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Care & carers

How to tell Dad that he needs residential care

(74 Posts)
Mishap Fri 26-Apr-13 19:27:12

Many of you will know the saga of my poor 93 year old Dad.

Things are not really working out with his care at home - he is simply to ill to be dealt with at home. There are problems with the carers and the package is so huge that the cost is nearly £1900 per week. It is not sustainable either financially or practically.

He may get continuing health care funding, but this does not solve the whole problem. We have to have two care agencies involved for both live-in and waking night care. There is friction between them and the carers are not really up to scratch. My sister, who lives locally to him, is spending hours dealing with problems - and I am up to my eyes in appeasing the carers and generally trying to monitor and supervise what is going on from a distance. It takes up a large chunk of each day.

The bottom line is that I do not think we will ever get together a care package that will properly meet his needs. We have found an excellent home (we know it is good because a previous family member was there) and need to try and broach this subject with him. I simply do not know where to start. I just keep thinking how I would feel if someone said that to me and wanted to tear me away from my beloved home.

Anyone had to face this challenge? It is filling my every waking moment with worry. It is so cruel to see him in this condition.

j08 Fri 26-Apr-13 19:31:13

Oh Mishap this is so sad. I am really sorry him being at home has not worked out well.

I guess the only thing you can do is praise the home to high heavens to him. Does he remember the previous family member who went there? If so, that might help. I do hope he comes round to the idea.

j08 Fri 26-Apr-13 19:33:10

I would feel the same as you about being taken away from my home, but perhaps he is coming to realise that this is the best thing. Maybe when we are older, we will see things differently. Who knows?

absent Fri 26-Apr-13 19:39:10

Mishap You may be surprised. When my mother needed help and we moved her to our house (not quite the same as a care home, I agree) we suggested that it was on a temporary basis in spite of knowing that it was for the duration. As time went on – and as her well-being deteriorated – she took it for granted that our home was her home and that was the place was she was happiest, safest and most content and secure.

gracesmum Fri 26-Apr-13 19:40:05

Could you try an "introductory" /respite stay? He might like it better than he thinks.I remember my Dad insisting he would have to be carried out of his house feet first and then out of the blue I got a phone call (350miles away) to say he wasn't coping, could I get him into a home NOW. Sometimes they are more aware of the situation than we give them credit for.
Would appealing to his fatherly instinct (you can't manage this and it is wearing your sister down) i.e. for your sakes also be any use?
Horrid problem, but how wonderful to know you have a good care home available.

gracesmum Fri 26-Apr-13 19:40:31

Great minds, absent!

grannyactivist Fri 26-Apr-13 19:46:16

absent we did something similar when my husband's gran needed nursing home care. Initially she went in because she'd had a bad fall and needed nursing care whilst recuperating - and over time she came to the realisation that she would continue to need nursing care. It was slightly easier for her than Mishap's dad though as she had already left her home of fifty years in order to move closer to family.
Mishap there isn't going to be an easy way to broach this subject, I'm afraid, but your love and care for your dad shine through all of your posts about him so I'm sure he'll know you have his best interests at heart. (((hug)))

kittylester Fri 26-Apr-13 19:46:51

Mishap lots of ((((hugs)))) What a rotten time you are having.

We've been there and eventually persuaded mum that it was worth a month's trial and sort of didn't mention going back. Of course Mum has dementia which I don't think is applicable to your father but I have heard of lots of older people relaxing once the stress of everything at home is taken away.

Also, my Mum and I have had a difficult relationship so I think I was able to be more practical about things than my brothers who agonised for ages about whether it was the right thing to do or not. I don't think that applies with your father either.

It will probably be a good thing for your sister too as you have mentioned that she has problems of her own and one should take a holistic view of this problem.

It is obviously the right thing to do but a really difficult situation. Take care. flowers

merlotgran Fri 26-Apr-13 19:56:52

Mishap. Mum settled quickly into her nursing home. I didn't know where to start when it came to telling her so I asked her if she trusted me to make the right decisions regarding her care. She said she had always trusted me so I told her she was going to a nursing home to assess her care needs and if she liked it she could stay there. She was confused for a day or two but soon became calm and relaxed.

I don't think she has much longer but am now reassured that she will receive the appropriate care when the end comes.

It's not easy. I hope it all goes well. flowers

Elegran Fri 26-Apr-13 20:12:56

Would they take him for a week or two's respite care, as "Gracesmum" suggests? After a while being looked after properly, not having friction between the sets of carers, and with you saying how relieved you are that it is all being taken care of professionally and saving you work and worry, he could easily find it very pleasant to be there.

It is not easy. Home seems best to him, but the reality is, it is not always best.

Florence56 Fri 26-Apr-13 20:24:53

Hello Mishap, really feel for you - its such a dilemma. In our case (frail parent with mobility and mild dementia problems) we realised that he thought we were coping with all his needs AND the stress. So we began to let him see we were not doing such a good job and that there might be somewhere that would do it a lot better.( We didn't actually do anything less - just voiced our concernes/frustrations more and in his hearing). By shielding him too much we were not really doing any of us any favours. The care home we found suited him down to the ground, It was more like a country house hotel but with lovely warm caring staff who treated him as gentleman. Promises of daily visits, a direct phone line etc reassured him that we were still very much 'taking care of him'. I do hope you find a solution for you all.

nanaej Fri 26-Apr-13 20:41:40

Sending you positive vibes mishap Cannot be easy.

However on an encouraging note a friend of mine, whose dad is in his 90s & who lived in a very isolated house on his own despite various ailments including serious sight loss, has been pleasantly surprised by how happy he is now in a care home. It happened when she was away on a holiday and he had gone to stay with her brother. She lived an hour away from her dad & her brother more like 3 hours away. Her dad had always been resolute that he did not want to go into a care home though now denies he ever resisted such suggestions!

FlicketyB Fri 26-Apr-13 20:46:05

Why not start with Elegran's suggestion and encourage him to go in to home for respite care. You could offer the problems with Carers, that they may not be able to come all the time required, you could suggest that it is you and your sister who are failing (health and stamina wise) and need a break (not, of course that HE needs the care) and because of the problems with care, you could not relax during your break if you were worried about his home care. It may work

If it does work, once in care talk in short term increments to his stay. An uncle of mine went into a care home straight from hospital. To begin with it was suggested that it was convalescence, then as the weather was cold and it was November, it was suggested he extend his stay until Christmas, he then decided to stay until winter was over and by then was settled and happy and decided to stay permanently.

If oblique methods like this do not work. You have to gently present him with the facts, the unreliability of carers, the cost and the strain on you and your sister and the effect this will have on the quality of his life, again suggest a short stay.

The alternative is the situation I found myself in several years ago when a hospital discharged a physically disabled dementia patient home to live with their physically disabled spouse who also had dementia and thought carers three times a day for half an hour would be adequate. In three days they had 1 visits from the GP, 1 visit from the locum, 2 from paramedics and 2 from the psychiatric nurses as a result of accidents and other problems. At which point I rang social services to get me two care home places immediately (they were self funding). I moved them in the next day. It was distressing and traumatic for all of us and I was persona non grata for some time, but, for their sakes, and mine, it was the only thing we could do.

Mishap Fri 26-Apr-13 21:07:58

Sadly Dad does have the beginnings of dementia - it is very variable - he is with-it at times but not at others. He has some paranoia, wanting his stick to defend himself. And then 10 minutes later he seems to be his old self. So you do not know who you are dealing with from one hour to the next.

I have sown a seed this evening on the phone - he had another fall today (no injury I am glad to say) and was freeling upset. I said that I thought he had gone home from hospital too soon and that it is very hard to get him safe care at home. But that seed will likely have been forgotten already.

Thanks for the support.

HUNTERF Fri 26-Apr-13 21:58:53

Sadly very few are happy going in to care.
Somebody I know complains to his daughter all the time the home is taking all of his money but he is on full NHS funding.
The latest problem the daughter had was she promised Dad her silver car 3 years ago if he got better and was capable of driving.
Sadly this will never happen as he has got advanced dementia.
She replaced it with a blue car as the mileage was clocking up which was better in most respects.
She could not get it through to him he would get the blue car if he gets better and she would buy another one.
A relative and myself went to speak to him and when we left he was happy.
Really the daughter was updating her promise not dishonouring it.


cathy Fri 26-Apr-13 22:04:01

Mishap firstly he is very lucky indeed to have a daughter that cares so much about him, also the home you have chosen is a good one, as you have checked it out.

You are just trying to do the best by the Father that you love, as he tried to do the best for you when you were little.

I think if you can point out how comfortable it would be for him and how he would never be alone and have constant care it would help him see the reasoning behind it all.

I feel so sorry for you as it must be one of the most difficult decisions to have to make.

Gently gently approach my sweetsmile

ninathenana Sat 27-Apr-13 10:24:55

my mum had been coping with 3 visits a day from cares for 2 years she was living with my brother in his house. But then he changed job which meant he was away long hours and sometimes over night.
We explained to mum that we were worried about her on her own. We also told her the GP wanted her to go to be assessed. She wasn't happy but agreed.
The day I moved her in, she had forgotten all this even though I reminded her the night before. She grumbled all the way in the car. She was rude to the lovely lady that had been to assess her.
I rang the next day and to my immense relief she had settled happily.
I too had spent several sleepless nights over the whole thing but in the end the thought was far worse than the deed
Thinking of you.

Mishap Sat 27-Apr-13 10:30:00

Thank you all so much for your understanding. It means a great deal to me.

The good news is that I have told him this morning on the phone. I spoke to him just now and the moment seemed to be right - the gist of the conversation was going in the direction of how difficult things are at home, and it seemd right to acknowledge that and propose an alternative.

I suggested to him that he might be safer somewhere with more care available and that he might have left hospital too soon. I proposed the home where Mum was so well looked after (and where she died) and first of all he did not remember it, but when I jogged his memory he said that they were kind there. (They remember Dad, as he used to go there for his lunch and tea while Mum was in there). He asked how he might get up the stairs, so he obviously remembered the layout, and I reminded him that there was a stairlift.

He said as I went off the phone "Can you arrange that soon then?" It would seem that he realises things are not going well at home - he will hopefully feel safer in there.

In fact we know they have a bed and they are holding it for him.

grannyactivist Sat 27-Apr-13 10:39:31

Oh Mishap what relief for you. I expect there will continue to be one or two hiccups, but the major hurdle is over and I'm very pleased for you. flowers

Elegran Sat 27-Apr-13 11:00:43

That is so good, Mishap If you move swiftly he will remember your conversation, and be installed as soon as possible. It sounds like a happy ending is on the cards.

Zengran Sat 27-Apr-13 11:22:08


soop Sat 27-Apr-13 11:39:48

Mishap a smile for you and a smile for your dear Dad.

annodomini Sat 27-Apr-13 11:50:23

Mishap, what a weight off your mind. Your poor father will feel relieved as well when he is settled in a caring environment. flowers

Bez Sat 27-Apr-13 12:43:55

Lovely news Mishap. Hope it all goes smoothly for you now. flowers

j08 Sat 27-Apr-13 13:11:40

Oh, that is good. smile