Care support for elderly parent

Mistermeaner

Apologies if not in correct forum, will move if needs be but this looked best place

Post is regards my father, age 87, diagnosed with heart failure and probably not long to live. He also has osteoporosis, several fractured vertebrae and a host of other medical conditions plus takes all manner of pills for his heart, pain mgt etc. His blood pressure is in his boots, he is weazing / breathless all the time and in and out of hospital but refuses to go into a home of any sort

Things have reached the point that me and my partner (plus neighbours who have been helping) can't really do what is required to care for him. We have spoken with a district nurse who recommends we apply to the council for care support but that could take months so thinks we should look to sort a few things privately.

He alreday has a cleaner and gardner so that is OK

The things we were specifically looking at is:

- In home carer, to visit once a day for a few hours and help with light medical care (dressings/creams etc.) but primarily things like cooking, washing. shopping and a bit of company. We don't mind paying private so we're going to contact a few local agencies - any advice on this appreciated

- A life aid emergency contact/fall detection system. Was looking at this one recommended by age uk https://personalalarms.ageco.co.uk/pages/gps-fall-detector-alarm  - its the best version with speak/listen via the pendant as would not be confident in a base speaker version. Any thoughts comments / recommendations?

- We have been told to look at applying for attendance allowance. My understanding is that this is not means tested and my dad would likely qualify?

Is there anything else we should be applying for or any government / NHS / council bodies we should be registering him with to get support at home?

If it makes a difference i don't think he will qualify for any means tested benefits as he owns his own home outright, has several 100K in the bank and has full state pension plus DB pensions (ex teacher). He lives in Cheshire

SunnyCyprus

I think it would be best to contact a good local care agency, and arrange daily care visits. 
Depending on what your father can afford, visits could be 2 X 1 hour daily, to cover morning and evening personal care and medication.  
I previously worked as a domiciliary carer, we had no idea which of our clients were NHS funded/private (although quite often, private clients liked to make sure we knew they were paying personally for the visits!). I know that our clients paid £32 per hour (South Devon) in 2021. 
But don't delay the decision, the sooner you get professional daily help, the better (for your peace of mind, more than anything else). 
Good luck x

thegreenone

Sorry to hear your Dad is so unwell.  

Definitely apply for Attendance Allowance.
Key Safe outside - could be back door, if accessible.

Contact his local Ageuk, they were brilliant with advice and helped my late Mum fill out the AA forms and when it was rejected first off. 

My SiL works for an agency that do what you describe, although she isn't qualified for medical things.

The last one is going to sound a bit odd but ......... contact your local Fire Station and ask them to put Dad on their vulnerable list.  They will probably visit to check access should the worst happen - not just at his house but surrounding properties.  My mum had a visit and, sadly, they were needed when she had a fall as the ambulance staff couldn't get the stretcher out the main door of the flats.

I do hope Dad accepts the help.

Brie

Def get the key safe.  It means that carers can access the house without dad having to go answer the door and is really useful if there's an emergency.  Frankly ours has saved me a few times when I've simply locked myself out of the house!!  And tell everyone vital that it's there - like the neighbours (that you trust), doctor's surgery.  

Apply for AA and then if you or your OH doesn't work more than 16 (I think) hours a week you can apply for carer's allowance as well.  

An AA application is quite straight forward.  I've done a few over the last few years for various people.  The thing to ensure is to be truthful.  So IF dad could run for the bus that should be stated.  But if running for the bus today means he's flat on his back for the next 2 weeks that should be stated as well.  It's not just whether he can do something but what's the impact of doing it.  Yes he can get up and get a cuppa tea but doing so means he won't have the energy to go to the loo 2 hours later, etc.  

And register him as vulnerable with all his utility and water suppliers.  Also I got one of those "plumbing emergency" policies for MiL who kept flushing her disposables down the loo and I thought we'd need to get the drains cleared.  

Brie

Oh - MiL's carers cost £69 for 2 hours.  There was a £13 booking fee and then £13 an hour.  This was 12 months back so prices likely to have gone up and a large southcoast seaside town full of pensioners.   This was the second care company she had as the first were useless - sending random people who didn't know or want to do what was required, would turn on the TV so they didn't have to talk to MiL, generally not nice.  Second company almost always sent the same person so there was a good routine and friendship, very caring, very nice and well worth the money.

tooldle

I see you have mentioned no care home but, maybe take Dad to see one or two local homes. The daily rate for 24/7 care, food, entertainment and of course company, is not much more than several hours of ‘at home’ care.
My mum (a self finder) recently moved from residential care at circa £6 per hour to nursing care at circa £5 per hour.
 Provision does of course vary as to people’s perceptions of what such homes are like. You never know, he may change his mind. 

In our area there is a shortage of carers. I’ve contact with two local homes, one care only and the other nursing and care. Both have recently taken on staff moving from the ‘at home’ care businesses. These staff say pay and conditions are better in the care/nursing homes. 

Attendance Allowance forms are very straight forward. 

elsien

It really depends what his needs are based on - whether they are health needs or social care - washing, dressing etc.
He could look to see whether he is eligible for any NHS funding which is not means tested - this tends to be seen as for care homes but does apply to health needs being met at home as well. 
NHS continuing healthcare - Social care and support guide - NHS (www.nhs.uk)

If he requests a social care assessment they will do a needs and wellbeing assessment which will identify where he needs help and what sort of help he wants. It will be means tested and if he is over the threshold they are likely to give him a list of agencies and tell him to find his own, so on that basis it's probably not going to be worth the wait. 
You can check domiciliary care agencies out on CQC (care quality commission) website but they can be quite old and not entirely accurate. Word of mouth will be equally as helpful. Ask about how they monitor the time spend with the person - they are used to doing quick calls then shooting off elsewhere. My grandmother used to pay for an hour but they regularly left early when they had done the jobs - sitting and chatting wasn't on their radar as they were more keen on making up time they'd lost with other visits that had overrun.
And as someone else said, consistency. Many agencies cannot/will not try to send the same people out on a regular basis.

The other option is to look at hiring personal assistants which also has pros and cons.
Hiring a PA for care at home | Disability charity Scope UK

Savvy_Sue

As well as asking around agencies, it may be worth seeing if there are any local day services which he would enjoy (or at least tolerate!)

My parents used to go to their local AgeUK centre, picked up by minibus, most days. They got a hot meal and there were activities most afternoons: whist, knitting, talks etc. Near me, I know there are similar possibilities, and there may be assisted bathing available. 

The big advantage of such centres - and indeed of care homes! - is the additional company, and it spreads the load of care beyond the neighbours and family. MIL went into a care home reluctantly over a year ago: she said recently that although she would love to go home, she could see that this was the right place for her. From my point of view, she gets human interaction every time someone goes down the corridor - they will pop their head round her door to see if she needs anything. Whereas at home there would be very limited interaction. 

Mojisola

Mistermeaner said:

Post is regards my father, age 87, diagnosed with heart failure and probably not long to live. He also has osteoporosis, several fractured vertebrae and a host of other medical conditions plus takes all manner of pills for his heart, pain mgt etc. His blood pressure is in his boots, he is weazing / breathless all the time and in and out of hospital but refuses to go into a home of any sort

Things have reached the point that me and my partner (plus neighbours who have been helping) can't really do what is required to care for him.

As well as sorting out the care suggested, make sure your GP knows that you both have carer responsibilities.  

It's also important to put together an emergency plan for your father's care if you two are suddenly not able to give your normal support.

It used to be something that was done by the Elderly Support team at the council but these departments are so over-worked now, that may not get done - or not for months, anyway.

Perhaps discuss it with the care company you choose so they can step in with extra help in an emergency?

lr1277

My dad needed care as well. This included personal care, feeding him (with meals made by mum) and giving him his medicine. The pills had to be taken at specific times.

The first care company would come in 3-4 hour window for the morning visit. This was useless for us as the pills were not being taken at the correct times.

After various events we found a 2nd care company who were generally on-time. The only time they weren't was when another of their clients had an accident and they needed to stay with that client. But if memory serves they kept us updated in that particular situation.

The 2nd care company were suggested by somebody I think at the county council who deals with these kind of things, but I am sorry I cannot remember the name of the department. Your dad's GP might know who to contact at the council that keeps a record of the care companies in the area. Or your dad's GP might be able to suggest one or two companies.

The first care company insisted they needed 2 carers per visit to deal with the personal care. When we took on the 2nd care company we asked for 2 carers per visit.

The other problem for us that staff at the gp surgery would not talk to anyone but my dad about this health not even his wife. This was solved when dad wrote a letter to the surgery saying who the surgery staff could talk to about his health. We found this very useful. A few weeks before dad died they wanted us to complete some forms for the same purpose but we never got around to it.

I think the county council provided equipment like an electric bed, commode etc But this was after a referral from an NHS hospital after he had an admission. If your dad needs equipment I am sure the GP can make the same referral.

The only equipment we ddn't get from the council was an electric chair, which we rented privately.

Edited to add: You or your dad on speaking to the GP could find out if a vsit by an occupational therapist would be of use. They might be able to reccommend equipment for the house.

Savvy_Sue

You mention he's in and out of hospital: the situation may be resolved by the hospital declining to discharge him other than to a care home if there are too many issues with him returning to his own home. And that can be especially important if you and your partner make it clear that you cannot be there at all hours. Another possibility may be 'respite care' being suggested as an option: a couple of weeks of care and rehabilitation to improve the chances of him being able to cope at home.