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Mum age 90 and can't manage - Carers UK Forum

Mum age 90 and can't manage

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Good morning all. Just wonder if anyone can give us any pointers on this please? Mums 90 and in poor health. She has around 16 ongoing health issues including high BP, 5 Tia's, enlarged heart, vertebral osteoporosis, 2 heart attack, angina a (controlled), hiatus hernia, another hernia, prolapse, lumbo sacral spondylosis, overactive bladder, oedema to feet, o/active thyroid, multi nodular goitre, severe triple vessel disease and heart failure (diagnosed within the last 5 weeks). She's had 3 hospital stays in the last 12 months. The last one being in September where she was admitted with chest infection/pleural effusion when they drained off 5 pints of fluid from one lung! They then told us there was a high possibility she had ovarian cancer as the CT scan had revealed an ovarian mass. Gynaelogical dept said "no it wasn't" and decided not to intervene. She took a turn for the worse as they tapped the fluid off and we were told she had a blood clot on her lung, which they treated her for. They then decided she HADN'T got a blood clot but she had pneumonia. She was still a bit breathless so the did a heart scan which revealed she had entered heart failure stage. They tried her out on some stairs and OT signed her off as fit for discharge and with a recommendation for 3 care visits a day (she has had 1 lot of reablement care which ended in September). We know very well that what the hospital recommends isn't what Social Services provide, mums self funding anyway but we have tried and tried to get a local care agency to take her on but the ones near us are all full to capacity or rubbish reviews. Anyway, we talked to mum and she agreed to go into residential care, initially for 4 weeks with a view to staying there. She lives alone in a house with no central heating, very steep stairs and no decent kitchen or bathroom. The reablement carers were good with mum although she had struggled to do the dressing/washing herself, to prove a point I think. She is an accident waiting to happen in the house, she's fallen a few times, even with the zimmer. She doesn't want the bed downstairs and anyway the bathroom is upstairs. She has 2 commodes, 1 for downstairs, 1 upstairs in the bedroom - they still need emptying. Most of the care has been falling on me and my sister and we are exhausted. We have been caring for nearly ten years, admittedly not to the same level as this last 18 months. Well, she is coming to the end of her 4 week stay in the care home, which is lovely. She says the staff are lovely.If she does decide to stay in the home, does anyone know what happens regarding funding when all her money has gone? She will have enough for about 3 and a half years after her house has sold, bearing in mind she was not assessed by anyone as needing a care home. We went to see her at the weekend to ask if she wanted to stay permanently but she didn't know. Went again last night and still had the same answer. She says she can't manage at home. She asked what we thought she should do and me and my sister both agreed she would be better in the care home (it is a really nice home). To which she replied "well of course you want me in here, you'll be rid of me then". Gobsmacked is the word to describe how we felt! After all we've done over the years - the cancelled holidays, cancelled days out, the running round after doctors appointments, going up to see she's ok after we've had a full day at work..... Etc. We then asked her if she'd consider a ground floor sheltered flat (she's on the list) and she's been offered one just this week. She wasn't too enthusiastic about that either. We are at a loss with what to do next. The council want a decision about the flat and the care home want to know about the room. I would be grateful if anybody can help on this one. Feeling gutted. Many thanks.
I can't give you the answers you're looking for myself, but I would suggest you give the CarersUK helpline a try - even if they can't help you directly they will signpost you.

The trouble is, rules about funding for residential care seem to change as often as the wind, with the current government now kindly postponing bringing in all the wonderful :whistle: changes that would make life so much fairer for self-funders, so you're best off getting the most -up-to-date info you can.
Hi Jaymarie
Have you asked for an urgent CHC assessment to be done? This is absolutely a must if you haven't already explored it as it may fund all mums' caring needs. It is very hard to get but with so many severe and varied health needs I would say you stand a chance.
You will see the emotional blackmail card frequently used by elderly parents on here trying to keep their children as main and sole carers. It is hard to accept that there comes a stage when you need to make the decisions, accept the "fallout" and explain what is happening to mum and try not to be phased by the response. The elderly are always reluctant to change but your mum will be facing change in either scenario as it sounds as though you will need additional outside support at home if you pay for home carers.
If you have a care home in mind then ask if they can offer your mum a week's respite. I did the with my dad, then 92, at the home's suggestion. Towards the end of the week he was given the choice of another week or going home. He took another week and then decided to stay. The idea was to get him over the threshold of the care home in a non threatening way - as a bit of a 'holiday', to see what it was like - with the decision being left to him. They said he could have 3-4 weeks like this but would then need to decide.
What happened was that he realised it was nice to have company, be fed and eat with others, have people to help him whenever he needed and activities with others or his own space when he wanted. Home was quite different. I took in some photos, books, CD player and some of his favourite music to help Dad have his own space and I popped to check he was okay. It as like leaving a child at school for the first time.
Dad was self funded and would have had enough for two years (he passed away at the home eight months later) - that's the normal expectation of time in a home. When the funds go down to around 23K, social services get involved.
Hope this helps.
Yes, by the sound of it, mum definitely needs a CHC assessment (contact Social Services and insist!). If she ticks all their boxes, she would get all her needs fully funded.

If not, and more than likely, and she is self-funding, you can pay the home fees from mum's money until she only has approx. £23K. Social Services would then be obliged to pick up the costs from that point on (up to their maximum allowance). They will try not to pay the full amount. If the home belongs to mum, you may be able to postpone the sale until after her death (in essence, Social Services puts a charge on the house). The funding is complicated and it may be worth asking the Adviceline for their advice too.

A bigger problem is if mum is deemed to have mental capacity and refuses to go into a home :dry: Do you have Power of Attorney by the way?

Bluntly speaking, at the age of 90 mum is not going to get any better. Personally I feel that the ground floor sheltered flat would mean that you are still doing all the care. As mum's health declines, you would then be in the same situation. Be careful to choose a nursing home which can cope when mum's health declines. You do not want to move her twice. It is a long battle; my mum went into a home at the age of 87 and died 3 months later ...

Good luck, it is always very tricky, Anne
I don't post very often, but felt that I needed to reply to you.

You have a 90-year-old mum with multiple serious health issues. It doesn't sound as if she would be able to cope at home, even with carers. You have found a "lovely" care home and your mum thinks that the staff are "lovely", they have a room available for her and are willing to take her. To many, this would be the "dream scenario"!

I fear that if you go down the sheltered housing route (and all the arranging that that entails), then there will be a fall or other medical emergency - perhaps necessitating a further stay in hospital followed by full-time residential care. In the meantime, you have lost the room in that excellent care home and will have to start all over again.

At this point, it's probably more about what mum "needs" rather than "wants". It seems that she hasn't said a definite "yes" to the current care home, but then she also hasn't said a definite "no" - perhaps it is time for you to take that decision for her (however hard that may be for you).
Hi Jaymarie
Grab that place in the Care home and hang on. I just wish my Mum would even try and she does not have anywhere near the health problems your Mum does. If she likes it, she just might be in need of reassurance that you are not abandoning her because she is a problem. Reassure her that you are not doing that but truly believe that it is the best place for her to be looked after properly and that you will see her very often. My Mum can come out with some hurtful things too. I feel that it is something to do with trying to regain control of life and health that has gone haywire. As her children you are the ones she feels she should have some influence or control over still.
When it comes to paying for Care the value of Mum's house (presuming she owns it) will be taken into consideration if there is no member of the family who can say they have been living there with her for years.
However it doesn't have to be sold immediately. I believe there is a scheme where the council will pick up the care bill and then claim their money back after the sale of the house, possibly after Mum dies. You need to check on that.
I believe that once Mum's Care bill, over time, is more than the value of the house and any savings she might have, down to £23,500.00 (ish) then the council will pick up the whole bill. However they will only pay a Care Home their set amount. So if the Care Home charges £800.00 a week and the council will only pay £700.00 a week (for example), either someone will have to top up the bill (Mum's savings first) or Mum might have to change Care Homes. Check this with the Care Home. Will they keep Mum if she goes completely council funded?
Given your Mum's health problems I'm sure she would be better off in a Home than in a flat. You can't cope with that amount of nursing care. Her home is unsuitable. Surely the current Care Home is by far the best for all?
Good luck
Judging by the list of serious health conditions that your mum has, she needs proper nursing and social care day and night. It is impossible to predict how long an individual will live, some of our parents are excellent survivors, with both of mine well into their nineties now, despite multiple health conditions. Three and a half years looks very optimistic to me, but you never know: in any case it is their money and they saved it for a rainy day, and this is that rainy day.

In my parents case, they have opted to stay at home with live in care - it works out at half the cost per head because there are two of them, but if one of them passed I am sure the nursing home option would be fairly inevitable.
If you have found a good home, stick with it, and don't put up with any more nonsense: there comes a point with all our parents (and in due course with us too, lol) when the adult children simply have to put our foot down to save their own sanity, and this is it.
DON'T TAKE HER OUT OF THAT HOME!!!!! Leave her there, please, please, please! As others are saying, if it's a lovely Home that's brilliant! Sadly, yes, she won't 'get better' will she? It is hard to 'let go' of the life one once had, but that is the price of living to the age she has (not everyone gets that privilege).

Ignore the 'you want to get rid of me'.....justice, sadly, is not something that 'elder carers' get from those they care for (well, mostly they don't).

I do hope that in her lovely new home, she can have some nice 'quality time' with you, now that the pressure of caring is off you, and an 'easier sunset' in her life than if she struggled on in her own home, or even in a sheltered accommodation, where, as others are pointing out, you would still end up doing far, far too much for her. Once 'someone else' (ie, the Care Home) is doing all the 'everyday care' (the drudgery stuff!), family nearly always find it far more enjoyable to spend time with their elder-in-care.
Hi all, many many thanks for all your replies. You have reinforced mine and my sister's thoughts entirely. Mum is certainly giving us the emotional blackmail treatment at the moment. Complaining that it's too hot in the care home and she can 'hardly breathe' in here because of the heating, as she sits in a vest, tee shirt and cardigan! The breakfast sausages are 'too fat'! When I asked if she'd eaten her tea she replied, 'yes, such that it was, I only had a sandwich' . She's giving us a lot of the silent treatment. I will do as you suggest and contact the helpline and take on board what they say. We will also investigate the CHC assessment but I've looked at the form and I have my doubts as to whether she'd qualify - the odds seem to be stacked against ANYBODY qualifying. We don't have power of attorney but, again, we'll look into that. Might have to get a solicitor to do it as I can't get my head round it just now. Mum will probably dig her heels in over it anyway. We don't want to take her away from the home just because she doesn't want to stay, however I'm well aware that if she puts her foot down and says 'take me home' then we may not have a choice. We could always tell her if she goes back home it is without our blessing and threaten to withdraw our caring duties. I sincerely hope it doesn't come to that though. She does seem to revel in being miserable. She was miserable at home before she went into hospital. Complains she's bored, just sitting about but won't go into the TV lounge to watch television or anything. We've taken in magazines but she doesn't read them. There will be another fall or some medical emergency and there will be another hospital admission I have no doubt about that. I really am not looking forward to going to visit her on Saturday, I might just snap and say something I will live to regret. Once again, thank you all.