Care options for elderly mother

longwalks1

my mother in law is 84 and lives on her own since father in la passed 8 years ago.  Until recently she was petty healthy, aside from slowing down a bit.  she had a nasty fall last weekend and has spent 3 days in hospital.  The direct family she has is me and my partner (her daughter), we live 30 miles away, and her son who lives 10 miles from her.  She's said she cant cope on her own anymore, so I'm here to ask what options are available.  she owns her own home.  aside from a full time care home, and visiting carer what other options are there please?

We had a bad experience 10 years ago with carers who popped in 3 times a day to care for dad when he was ill.  Thank you all in advance

elsien

Housing with care/sheltered housing if she doesn’t need full-time care, doesn’t want carers and is happy to move.
These can be places that people buy,  which I wouldn’t necessarily recommend because they can be hard to sell on, or they can be social housing. Some of them are mainly warden controlled where people just need someone there just in case, others provide care calls as part of the package but you tend to need a certain number of care hours to be accepted. My suggestion would be for her to contact the local authority for a care act assessment around her needs and then take it from there. There is a backlog so if she’s low priority it won’t be quick but it’ll give a clear a picture of the type of support that might benefit her.
When she says that she can’t cope on her own anymore, it’s probably important to be clear on whether that’s a confidence thing or whether there are things that she can no longer do. Having too much support would disempower her and make her more dependent on people.

https://www.scie.org.uk/housing/role-of-housing/promising-practice/models/housing-with-care

RAS

And if you've not got EPAs in place sort it urgently.

It may be that someone managing the bills, ordering the shopping and some practical support from son would enable her to stay at home safely in the short-term.

Or is it that she needs help with meals?

Until you ask open questions, you have no way of knowing.

Keep_pedalling

RAS said:

And if you've not got EPAs in place sort it urgently.

I agree although EPAs are obsolete and have been replaced with LPAs.

One. Option if the OPs MIL has sufficient assets to pay for it is a live in career.

gettingtheresometime

My mum has put her name down for one of these places, run by the local HA, where the person has their own little flat but there's a 2 course mid-day meal thrown in and there's entertainment thrown in every so often together with a hairdresser etc. There's central antrim so you can have a coffee and just watch the world go by.

The cost is about £300 per week.

Is there something similar near you?

bunnygo

Live-in care could be the answer; as it sounds, a carer/helper moves in and so is there all the time (or maybe 5/6 days a week). Carer needs their own room with a bed and some storage space, but can share bathroom. Agency can make arrangements for relief carers, and some 'downtime' should be allowed each day. If it gets to needing help in the night then a 'shift system' will be needed.

Your mum doesn't have to need personal care for this; the carer will do cooking, some housework, provide transport to aid socialising, help with meds and be as much or as little company as needed. The big plus is that your mum can keep to her own routines and stay in her own home. It is also a tremendous load removed from the relatives, knowing that someone is there.

It does of course cost a LOT, and you still have to pay the costs of running the house. Ballpark of around £55k a year. And worth every penny.

bunnygo

and yes, get busy with that lasting power of attorney. Even once receipt is acknowledged, it will be at least 20 weeks before it is in place.

lr1277

This is my experience of having dad at home.. Dad had been ill for a long time. I can't remember the reason but in January he was admitted to the local NHS hospital. Because the medical staff assessed he needed a care package when he was discharged and mum was happy to have him at home, the local authority organised the following (for free)

3 care visits a day for a month. After that it stopped. Mum was not happy with the carers because their window for the morning visit was anytime within a 4 hour period. The doctor had given certain medications that had to be taken at certain times. So the 4hr window was no good. Mum thinks dad was less of a priority because he was organised by the LA. And the way the carers were managed was less than optimal.

However as dad was at home, he was on a double bed. The carers found this difficult to move him about and insisted on a hospital bed. Because we had support from the LA for 1 month, they organised this for us. Their referral/request was made within the month, but I can't remember exactly when the bed arrived. But the bed was free and stayed for all the time that dad was alive. No time limit on this piece of equipment or in fact on any equipment we were loaned.

As the month was up they gave us the name of a couple of local care agencies for us to organise ongoing care. We already had wore with one of the agencies where their staff took him for walks in the park, however they were £6/hr more expensive than the other care agency.

So we interviewed the other care agency and took them on. 2 carers visiting 4 times a day. This was for personal care, feeding him, giving him medicine and moving him about so he didn't seize up. Mum was very happy with these carers.. Their arrival times were a lot more consistent. This could have been because we were paying. Or it could be because they were a good agency and the LA recognised that.

The chosen care agency kept working with dad till he passed.

On the assumption that your MIL needs a care package when she goes home:

My recommendations are if you and your MIL choose for her to live at home, make use of the LA help. But it will stop after 1 month unless I am guessing there is another referral possibly from a GP. In that month get everyyhing set up as your MIL wants.

The month period will allow you and MIL to work out if home is the best place. If not, you have some breathing space to find a care/residential facility.

I don't know about residential places, but care agencies and care homes like to see the patient before they take them on

Obviously this didn't happen with the first hospita;/LA appointed care agency, but then the agency we took on did come and see dad before they worked with him.

In terms of setting everything up for dad, I spoke to many people from different departments. Some doing the job for the hospital and others doing the same job for the LA. Also we were put in touch with charities that could help with some logistics but not all. For example the hospital bed was going to be placed in dad's bedroom. But the existing bed had to be removed first. So a charity dismantled the bed and took it downstairs but would not transport it anwyere. We had the dismantled bed put into storage. The cost of the storage was more than the cost of an admittedly expensive bed. So be mindful of what you keep and what you let go.

HTH

elsien

The short-term Hospital packages tend to be health funded and their purposes just to put a basic level of care for a shorter time in while fuller assessments are done in the community if needed. 

They’re not chargeable because they are health rather than local authority.
My grandmother paid for private care but they would still turn up at any time within a certain window and they came to put her to bed ridiculously early because there were no free slots later in the evening. It’s not necessarily to do with who is paying but about resources, how many other people the agency  can manage within a certain time slot, that kind of thing. 

But in response to an earlier post suggesting full-time live in care, it’s a bit of a leap from not having any support to having someone there 24/7 and could potentially be very deskilling. Which is why it might be helpful for MIL to have a proper assessment to see where the gaps are. 

Marmaduke123

I think it's important to try to find out why MIL feels she can't cope any longer, as that will determine what sort of help she needs.

 She might have lost confidence and be afraid of falling again, in which case modifications to the house, an alarm pendant, or sheltered housing might be appropriate.

If she's having difficulty withe practical aspects of life - shopping, cooking, cleaning, managing finances, there will be solutions to all of these without a care package as such.

Has she been left with physical disabilities, either temporary or permanant following her fall? If so she might need modifications to the house, walking aids and so on.

Is she having problems with self care, washing. dressing, toileting etc? If so daily care visits might be needed, either temporarily or permanently.

Is she increasingly lonely? Being in hospital with other people always there might have made her realise this. Possible solutions - sheltered housing, lunch clubs, Age UK visitor, more family visits to a regular timetable.

As she's not had any support before its important not to deskill her by putting in too much support for her actual needs, as others have said.

longwalks1

Thanks all, apologies for the delay in replying, been up the hospital visiting every day, then had a call yesterday to say MIL has caught covid and been transferred to isolation, so we can’t visit at the moment. Will read through your posts with my partner and reply in due course.  Quick chat between us and my brother in law we are leaning towards a live in carer.