Friday, 28 December 2007

what I have learned in 2007: different types of Care Home

Coping alone with a family member who is suffering Dementia is exhausting. That's the only excuse I can come up with for the following. In my search for a Care Home for Mum, I kept making the mistake of not distinguishing between the different types of Home out there. This is by no means an exhaustive list.

Retirement/Residential Home: these Homes provide accommodation, meals and (hopefully) activities, as well as some support with such activities as bathing and dressing. They are a good fit for those who are still mentally sound but who are becoming frail or unable to feed or look after themselves. They don't generally provide nursing care for medical conditions.

Nursing Home: these Homes provide all the above but have qualified Nurses in attendance at all times. Usually, these Homes are geared towards those with physical needs rather than Dementia, though some will specify that they can deal with Dementia patients. In my experience, these places tended to be quieter, with Residents in their rooms and the common areas empty. The fees tend to be higher (but then the NHS provides a free non-means-tested benefit up to around £100 for nursing care)

Dementia Unit/EMI: those Homes with an EMI (Elderly Mentally Infirm) capability will be secure units with higher staffing levels. This reflects the possibility that the residents are going to try to wander and will need higher levels of support. In my experience, there will be severely demented residents in the common areas, which might be distressing to witness. The assessment you receive from Social Services will tell you if an EMI unit is required.

Physical Disability or Learning Disability Care Home: these Homes are self-evidently for specific care groups, and may well be for other age groups.

Of course, there are some Homes that feature a mixture of the above categories. The place where Mum is currently living is designed as a 'village', comprising a set of common social spaces and facilities surrounded by 3 types of accommodation: self-contained apartments, secure EMI households and a floor of Nursing Care rooms.

If you are looking at Care Homes, make sure you have spoken to your Local Authority who will carry out an assessment of your relative's needs and then provide a list of homes fulfilling these criteria. Also, check the CSCI reports for the homes you find. These will show you what the home is doing right and any areas where they need to improve their service.

My advice is to look at as many homes as you are able. Plenty look great in the brochure or on their website, but you only get a true feel (and smell!) of the place if  you visit, and they ought to be able to cope with you visiting unannounced, too.


BigAssBelle said...

If you are looking at Care Homes, make sure you have spoken to your Local Authority who will carry out an assessment of your relative's needs and then provide a list of homes fulfilling these criteria.

oh, hahaha!!! well, i guess there may be an authority somewhere in these wretched united states who gives a crap about people caring for their loved ones with this fucking disease. if that's the case, i've not managed to meet up with him or her.

there is one daycare program in the town where my father lives. in desperation, my stepmother took him there to see what it would be like. five other individuals, all of whom were MUCH worse than my father, practically comatose, and she couldn't bear to leave him there.

it's just so damn frustrating. there is so little available and what there is is so incredibly expensive. nursing homes run $5-6,000 here. my parents live on a fixed income from investments and social security. the nursing home would eat up 2/3 of their investment monies before any kind of federal assistance would kick in.

when my father dies, that would leave my stepmother living on one social security income instead of two, with 1/3 of the investment money to add to her income.

it's impossible. i find myself praying that he dies before he gets so bad that he needs 24 hour care and that sucks. i HATE this disease. but i've said that before, haven't i?

Greg said...

I just got a strong flashback from the Michael Moore film "Sicko" reading this. Sorry to add to your pain by mentioning some of the good things about the UK's National Health Service and our Local Authorities.

I checked out lots of homes on my own precisely because I wanted to avoid exposing Mum to the "much worse" cases and freaking her out. I also knew that if I took her somewhere where there was a smell of urine, then she would be prejudiced against the whole plan. In the end, though, one place we visited DID have a couple of residents who lolled and groaned toothlessly. Oddly enough, Mum didn't seem to register it. I realised that Mum is focussed solely on the immediate things like who is talking to her, which chair she is going to sit in, her need to go to the toilet. Niceties and practicalities are my job to worry about.

The "praying that they'll die" thing?... Yes, I've found myself imagining that once or twice - scary.

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