last edited: Sep 10, 2015
    No, you're doing it for her wellbeing! But you will also, when things settle, be less stressed, which is good. You will not stop caring for your aunt just because she is living elsewhere.
  7. Risa

    Risa Registered User

    Apr 13, 2015
    Hi Nick

    As already suggested, try having carers come in to see how that works out and it could give your Aunt a while longer at home. Being realistic though, your Aunt's need for assistance will increase as the illness progresses and if you are not in a position to care for her full time then you shouldn't feel guilty about it. By looking out for her and ensuring that her safety and well being are taken care of, you are still caring for her.
  8. AndreaP

    AndreaP Registered User

    Well Nick don't get your hopes up! She may talk about a care home, may even look at a couple but then she will probably back out. Making decisions is one of the first things to go in my experience and deciding to leave your home and go somewhere unfamiliar is very very difficult for someone with dementia.

    Paranoia is very common and the paranoia can have no logic attached to it eg she hears people in the kitchen and a normal person would investigate, find nothing amiss and that would be it. The dementia sufferer doesn't think it odd that these people return every night. It doesn't enter their head that there is no way of anyone getting in or that that the whole scenario is too bizarre to be true.

    Paranoia basically means that they feel threatened and unsafe so entering a new environment is particularly frightening. All sorts of fears would be going through her head. My mother is in a care home and carries her empty handbag everywhere in the home. Otherwise someone will steal her purse you see even though there is no purse or money in it. Makes perfect sense to her though.

    It's virtually unheard of for anyone to go willingly into a CH so be prepared for resistance. You may well have to resort to coercion. We told mum she was going for a try out and once she was ensconced and asking to go home we had to say no. You could always say "the doctor says you can't live alone anymore" as doctors are generally revered by that generation.

    Good luck - I hope for your sake it goes without hitch.
  9. Nick71

    Nick71 Registered User

    Sep 9, 2015
    Thanks for the replies and insights.

    We saw a nurse at her surgery yesterday for something unrelated; however the conversation turned to her care as it was obvious to the nurse what was wrong. She was certain that the time was right for a home, but in the meantime, advised us to get a carer to call in regularly to ensure auntie is safe, eating well and generally not getting into too much mischief.
    She also gave advice and even made an appointment to see another GP about the medication auntie is on. One previous GP suggested that any drugs which may "help" with the dementia could not be taken as she was on another drug for her epilepsy, Phenytoin (she's not had a fit in over 12 years).

    Anyway, we'll be sorting a carer out to visit her at home just as soon as we find out how to do so, social services probably.

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