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When to move to residential care: Earlier or later?

Mwalimu

New member
Jan 28, 2022
4
0
Hello all,

Our mother, aged 72, has been diagnosed with Alzheimer's and vascular dementia. She lives alone in a large house where she has lived for 40 years.

She is in the early stages but it appears to be progressing quickly. She is developing paranoia and exhibiting distrust in those who care for her. Particularly around money and jewellery. Hiding things. Increasingly sensitive to perceived slights and easily angered. However, physically she is very strong. She swims at the local pool three times a week and walks 3 miles in her local park almost every day.

The house is a source of stress we have observed. When out of the home, and in the company of others, she does very well. You may not even know she had dementia bar some repeated questions. But inside the home she is anxious and easily agitated.

The usual path to a care facility appears to be keep someone in their own home until some catastrophe occurs or it otherwise becomes apparent it is not safe for them to live there any longer.

But I wondered what people thought of moving early to a care facilty while they are physically and mentally still quite robust? Might an earl move have advantages? Develop familiarity with the place and find the change less stressful, take better advantage of the opportunities for social interaction, and make the eventual move to a higher level of care easier.

What are the disadvantages? Cost, the risk they will run away back to their home as the condition advances. Curious to hear others' views on this.
 

northumbrian_k

Volunteer Host
Mar 2, 2017
2,464
0
Newcastle
Hi @Mwalimu and welcome to Dementia Talking Point. You will find this to be a friendly, helpful and supportive community. I am not best placed to answer as it is my wife who has dementia. As she was living with me rather than on her own this may have meant that her dementia was more advanced before she needed residential care. However, I was keen that she had sufficient of her old self for staff to be able to relate to her as a person. As they would say, she still has a personality. This has helped her settle in. I hope that this helps.
 
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Grannie G

Volunteer Moderator
Apr 3, 2006
76,335
0
Kent
Hello @Mwalimu. Welcome.

My base line is the risk or fear factor.

Do you feel your mother is at risk of harm in any way, eg to herself or to her property?

Does your mother seem to be afraid of being alone?

From my experience after having a mother and a husband with dementia, my mother went into residential care at an earlier stage than my husband.

I felt, even with Monday-Friday day care, there were too many hours in the day and night when my mother was by herself. My husband was never left alone once he passed the stage when he wasn`t sure where I was, but I was able to keep him at home where he was well supervised.

There are care homes, not necessarily only for people with dementia, which do have secure exits.
 

JHA

Registered User
Aug 7, 2021
643
0
My mom is quite fit and at times totally with it she lived alone with no carers only me visiting every morning and a phone call late afternoon. Unfortunately she hallucinates and begun to leave her house in the middle of the night - the first time she went out looking for my son could not find him so returned home. She promised if she ever felt the need to leave again she would ring me but sadly that never happened. I had a phone call from the police just before 1am one morning to say that she was on the corner of her road because there was someone in her house. As expected there was nobody there but it became evident that she could not be left alone any longer.

I stayed with her for 8 days before I admitted defeat and took her to a respite bed in a care home with the intention of her remaining there permanently. Unfortunately as she is fully aware at times of where she is settling in to put it bluntly has been a nightmare she is doing her utmost to leave or to get them to make her leave. Its still early days (just over four weeks) and as they are on lockdown following a covid case I have not been into visit - I have spoken to her on the phone a couple of times but the last time she floored me by calling me all the names under the sun I have taken a step back as it was doing neither her or me any good.

Part of me wishes that I could have waited a little longer but I could no longer ensure her safety and only managed the 8 days as it was just before Christmas/New Year.
 

Jaded'n'faded

Registered User
Jan 23, 2019
3,430
0
High Peak
Hi @Mwalimu a lot of people do well in care homes because they enjoy the company and don't have to worry about looking after a house, meals, etc.

However, as you surmise, the way it usually happens is after care at home has failed. The main thing you are up against is your mum. If she would be happy to move to a care home, that's great, and if she's self funding you can just go ahead and find one. If she refuses, (and most people do!) you have a major problem. You can't put someone in a home against their will so it all comes down to whether the person has capacity. If they do, they can live where they want. Most care homes have locked doors and need a Deprivation of Liberty Safeguarding order for each resident in order to keep them there. This is only granted when the person has lost capacity and a social worker determines that they need to remain in the home on a 'Best Interests' basis.

As your mum is still going out and about by herself it sounds like she still has capacity so you would only be able to move her into care if she agrees. If she does, go for it!
 

Helly68

Registered User
Mar 12, 2018
1,312
0
My Mum went into a CH fairly early, whilst still physically fit, and I think it worked for her.
You could try respite or going to a CH during the day, if you are self funding to try it out. The only thing that occurs to me is that most homes may struggle with the staffing to take her swimming/walking with the frequency you mention. I did regularly take Mummy out, whilst she was able, while in a CH. There was never any issue about this as long as we told them where we were going.
 

Mwalimu

New member
Jan 28, 2022
4
0
Thank you everyone for your thougtful advice.

Mum says she is willing to go into a care facility but usually she says this is when she is having a bad moment. Her mind is highly changeable. So there would be the risk she moves and then decides otherwise, for example if she had a bad interaction with another resident or staff member.

A difficult judgement to make.
 

Sarasa

Volunteer Host
Apr 13, 2018
5,044
0
Nottinghamshire
Hi @Mwalimu and a warm welcome to Dementia Talking Point from me.
Both my mother and my mother in law are ninety-four and both have advanced dementia. My mum went into care three and a half years ago, but mother in law stayed at home until six months ago. The difference in MiL staying at home longer was partly to do with available care from the family. My brother in law lived nearby and called in twice a day, and the other three sibling visited regularly. When mum was at home I only saw her twice a week as it was a bit of a faff to get to her place, and my brother saw her rarely, though he did have her to stay a couple of times a year. However, the main difference was that mum was very mobile, insisted on going out at least once a day and she was also getting more and more paranoid about various things. Fire in the attic, neighbours stealing etc. She was often calling the police and fire brigade. MiL on the other hand was happy to sit at home with the newspaper and her beloved books, and as long as she was continent and could prepare simple meals things were more or less fine.
I moved mum into care when she started drinking with random men in the local pub and bought at least one of them home. My husband felt it was too early as mum sort of knew where she lived and hated the thought of being shut up in a home. She tried to escape a few times and the first few months were really tricky. However I felt it was the right thing to do, it was shown she no longer had capacity to make decisions, and I was happy that she was at least safe if not exactly happy. MiL moved when she no longer could do anything for her self, no longer understood what she was reading, and became incontinent. By then she had carers three times a day, but that wasn't enough. She's settled really well and I don't think she realises she is somewhere else. I moved mum at about the same time as MiL went into care as we've moved 150 miles away from where mum was. The move went well and like MiL I think mum doesn't really understand she has moved.
I think a move now would be a good idea. The first home mum was in had amazing activities, and though mum didn't get as involved in them as I'd hoped she was happy to go along with things if I was there. The two of us were part an amazing flash-mob dance in a local shopping centre for instance. If you find the right home your mum will settle, though it might take some time
 

Bod

Registered User
Aug 30, 2013
1,584
0
Hello all,

Our mother, aged 72, has been diagnosed with Alzheimer's and vascular dementia. She lives alone in a large house where she has lived for 40 years.

She is in the early stages but it appears to be progressing quickly. She is developing paranoia and exhibiting distrust in those who care for her. Particularly around money and jewellery. Hiding things. Increasingly sensitive to perceived slights and easily angered. However, physically she is very strong. She swims at the local pool three times a week and walks 3 miles in her local park almost every day.

The house is a source of stress we have observed. When out of the home, and in the company of others, she does very well. You may not even know she had dementia bar some repeated questions. But inside the home she is anxious and easily agitated.

The usual path to a care facility appears to be keep someone in their own home until some catastrophe occurs or it otherwise becomes apparent it is not safe for them to live there any longer.

But I wondered what people thought of moving early to a care facilty while they are physically and mentally still quite robust? Might an earl move have advantages? Develop familiarity with the place and find the change less stressful, take better advantage of the opportunities for social interaction, and make the eventual move to a higher level of care easier.

What are the disadvantages? Cost, the risk they will run away back to their home as the condition advances. Curious to hear others' views on this.
My argument would be, if you can find a Care Home now, that can cater for her current needs, swimming walking, as well as future needs as the dementia progresses. Then a move sooner, will allow her to settle whilst she is able to take part in activities, trips out, and enjoy them fully.
Yes it will be expensive, but to put against that, the house maintenance, the cost of bring in care to her, not just personal care, but collecting shopping, medication,papers, etc. it all adds up.
Seeing my father's joy at taking part in musical activites, I knew I'd done the right thing, just I should have done it earlier, before he got truely confusied in his own house.

Bod
 
Jan 30, 2022
1
0
I am currently in the same position, as Mum is in her 5th year of vascular dementia, she was diagnosed while living at home with Dad who had early onset Alzeimers. I gave up work and supported Mum to look after Dad at home as Mum had refused all external support and help. As I had worked supporting people with learning disabilities, I brought in social services in 'Dads best interest' This meant he got one on one care and social events away from Mum going her the rest and giving Dad the social input. And respite of 6 weeks, this 6 weeks was just so helpful as Dad got the stimulation he needed. Eventually it was the decision of the social worker in Mum and Dads 'best interest' that Dad went into full time care. Dad died recently after a fall after 3 very settled, happy years in his 'New Home'.
Mum needs help for herself now. and again, she is refusing. This time after being responsible for putting Dad in a home well before he should have been I find it hard to get Social workers involved, but now I have all the problems previously mentioned and Mum is much worse than Dad ever was. I know she needs it but don't feel that after Dadinner old be left to make the decision again. When my brother and sister have had little involvemet. I agree totally that if there is a risk to health and after exhausting all help that is available either through charity groups or social services then next step has to be full time care. And once in there you can still use charity groups and volunteers to take Mum out swimming and walkinģ. There are also carers who are experienced,trained and qualified in dementia one on one. You can pay per hour (interview with Mum) and find her 'new friend'carer someone both you and and your Mum likes and trusts. I think it will give you peace of mind that you are not taking away her independence. Just remember every decision you make you have Mum's Best Interest heart.
 

FranL

Registered User
Jan 22, 2022
22
0
Hello all,

Our mother, aged 72, has been diagnosed with Alzheimer's and vascular dementia. She lives alone in a large house where she has lived for 40 years.

She is in the early stages but it appears to be progressing quickly. She is developing paranoia and exhibiting distrust in those who care for her. Particularly around money and jewellery. Hiding things. Increasingly sensitive to perceived slights and easily angered. However, physically she is very strong. She swims at the local pool three times a week and walks 3 miles in her local park almost every day.

The house is a source of stress we have observed. When out of the home, and in the company of others, she does very well. You may not even know she had dementia bar some repeated questions. But inside the home she is anxious and easily agitated.

The usual path to a care facility appears to be keep someone in their own home until some catastrophe occurs or it otherwise becomes apparent it is not safe for them to live there any longer.

But I wondered what people thought of moving early to a care facilty while they are physically and mentally still quite robust? Might an earl move have advantages? Develop familiarity with the place and find the change less stressful, take better advantage of the opportunities for social interaction, and make the eventual move to a higher level of care easier.

What are the disadvantages? Cost, the risk they will run away back to their home as the condition advances. Curious to hear others' views on this.
My mum was moved into a care home by the hospital a couple of weeks ago following an ‘incident’. On good days she knows exactly where she is and still wants to go home. We are waiting for a social services review to decide what happens next. I live in fear of her going back to her home as she will not allow careers in - wont even have a window cleaner. My husband and I have been cleaning her house, one room at a time, while she has been in the home and it is vey obvious to us that she cannot cope on her own seeing the state of the house. She has vascular and frontotemporal dementia. like your mum, mine had paranoia, has become distrustful at times and she also hallucinates. She told me yesterday that she had to leave the care home as it was being bombed with coal from helicopter. It is very difficult to decide the right time…if her social worker says she can go home but I disagree, she will blame me forever! My mum is still very healthy and active otherwise and she is struggling with being the most active in her home. Have you considered respite care to see how she settles in - she may want to stay?