How to handle the move to a care home

It's an awful situation but I'm afraid many of us reach the point where we have to tell our parents what to do - because it for their well-being and safety- even it is not what they want to do.
I had to do it for my dad and it is hateful.

I've never been in this situation but my closest friend is, right now. Her 94-year-old dad has dementia, was told he was going into a care home for respite care (which it was at that point). He settled well and, months later, seems to have forgotten that he owns a bungalow. The family have now sold the property to fund the next few years in the care home.

Prior to that they had tried to have live-in carers but that disturbed him.

My friend and her family are lovely and haven't made one move without feeling terribly guilty and sad that her dad doesn't know about the sale of his home. But it is definitely working out well for him, even if it probably wouldn't have been his first choice.

I think he should be involved. It should be discussed at a level that he can understand and in the context of his life; problems arising; how this move would alleviate those; impact for his family etc.

Dementia (ldoes not remove the right to respect and dignity..even though the motivations for not telling him are I'm sure all intended to be kind and protective

I feel for you all and him

Yes, my two siblings and I made the sad decision for our Mum. She was in hospital at the time, unsafe for her to go home, her dementia meant she couldn’t really understand what we were trying to tell her.
She wasn’t agitated at the move, had forgotten about her own house and thought she was in an hotel, most concerned as she couldn’t ‘tip’ the staff.

I’m with madgran here, he has given you all PoA as he trusts you to respect him and do best by him. Which is of course what you are intending to do. My instinct would also be to keep him informed all the way. Tell him in a matter of fact way, if n doubt take advice from his new home on the best way. They will be experts at this.

If you have PoA for Health and Welfare - then you have the right to decide where he lives. If the PoA is just for financial issues, then, strictly speaking, you need his agreement to the move.

I think he should be kept well informed of your intentions (even if he forgets or has trouble understanding) just in case he has objections. Has he officially lost capacity to make decisions?

Also you can get good advice on communicating on difficult issues with people with dementia from DementiaCareUK

We had a similar situation with our dad. Siblings agreed 2 of us would talk to dad together about his well-being and care going forward. We talked about the POA, and that he’d set it up, and that if we felt we needed to make good decisions for him we would. Obviously talked about how we’d all agreed what was best for him as he wasn’t safe to live alone anymore. He understood no one in the family could step in to do the caring as they all had commitments with their own families. We assured him we’d find a good residential place for him-and pointed out the benefits. ( no worries of running a home, food all served and laundry done- even some entertainment).
We asked him to decide whether to move sooner, or later, & he said sooner.
Took him a while to settle but we knew it was best for him. He’s not mentioned his old home once but did find some other residents irritating. I just tell him to switch off his hearing aids, go to a different room or distract himself with puzzles/tv. After 5 months he now introduces me to new friends. Good luck to you all it’s hard making those decisions

I certainly don’t think you should just spring this on him, lots of conversations with him to try to make him understand first. You’ve obviously had lots of chats with your siblings but I doubt that the thought has occurred to your Father.

By the time MIL was put in a home, she didn’t know where she was and she was deemed to be unsafe in her own home, should she have gone into a home sooner? Probably, but my SIL was adamant that she could look after her.

My view from a purely human perspective is that your father should be involved, it will be a huge adjustment for him and is perhaps best carefully prepared for.

Assuming he has capacity, which he may well have with early stage dementia, my understanding is the H&W LPA can’t be used, it’s only when capacity is lost that attorneys can make decisions and even then with as much involvement as possible. Financial matters are different, the LPA can be used, with the donors permission, while they have capacity. I could of course be wrong, but this is how it was explained to us.

In my experience a move to a Home involves both. LPA’s. Age U.K. or the Alzheimer’s Society could advise I think.

You are all trying to act from a place of love and care in your fathers best interests bytheway. Perhaps an honest chat via zoom or something similar between you all would be sensible to allow everyone to share information and express any worries they may have.

Absolutely tell him in an appropriate way. Love Jaxjacky’s story about her mum. Tried to tip the staff . Ahh.

My father had dementia which got worse dramatically a year ago and he became doubly incontinent. So my brother and I decided to move him to a care home. All the family talked to him about. On the day of the move I was with him and he looked totally amazed when he realised he was staying there and said it was a wicked trick. The first night he wasn't happy, but after that he seemed to settle. Then 10 days later he had a cardiac event, he was taken into hospital where they said he won’t be coming out. Twelve days later he died. The hospital consultant said this often happens when older people are moved. I felt dreadful but we really had no choice. He was unsafe and scared in his own home, couldn’t even work out how to open the front door. Awful time, but we made the decision to keep him safe.

As an only child it fell solely to me after my father died to look after my mother who, at that point, had mid stage dementia.
Luckily I had power of attorney (thank you parents) and when caring for mum became too difficult I moved her into a dementia home but told her repairs/decorating was ongoing at her bungalow and it wasn't safe to live their at that time.
She luckily accepted this and I was able to sell the property to fund her care home fees.
It's an awful time for all concerned. Hope all goes well

Oh my goodness if I put myself in your Dads position I d be mortified if my children put me in a home without even discussing it with me unless I was far gone enough not to know but you say early stages so please do talk with your Dad and hear what he wants and expects
It’s heartbreaking for you all I had my Nan with vascular dementia I looked after in my home for 3 years
When my mum got Alzheimer’s she was not knowing the time of day by the time we had to find her a home, we couldn’t discuss it as she was beyond understanding but I did have to tell her it was just for a night or two and that settled her till the next day
It was awful I can’t even tell you how bad for her me and Dad
Please please don’t just spring it on Dad if he has some understanding still

Elderly people with capacity do have rights. My neighbour point blank refused to move into a care home. His son only had the financial PoA and Frank refused to give permission to use it. He had carers twice a day instead. He had very limited mobility, the house was a complete mess (nobody cleaned or maintained it) and his family worried - but still, he did have the right to choose to stay there.

This has brought back memories and has made me cry. It is so sad having to put a parent into care but when you weigh it all up it is for the best as looking after someone with dementia is very difficult. Our circumstances were different - Dad's wife who was 10 years younger than him died within two weeks of her cancer diagnosis, therefore we had no alternative but to put Dad into care as he had dementia and couldn't possibly look after himself, his wife had been his carer for 10 years. He begged his wife not to send him away but there was nothing that could be done, he went to the same care home that he had spent a week in for respite but this time he had a much nicer room which we said we would pay extra for as we didn't want him moved again. Dad settled really well, he loved the food, and we visited often until covid hit and then it was just FaceTime. When visiting resumed and we could eventually enter his room again, it wasn't long before he died, he was in care for almost three years. The staff were lovely, it wasn't the fanciest of places but we felt he was happy there. I had PoA and sold his house to fund it all. Only you and your siblings can make the decision about his involvement at this stage, I wish you all the luck in the world as it is truly heart breaking.

We told mama she was going for a little holiday so I could have a rest. Within 2 days she had forgotten she had ever lived anywhere else. Good luck.

When my older sister had a stroke, causing dementia and the hospital would not release her to anything other than a nursing home, we activated the Powers of attorney, found a large room in a nice home, had it painted in her favourite colour, used her curtains, brought some furniture and ornaments from her home. When she was brought in in a wheelchair she said, "Oh, there's my cupboard I love so much" (a display cabits with orbaments). BUT the hospital social worker deemed her to have capacity to decide where she wanted the home to be and she chose the town she was living in, which was 143 miles away from where we live. For seven and a half years until her death last year, we trogged up and down that distance one day a month and it was a killer. Check that any social worker involved doesn't say your father has capacity to refuse to go into a care home. And you won't be consulting him, but informing him, since the decision has been made. I'm sure you will do it kindly.

Your father must be involved, LPA doesn’t necessarily mean you can do what you want. He may have capacity for some things and not for others. As others have said, respite in a nursing home initially might help.

My late father went into a nursing home for the last few months of his life, via the hospital pathway - he didn’t have dementia, although the SW at first thought he did because dad wanted to go home, which was (as far as he was concerned) reasonable. We took turns to look after dad for 3 years in his house until he became too physically weak to stay at home with just one person. We should have got help in sooner. But one sister didn’t want to spend the money on care but it seems that the money will go either on care or on tax, so do what makes you feel comfortable.

We searched hard for a good nursing home, and it worked well.It wasn’t the most expensive, but the staff were wonderful, and that’s what is important/

It was, nevertheless, all hugely upsetting. Seeing one’s father deteriorate is very very sad.

🌷🌷🌷

I assume that your two siblings who have principally dealt with all this have done so following one or more consultations with your Dad's GP and have made sure that they legally can take this step on his behalf. I assume you can, as all of you have a power of attorny, but I am not a lawyer.

My field of expertise is history of religion, and going on that background, I can safely say that you and your siblings have a moral duty to take care of your father, now that he is no longer fully competent to make his own decisions.

Most of us feel slightly guilty when facing your dilemma, but really there is no need. You are all doing your best for your father in a very difficult situation, and managing it without falling out with each other in the process. Few siblings do so well!

Someone now needs to tell your father of these plans and agreements you have put in place.

If at all possible, I would suggest that all of you( that is his children ) should be present, delegating the actual telling to one person.

This precaution ensures that you all know exactly what was said and whether your father took it in at all, and if so, how he reacted.

You need all to be prepared for him either refusing point- blank to conform, or at the other extreme forgetting immediately what has been said.

However, the step is necessary for his well-being and for you and your siblings' peace of mind, so the matter will have to be broached.

Depending on how much your father still takes in and remembers of what is said to him, you may find it best to leave the actual announcement until as near the time of his move as possible.

Please do all remember that as dementia increases, it becomes more and more dangerous for a dementia patient to live alone, and that your father both now and later will be far better off being cared for professionally.

If you leave it much longer, you might end in the situation two brothers I have known since we all were children ended up in. Their mother was found wandering in the roadway outside her house unable to find her way back home, at four o' clock on a winter morning when the temperature was well below freezing, clad only in nightie and slippers!

When my brothe in law was getting too much for my sister to deal with the assessment discussed a care home with him. He said he wasn't going to go but 5 minutes later he'd forgotten he didn't want to go. He did go for respite first and got on fine. Then he came home for a bit and the same thing happened, no way was he going to a care home to live. But he was told it was for respite care again as my sister was ill. He was happy to go then, and is very happy there, he thinks he is the care home's resident handyman and he thinks my sister is an old girlfriend from the 60s. Generally speaking as long as you agree with them most dementia patients are content with living in care homes.

I would have to tell my parents, even if they didn't understand. As someone else has said it might be an idea to suggest going in for respite and take it from there.

We couldn’t move mil with vascular dementia into a care home as it was considered by the authorities that she still had mental capacity and therefore could decide for herself. She had carers 4 times a day and it was a constant worry. She ended up in hospital with a twisted gut weighing 5 stone. The hospital wanted to send her home but we refused so a compromise was reached that she would go into a care home for 6 weeks which would be funded. It was such a relief to know she was safe and looked after and we just kept her there. If she asked to go home the staff would divert her question.

You try to keep them at home for as long as possible but sadly it reaches the point where they have deteriorated to the extent that there is no real choice. At the moment if dad is at early stages he had the right to say no and you have to respect that. You can try persuading him but you can’t force him. It is very difficult for caring relatives who know mental capacity or not their parent would be better off in a care home. I think you should take dad to a few care homes to see which ones he likes.

My mum has Alzheimer’s and was transferred to a care home from hospital. She had no insight into her own care needs. She spent most of her early days there fighting to go home, refusing to settle. She has screamed, kicked, sworn at and eventually even bitten the staff as her condition worsened. She is now on a “ much more severe” dementia wing where she has at last found a friend. She tells me she hates me when I go to see her. She is 96. I tell this story because, despite all her objections, she could not have stayed at home. There was no choice. She threw objects at my elderly Dad who had vertigo, hid his iPad, stood in front of the tv, emptied kitchen cupboards in the middle of the night and expected him to clear the mess up and drove any help we got for them out of the house. Alzheimer’s can make people aggressive not gentle and if you do discuss something with them, they can forget the second after you speak. No situation is the same and no situation is easy .