With Hindsight - And given the funds - What I would have looked for in a care home

[Navara]

My mother is now in the late stage of mixed dementia (alzheimers and vascular). She's spent the last three years in a residential care home not specialising in dementia but has now moved into a nursing home which does specialise in dementia. Frankly the difference between the two is staggering!

With hindsight (which as we always say is a wonderful thing) I can now see how much better mum's quality of life could have been had she had the funds to be able to be in this home from the start. They are totally geared around making life good for each individual, and have small dedicated teams for each resident so they get to know them really well. The set up of the building is so much better too. Very large open plan lounge and dining area so that residents who are safe to do so can "wander" to their hearts content, organised activities three times a day, and outings! But of course the best thing is that no-one with dementia has to move on because they can move seamlessly from their wandering days to their bedridden days in their same familiar surroundings.

Of course, this home costs twice as much as her previous home. But with hindsight, and given the funds, this is absolutely the kind of place I'd advise anyone to look out for.

 

[sinkhole]

Hi Navara, I'm glad you've found a good CH, even if you wished you'd found it earlier.

I am in the early stages of looking around for a suitable CH for my aunt, who already has mixed dementia.

We will be self funding.

How did you eventually find the home you've settled on and do you have any tips based on your experiences?

 

[Navara]

Hi Sinkhole - well really it depends on how much money you're going to be able to spend. If you go for a care home with nursing (which will be able to see her through to the end of her days) in my area the cheapest rooms (basic single with shared bathroom) are about £850 a week upwards to £1000 plus for a more luxurious ensuite room.

Most importantly I would look for a home which isn't rigid in its routines. My mother hated sitting still and liked to wander around all day. It made her very unhappy to be told to sit down in a chair in a room where the TV was constantly switched on (which she'd never been inclined to do even when she was well!). I would also look for a flexible approach to mealtimes. Again, my mother grew to detest having to go into the dining room and sit at the table for every meal. She would sometimes have enjoyed and eaten better if she could have had a sandwich on a lap tray in her room or in the lounge.

People with dementia do better if they have familiar faces around them so I like the approach of having key workers who can really get to know the residents little peculiarities.

The home my mother was in had a couple of activity sessions every week but this new place has three optional sessions per day - morning, afternoon and after the evening meal. Even those who don't choose to actively participate can be on the sidelines watching what's going on. It brings a bit of life into their days instead of just sitting there dozing.

The main difference between a residential care home and a care home with nursing is that the latter have medically trained staff on duty at all times so potential health problems should be picked up sooner. Once a resident is deemed in need of nursing care (usually in the later stages of dementia) they will get an NHS allowance (about £110) towards their fees and if their medical need becomes more complex may be entitled to having the full fee paid (but don't rely on this happening!)

Finally I would definitely steer clear of places that have dementia as just one of the categories of resident they care for. I think its much better to go for somewhere specialising in dementia from the start as there will be nothing that phases them, they have an in depth understanding of all the different types of dementia and how they present etc etc.

Good luck with your search. Your aunt is lucky to have such a caring relative.

 

[sinkhole]

Thanks for the information. My situation may become more complex as time goes on because my mother who is 89 (aunt is 86) is also approaching the time when I need to be planning for her future care and my concern recently is that she may be showing early signs of dementia herself.

They both have ongoing health problems which I can only see getting worse, so I can see a care home with nursing would be the best choice for both of them in the long run.

But going back to the question of how you go about finding homes, is it just a matter of Googling and visiting them to see for yourself or are there any independent organisations carrying out inspections or grading them in any way?

 

[Navara]

Yes you can go to the website of the Care Quality Commission to get the latest inspection reports.

The best way to find out what homes are out there locally is to contact your local council. In my area they produce a care homes directory which they emailed to me. It lists all the homes in the local and surrounding areas and the categories of residents they take. There are also some websites which allegedly hold lists of care homes but I've found they are often out of date so can't be entirely trusted.

When you've picked out a few you like the sound of just pop along - most will be very happy to show you around. I found afternoons were always a good time to go as they tend to be very busy in the mornings.

Good luck with your search.

 

[sinkhole]

Thanks, that looks like a couple of good starting points.

 

[canary]

When you go and visit, sinkhole, just turn up unanounced and ask if you can look around. Any decent care home will be quite happy for you to do so and it will also prevent any niggling fear that they were "putting on a show" for you.
Dont worry about the home looking pristine, so long as it is clean and doesnt smell bad - the home mum is in is a bit scruffy round the edges (think homely instead) - what is more important is the way the nurses respond to the residents.
Mums home is small, a dedicated dementia unit (with lock on the door) with bedrooms upstairs and downstairs is a large open-plan lounge and dining room with patio doors opening out onto a patio and raised flower beds that, in summer, means that residents can sit or wander outside. I believe that some of them can do a bit of gardening too. There is also an actively room for crafts, singing or whatever. The thing that impressed me most, though, was the way that the carers seem genuinely fond of the residents and difficult behaviour was dealt with efficiently and with good humour. I saw an argument break out beween two residents that was broken up with the minimum of fuss and one of them led away with the promise of tea and biscuits. One lady has an obsession with cleaning and tidying so she gets given a duster and "helps" the carers. When the tea/coffee trolly is brought round a couple of people are usually recruited to carry mugs or hand out the biscuit tin (they know who not to recruit too!). The first time that mum lashed out at one of the carers I was told about it and I was appalled, but they were unfazed, said not to worry and they would know how to deal with that situation again.
You might want to ask what sort of things they would feel that they could not deal with and under what circumstances they would feel that they could not accommodate someones needs and they would need to move.
Mum is happy there and thinks that it is her own home. So there are good homes around.

 

[sinkhole]

When you go and visit, sinkhole, just turn up unanounced and ask if you can look around. Any decent care home will be quite happy for you to do so and it will also prevent any niggling fear that they were "putting on a show" for you.

Do you mean to just turn up without even calling them first? I would have thought care homes would be quite touchy about security and unannounced visits.

 

[Navara]

They should be fine about you just turning up. As I've said, afternoon is always a good time as much of the serious business of the day - washing, showering, dressing, visits from doctors and so on takes place in the mornings and staff have more time after lunch when residents are napping!

You won't just be able to walk in by the way - they will all have security doors to stop the wanderers from wandering.

 

[Ladybird23]

We went by word of mouth as we knew someone who had been in Dads CH. We are welcome to go anytime, and ring anytime. Although if I ring I will ring after 11am when all the necessary CH things have been done.

The CH is always clean and residents are treated well.

 

[blackb15]

Because of the difficulties I'm having with mum I'm looking for a home in the moment and this information is really interesting i'm trying to work out who will fund it ,as any home I like is towards the top financial range.
Social, services don't think she needs a care home but she's not allowing the carers in the house normally or then them to feed her .Most importantly she is no longer happy at home being on her own so much although I visit for several hours every day.
Anyway thanks very much for the advice I will continue to look and try and get to the answer re the funding.

 

[Navara]

Well its actually pretty straightforward. If she owns her own home you can sell it and use the funds to pay for her care. If not, then unfortunately, unless she has plenty of savings, you'll have to wait until the local authority decide she can't manage in her own home any longer.

That's why I started this thread - to show how, even though people complain about having to pay for their care, if you have money you can do everything independently.

My sister and I decided when our mum needed to go into a care home. We chose a middle of the range home as she isn't a wealthy woman, but if she had been there are some top of the range ones we could have looked at. If you're going to have to rely on your local authority to pay for care there isn't much point setting your sights on the higher priced homes unless you yourself or another family member have sufficient income to be able to 'top up' her fees for her.

 

[sinkhole]

I paid my first visit to a care home today, in preparation for my aunt's developing condition. It is at the top of our price range, but it would be able to cope with almost anything from what I saw.

I'll probably also look at a couple of other mid-range homes and then I'll have some options when it comes to making a decision (who knows when that might be!).

The more options and choices the better, because from what I'm hearing the time to make a decision may come very suddenly and so to be prepared and familiar with the process and environment should make things a little less stressful.

 

[Pickles53]

The more options and choices the better, because from what I'm hearing the time to make a decision may come very suddenly and so to be prepared and familiar with the process and environment should make things a little less stressful.

Agree 100%. We were planning for my mum to move to a care home within six months and had identified our first choice. When she fell it brought all our plans forward but it would have been much harder to have to make a decision in a crisis situation.

 

[jen54]

we are also ringing around, and going to see some homes in our area- they are not cheap, but I am praying it will only be respite if any crisis. and residential last resort- I think mum could afford the best for about 6 years not sure if this new cap will help eek out her assets a bit more? but hoping to find somewhere that is dementia specialist, secure, and person orientated etc and have nursing too, so if she becomes ill she wont have top move it is making me so sad having to do this, I know I would not want to go live in one- and I know mum wouldn't want to. But need to cover all bases, as not sure what is to come.

 

[Navara]

You're all doing the right things. Its not easy, many sleepless hours eh? But at the end of the day we have to keep them safe don't we.