Overnight live in care.

Hi,
I don't know all the details, but the options are; asking social services to fund the care, and employing staff yourself. Or going through an agency who would provide staff.
The are agencies who provide whatever level of care is needed, at the times to suit. I know of someone who did employ (through an agency) a live in carer for her mum, and it worked out extremely well, though was fairly expensive. She considered it worth every penny.

The cost is huge. We had this problem with my Dad in that he needed a live-in carer + a night carer who was awake (as the live-in needed to sleep) and the costs became ridiculous. There are national agencies and local ones who will do this. If you google this, you will get an idea of the costs.

You need a full community care assessment by the social workers who cover the hospital and she cannot be discharged without a full package of care in place. If they try to discharge her with neither the assessment nor the package of care you MUST dig your heels in and refuse to allow her to leave until it is all done. We all understand their dilemma, in that they need the beds, but your mother must not go home without the proper care in place.

You need to also ask for a Carer's Assessment which takes your needs and availability into account - they are not allowed to assume that it will all fall on your shoulders.

Has she had a financial assessment to ascertain how much of the care costs might fall to her? This MUST happen before she leaves.

One thing it might be worth you looking into is continuing care funding, under which people with a certain level of needs have ALL their care costs met by the NHS whether they are in their own home or in a nursing or residential home. It is based on their care needs and NOT their savings or income. A basic assessment as to whether she qualifies for this should be done on the ward; and if she ticks the right boxes, then it goes on to the full assessment. Please note that this can be paid retrospectively - i.e. if the full assessment takes a long time, the patient can go home with the care package and the money is reimbursed later if the assessment proves to be in their favour.

Please pm if any of this makes no sense! The basic rule is that she cannot be sent home without proper care in place.

I think if the person has savings in excess of 23 thousand, they will be expected to pay towards their care.
I reckon for live in care, the cost would be around 1,300 ish a week.

I think it will depend to some extent on where you live, but we looked extensively into live-in care inc. nights for an aunt of Dh's, and it worked out rather more expensive than a nice care home - this was Sussex coast. In the end a care home was the only viable option. (She was self funded.)

One thing to bear in mind is that if continuity of care (familiar face) is important, any carer will need their regular days off and holidays, and someone else who is maybe unfamiliar will have to fill in, unless family is able to.

Do not say that you will sort it out or they will be happy to let you. Even if you have to pay for all of it make sure everything is in place before you let her come home - which is what Lucky said - sorry lucky!

A good plan might be to let her have a couple of weeks recovery in a home that would be suitable and see whether she would be happy there in the long term. Make sure it is registered for Dementia patients as we had to move mum when her dementia worsened.

My Mum who died in February was paying about £1100 per month while she was still self funding.

AgeUK is brilliant for advice. They have some excellent downloadable factsheets and I have always found them lovely on the phone but they are getting busier and busier. The Alzheimer's Society are great too.

I think your best bet is to stand well back, and let social services arrange care, whilst still exploring other options (secretly!)
It sounds dramatic, but if word gets out that you are going to take care of everything, then you'll be left to do just that, when social care is for everyone. Once you've an idea of what the plan is, then you can work from there.

I think there is a general impression that care at home is cheaper than living in a care-home but this is not the case. Remember that if she continues in her home you will still have all the ongoing expenses of maintaining the house - council tax, insurance, energy, unexpected emergencies etc etc. I think you are usually expected to feed the carer too There are some amazing dementia units within carehomes - maybe visit a few before you decide what is the best option long term

Another thing to bear in mind - my friend`s Dad had excellent live in carers but they were all quite young Eastern Europeans who could not drive and in his area there was virtually no public transport - so my friend often ended up ferrying the carer around as well as looking after her Dad!

I'm here at the house of someone who has care 24 hours in his own home. He has drivers during the day, and a sleep in person at night, and it works perfectly for him. I'm not exactly sure how the funding works, but pretty sure he isn't self funding.

My mum was paying £1100 per week. Not per month!! Concentrate Kitty!

Not sure if you live in England or Scotland as things are different either side of the border funding wise.Social workers are based in hospitals and in the community, and following discharge the community team will be responsible for your mums care and how it is funded, there is usually a limit to their budget.Is your mum receiving Attendance Allowance as this can help towards costs at home.
Either way Luckygirl is very right, do not let discharge take place until care is in place.

nn - I have sent another pm.

nn my thoughts from experience with my mum's stay in hospital are this;
the occupational therapists at the hospital assess whether or not your mum can go home or if she needs respite in a care home, they seem to be very powerful. They will not want to keep her in the hospital. There will also be a person in charge of her discharge and/or a hospital social worker. They will give you a list of homes that are prepared to take her for respite, that is if they decide she cannot go home. I had to sign that I would pay for this. The manager of the care home will also assess your mum and will decide if they take her or not.The hard organising work will be left to you once the powers that be know that your mum has a caring, supportive daughter.
My parents had carers 4 times a day organised by me with an agency. The sum of £23,250 savings is used to assess who pays. There is a sliding scale and your mum will still have to contribute if she has less than this. I have no experience of overnight care at home, the whole process is a practical and emotional minefield sorry. Please ask Age Concern for help.
Good luck to you and your mum, my very best wishes.

I agree about the difficulties that can present themselves when a live-in carer is from another country. My Dad's first carer was a man from E Europe whose English was poor - he stayed for 24 hours then walked out without warning, leaving my Dad alone. This could have happened had the carer been from anywhere at all of course, but the language issue was far from ideal, especially with Dad being quite deaf. But the carer who stayed the longest was from Ghana - there were a number of problems, including food. My Dad (in his 90s) was not mad about the food she cooked! - bit of a culture shock! In the end I had to order online from Asda and get it delivered there so that he could have the food he liked - and of course I also ordered for the carer. Her approach was very kind, but culturally very different - she treated him as a member of her family, which in the end caused confusions as Dad was not clear who she was and what her role was - suffice to say some quite serious misunderstandings occurred - I will leave it to your imagination!

Many of the carers on the books of live-in agencies are immigrants to Britain and, while they might be caring and kind, there can be misunderstandings.

I'd like to add 2 comments, thinking back to my own mother who, prior to her fall, had been living at home with a live-in carer and had dementia.

Firstly, she needed either a bathroom on the ground floor or to essentially 'live' upstairs.

Secondly, I was told by the manager of the care home which she ended up going to that every change of environment/routine for a person with dementia is an irreversible step in the worsening of the condition - for that reason, the idea of a brief stay in a care home prior to possibly returning home may not be in er best interests.

I feel for you, as we agonised long and hard about this, and it caused a major falling-out between we siblngs, which resulted in a case-management meeting in the hospital attended by an independent person who talked to my mother to try to establish what her understanding of 'home' was.

In the end, she was discharged to the care home directly, and seemed much more cheerful when there, in part, I suspect, because she had people 'looking after' her.