When is a nursing home the kindest option?

My Mother wants to be at home with me and the dogs but is spending more and more time calling out “help help help” because she needs the loo (requiring 2 carers and a hoist). So far we are coping at home with 2 carers coming in four times a day but I am wondering at what point would a nursing home suit her (and of course my) needs better?

I know there is no simple answer but I would be interested to hear what others think. Feel free to ask any questions. Thanks

Two answers … one physical , the other emotional.

Purely on the physical side , if her needs are too much for the resources available , a care / nursing home may well be the prefered option.

Even a consideration of CHC / NHS Nursing Care if said physical needs are great :

https://www.carersuk.org/forum/support-and-advice/all-about-caring/chc-nhs-continuing-healthcare-chapter-and-verse-under-one-thread-guidelines-and-links-32532

Self funding / home owner / assets / recent assessments ( Her and you , as a carer ) … all have been considered ?

Anything upto £ 1,000 per week … even more in more affluent areas … how long will those assets last ?

Online care home fees checker for a rough guide :

Financing Later Life Care - Which?

AGE UK on care home considerations :

Care homes | Information and Advice | Age UK

Is she the kind of parent able to see the merits in such a move or , like many out there , would need to be dragged kicking and screaming into one ?

I will assume that mental capacity is not a problem ?

Yourself … happy to allow others to become your mother’s primary carers … good / bad / indifferent ?

Future finances … if your mother’s income forms part of your own … a lone carer perhaps ?

All caring situations are different … in the circumstances so described , a choice of two end games ?

Hi Jaqueline,
I would think, when her needs are too great for one person (plus care visits,) to meet. Four care visits are the maximum, as far as I am aware. Why not start visiting homes now, the best ones often have waiting lists, so it’s worth starting the research early.

Melly1

Thank you for your informative reply Chris.

Melly I think I will start to do that. It is rather sad but best to be prepared … as far as one can be.

She definately wants to be at home for now. I want her to be too its just in case …

Looking at days off for me as a lone carer. It will cost around 80 pounds a day according to a local care worker. Savigs wont last long. Will have one day off a week for now, not two. Wonder if social services will fund this once we are no longer self funding. Not heard of it …

Your welcome.

On the care home costs side , allied with who pays what , that AGE UK link posted will come in useful ?

An upto date Carers Assessment might also come in useful … if time " Off " is a problem ?

Had an up to date assessment. 3 hours a week has been granted!!!

Am noticing that Mother has all the signs of early dementia. Noooooo. Somkeeping a close watch on her and will be asking the doctor for an opinion when they next need to come out.

Self funding time out should be fine but I am resisting paying atm. Daft really. I would twll anyone else to just pay up and enjoy the break!

Dementia ?

Potential Power of Attorney another consideration.

Self funding … you paying … chalk and cheese ???

I have poa for health and finance. Mother has savings so we will be working through those for as long as they last.

Bought Mother a train set recently as she has always wanted one. May as well make the most of her savings whilst she still has em!

Always bearing in mind the dreaded " Deprivation of assets " scenario ?

This isn’t really an answer to your question, but IF she is developing dementia, then, at some point, she will become doubly incontinent, because she will no longer be able to tell when she needs to ‘go’. It’s just part of the hideous process of dementia. (Which will also make her aphasic - ie, not talking any more - and immobile, confined to a wheelchair, losing the ability to walk) (the brain just forget how to do these things).

BUT, the reason I mention this is because maybe using the nappies that will become necessary at some point NOW, may actually be a help to her? if it truly takes a hoist to get her on to the loo, would it not be a relief to her to have nappies so she doesn’t need that? (Or even a bedpan???)

One other possible possible is a catheter? That way she might be restricted in mobility, but certainly would avoid hoisting.

It’s all so desperately sad, with or without dementia, as the horrible decline of extreme infirm old age starts happening.

PS - hope she enjoys the train set!

Jenny she has been in pads for a few years now. She needs hoisting so that the carers can clean her and stop her sitting in her own mess. She is completely immobile due to agonising arthritis in her knees and no muscles due to not using them and not wanting to do physio. Poor thing. At least we have a laugh and talk about and to the dogs.

She does get very confused, often muddling real life and whats on the tv.

She is still very sweet and loving to me thankfully.

Nursingnis defo better for you. they wont give you the 1-1 youre use to. can be tricky if youre not use to waiting your turn in queue meaning daily activities can take longer to achieve.

Jacqueline, at some point, mum’s situation will change, there will be some sort of crisis, a “life changing moment” when the current situation HAS to change.
As mum’s condition deteriorates further, which with age it will, then a nursing home will become the ONLY OPTION left.
As you have POA, then mum’s money should be used to keep her as comfortable as possible, and that means buying in extra care from her money so that her main carer, i.e. you, keep as well as possible as long as possible.
If you have been assessed as needing 3 hours off a week by SSD, that should be written in your Carers assessment. Are they going to pay, as it’s a service for you, not mum?
Every extra week you keep mum home, out of a nursing home, you save over £1,000, so why quibble over £80? Try to think differently, think of it as an investment, to save over £920 a week.

Good Heavens, do they really have to hoist her up to clean her??? I’m sure they didn’t do that every time with my MIL, but who knows? (she was in a nursing home). Surely one could be ‘rolled sideways’? Or changed ‘like a giant baby having a nappy change’?

It seems SO drastic to have to yank the poor woman up and down - no wonder she hates it! (I might well try and bite someone who did that to me constantly!!!)

I tend to agree with BB that the most likely scenario is a crisis of some sort, which ‘bumps them down a level’ after which ‘care at home’ just becomes impossible.

That might occur ‘at any time’, but of course is unpredictable.

I definitely think, in the meantime, that it is wise for you to start sussing out possible care homes. They do vary, and you will ‘know’ when you find a good one. Remember to look not for ‘flash surroundings’ (lots of those types up here in the Home Counties - they are designed to please ‘guilty families’ not the residents themselves!), but for the attitude of the staff, the general atmosphere of the place, and whether a programme of activities etc is routinely laid on.

In a past life I visited lots of nursing and care homes. It’s easier than you think to choose. If staff are friendly, smile, look you in the eye, are proud of their premises, it smells nice and the food looks/smells good, then that covers most things.


Find out basic details like cost before you visit, then draw up a short list of possibles, and visit one at a time, and make notes on each one. If mum has always loved gardening, hated traffic noise, or similar, then that might be another consideration.

Compare each one with her room at home, which presumably she can never leave now? From what you have written, be sure to get an NHS Continuing Healthcare Checklist Assessment as soon as possible though, and check that the homes you consider will take CHC patients.

I would hope in a nursing home she would be ‘mobilised’ with the kind of ‘padded wheeled armchair’ that my MIL was wheeled around in. It was incredibly comfortable, and she could be in it all day. It got her out of her room and into the main residents lounge where everything was ‘happening’.

Thanks all. Yes at home does give her more 1 to 1 care but she is getting slowly more muddled…

Jenny hoisting and turning both agitate her very much.

Bowlingbun I will be looking round homes once I get some time off organosed.

I get what you guys are saying re a home becoming necessary. I guess its a wait and wonder time atm.

Her mobility is non existant bit needs more things wrong to be eligible for chc funding.

Wonder if dementia (which vanished when the mental health nurse came over) would win her any chc points?! More exciting research coming up.

To top it all off the carers who were supposed to start tomorrow told me this mornong that they cant start til the new year!!!

Crt will continue til I find someone but want me to do so asap. Stress stress stress

Mother unable to make herself go when on the commode and then desperate for a poo when the carers go. Haveing meds but no luck so far. Ahhhh

CHC for dementia? Google Grogan case CHC dementia and you should find it, also look at NHS CARE INFO website.

Hi this is my very first post so apologise if I’ve done this wrong. I live with my mum she is 83 and has poor mobility and balance issues. I’m 47 and work 4 days a week. This is a local authority house and is in her name. I’ve just been told that our current care provider cannot continue and the social worker has informed us if they can not find another provider from their supplier list. She will have to go into a home…my mother refuses to go as she has been in her home 50 years and also grieving for her son who died Dec last year. Please any advice and help would be appreciated.