Elderly Mother in need of care at home

MonkeyWrench

I have an elderly mother in her 80's who has been managing okay at home for the last number of years. She has home help 3 days per week, who provide this service through the health board. The carer is very attentive and looks after the basic needs such as food delivery, washing up and cleaning. She is there to assist more than as a nurse/carer and although this has been working well up to now, we have noticed a decline in my mothers health over the last month. She has been very feeble over the last 3-5 years but she is noticeably frailer now and her appetite has been very poor over the last month.

We are looking for a number of options from here in terms of care that can potentially be provided. Myself and all my Siblings live at least 2 hours away and have families to support and be responsible for so it is very difficult for us to provide our own care for her. She is very adamant that she wants to be in her own home when she passes and is very nervous about even seeing a doctor as in her mind this will potentially lead to a situation taken out of her hands and possibly ending up in a nursing home.

Any advice on this would be appreciated from people who have had a similar experience with their elderly parents, its a very difficult situation for us as we do not want to go against her wishes, with her leaving her own home, however its getting to the point where a decision has to be made about her future now which taking into account her own wishes.

looksee

Does she want to be 'in her own home' as against a nursing home/residential care, or that specific house? Could she be persuaded into a small independent accommodation nearer to family? This would be a huge upheaval and would require a lot of dedicated effort from family to achieve.

If she wants to stay in the house she is in then I would respect her wishes and not try to move her. More care will probably have to be employed so she has someone at least looking in every day. One or another of her children will probably have to make the effort to travel down to her every weekend or couple of weeks. Presumably she is in some sort of telephone contact and also has an emergency button?

My personal opinion (as a woman in my 70s) is that it is more important for her to be content with her life for whatever time she has, and if that means staying in her own home, so be it. I would not agree with putting her in a situation she does not want for the sake of possibly extending her life by a year or two. But that's just me, others will argue to keep someone alive even if they are not happy. Both my mother and my husband insisted they wanted to be at home, and in the end it did not make any difference and they died peacefully, and attended, at home.

Telly

Could she move in with any of you?

MonkeyWrench

Thank you for the replies looksee and Telly. She has said for many years that she wants to be at home, she is very adamant about that and reiterates it regularly. So the option of moving in with one of her family is not really an option, she also gets exhausted with young kids running around so that is another negative in that aspect, it would be against her wishes and possibly detrimental to her health with the stress kids making noise etc.

My wifes grandmother was in a similar situation recently, had similar wishes to stay at home but her health deteriorated to the point where she had to go in for tests, she got one infection after another and is now in a nursing home. So that initial step out of the house led to her probably never getting back to her home again. I think its that step out of the house my mother fears, by going to the doctor she foresees that she will end up in a similar situation. So even getting a medical checkup is hard to convince her to do.

Would you advise on how to seek out a paid service that is reputable for home care? I see some online options but its difficult to know who and who is not reputable from that alone.

In the case of wanting to be at home, but going for tests and they are adamant that she has to go in to a nursing home because home care cannot be given, is it taken out of her and our hands at that point or is there still a choice in the matter?

10-10-20

My wife's granny was of a similar mindset 10 years ago. She was only just coping at home but had good help next-door, but didn't want to end up in a home.
As time progressed she agreed to go to the local HSE home for two days a week as a day-resident (the social-scene and activities were her main interest). As time went on she herself decided to increase this duration to the point where she requested to be moved in as a full-time resident as she was bored at home (and felt that she was a drain on her carers). Perhaps this helps.

looksee

I can't help with carer services, but someone else may be able to help you.

While I fully understand your desire to help her, I don't think you can plan too far ahead. Certainly get extra help for her, but then take it as it comes. If she does need medical intervention, deal with it as it arises. If she needs nursing at that stage she may have to go into a short term residential accommodation but there may be a way of getting her back home. Its difficult but I don't think you can do a lot of planning for the situation.

Telly

Contact her local health nurse. They'll be able to give you some names of care companies. Also contact the HSE as you may be able to get this service for free as we did for our Mam.

[Deleted User]

I’d also advise contact the public health nurse too as her existing care plan may need revising. Has an occupational therapist visited her home to assess whether specialist equipment is needed?
Meals on wheels is very active in the rural area where I live too so that’s somebody checking up once a day.

It’s completely possible for her to remain at home with the correct plans in place to do so.

Solli

10-10-20 wrote: »

My wife's granny was of a similar mindset 10 years ago. She was only just coping at home but had good help next-door, but didn't want to end up in a home.
As time progressed she agreed to go to the local HSE home for two days a week as a day-resident (the social-scene and activities were her main interest). As time went on she herself decided to increase this duration to the point where she requested to be moved in as a full-time resident as she was bored at home (and felt that she was a drain on her carers). Perhaps this helps.

This is good to know. What county or area is your granny in law in? Would it be possible to find equivalent of the HSE facility for day residents elsewhere? I just love this idea even though it is too late for my parents. When I looked at a HSE care facility it wax residency only at 3000 per week!
Still the local dentist managed to qualify for it...

[Deleted User]

Day services are on hold due to covid and from what I’ve heard they wont resume at all this year. They are usually held at the community hospital.

10-10-20

Solli wrote: »

This is good to know. What county or area is your granny in law in? Would it be possible to find equivalent of the HSE facility for day residents elsewhere? I just love this idea even though it is too late for my parents. When I looked at a HSE care facility it wax residency only at 3000 per week!
Still the local dentist managed to qualify for it...

Birr/Offaly.

Telly

Strawberry Milkshake wrote: »

Day services are on hold due to covid and from what I’ve heard they wont resume at all this year. They are usually held at the community hospital.

Some in north Dublin have opened back up again so worth ring around.

sweet-rasmus

I’d recommend getting more help in. While she may be reluctant to having more help, she will know it will help her to remain living at home for as long as possible. Hopefully given her condition has deteriorated the HSE would allocate more (free) home help hours. However it can be a struggle to get more - I always feel that not enough is provided free of charge to those who need it.

On top of that you could look at paying privately with one of the well known agencies or directly with carers local to you on Home Care Direct. With the latter you contact carers directly, so you have a bit more control. I would also suggest you don’t mention any private paid hours to the HSE as it may make them reluctant to offer you free hours.

Good luck.

AndrewJRenko

MonkeyWrench wrote: »

Would you advise on how to seek out a paid service that is reputable for home care? I see some online options but its difficult to know who and who is not reputable from that alone.

Is her current home care service through an agency paid by the HSE? If so, maybe you could pay them directly for additional hours.

endofrainbow

Contact your local Health Nurse as they are the ones responsible for requesting additional home help hours.

sporina

https://www.boards.ie/discussion/comment/117625180#Comment_117625180

do you mean Public Health Nurse?

endofrainbow

Local Health Nurse, Community Health Nurse, Public Health Nurse - which ever title they go under in your area

karlitob

https://www.boards.ie/discussion/2058197623/elderly-mother-in-need-of-care-at-home

A very difficult and common situation. I would do you absolute utmost to get a referral to a Geriatrician at your local hospital and in particular access to the Day Hospital, which is a fantastic multidisciplinary service.

A full medical, social, functional and cognitive assessment is required. A treatment plan put in place and most importantly this can be monitored by the team. There is a big difference between a geriatrician speaking to your mother about how she would benefit from a nursing home rather than her family.

Beat of luck.

Ace2007

If you need someone more to help/assist there are a number of foreign nationals that would be willing to help out in return for accommodation - given that you are in Offaly, i'm not sure of the availability - but it's just another option. Private care companies can be very expensive, and there is only so many hours in the day that public heath carers will do, so having someone staying overnight can offer reassurance. Even if you not comfortable going down that route right away, they are great for hiring privately to assist with an elderly person. From experience there were many south american available pre covid.

[Deleted User]

https://www.boards.ie/discussion/comment/117788074#Comment_117788074

Jesus don't do this.

Strumms

Contact your local health/public health nurse and enquire about getting the hours extended.... maybe too organize a call with their GP as he might be able to leverage influence.

Flinty997

You can increase the home help hours per day.

At some point you'll reach the point that is not financially possibly to provide support 24/7. Or there will be some medical issue that forces the issue.

Ace2007

https://www.boards.ie/discussion/comment/117791378#Comment_117791378

Why not?

The OP and their family are over 2 hours away from their mother, and the mother wants to stay in her own home - so having someone come in regularly that she knows could give her extra years at home and help the OP. Sure you can go to the local nurse, but there is no guarantee that they will come when you want them, or they will only stay 30 mins or whatever.

[Deleted User]

Because it has the potential to leave a vulnerable elderly person open to being taken advantage of.

There comes a point, when I'm sorry to say it but both the elderly person and the family will have to come to accept that staying in the home is no longer a safe or viable option and moving in with family or a nursing home are the only realistic options.

I've been down that road - twice - the first time with a grandparent and then with my own mother.

As an aside, HSE home care assistants are not supposed to do any cleaning.

Ace2007

https://www.boards.ie/discussion/comment/117792670#Comment_117792670

But if the mother in question just wants some extra help or someone in the house then that's a viable option. I know of people employed in Home help companies who have been approached by families offering cheaper accommodation as the price in Dublin is through the roof. They are garda vetted in their current jobs, so not just random folk.

I personally know people who have let a room out to a student nurse over a 3 year period so that someone would be in house with an elderly parent as no family were close by. Again it was a win win for both sides.

There are numerous sites like Childcare, Babysitters, Childminders, Nannies & Senior Care (mindme.ie) that can provide a service that you might not be able to get elsewhere. There are many different type of individuals on these website, from part time nurses, to retired medical personal who although aged 65 still have a lot to offer.

You shoot down a service because you say that they could be taken advantage when in reality it might be the perfect solution. You mention nursing homes - yet today Hiqa published reports today stating that half of the homes they inspected recently were not compliant - so is that better solution? - potentially paying thousands to a company that are no complaint?

[Deleted User]

Maybe you should have a read of this in detail - Citizens infomation - domestic workers.

You can't just offer someone accommodation in lieu of payment of wages. A domestic worker in the home is entitled to at least minimum wage per hour, a contract of employment etc. Also look at the deductions from wages for board and lodgings.

I'd be very careful advising people to go down a road that could land them in the WRC later on with a claim for thousands in unpaid wages made against them, as happened with Au-Pairs. .

Also workers from outside the EU (e.g. the south americans you suggested) would require work permits.

Ace2007

Your making it out as if you’ll be treating the person as a slave. I suggesting that there will be someone around if needed, like at night or for some light work. This is already happening - like I said I know of student nurses that have stayed with an elderly person for last few years and they do some shopping/cut grass - just the jobs that the person can no longer do as they are slowing up and in return get to save money on rent. They have home help for their personal needs.

i notice how you swerved the nursing home comment I made even though it’s all over the news…. Could these homes end up being sued and in court for failing to provide a service that the are legally supposed to do?

some people might not like my suggestion and that’s fine but to shoot it down and tell the OP that they have to put her in home or move in with them is having zero regard for their mother’s wishes. There are people in their 90s still living at home- nursing homes aren’t the be all and end all.

Just to add there have been many cases in the past where family members take advantage of elderly parents and make decision about their lives that the parents don't agree with - but again you seem fine with this, and throw out an accusation that a vulnerable person may be taking advantage of if the family hire someone to either stay over and do light work, or come in during the day and do light work.

[Deleted User]

https://www.boards.ie/discussion/comment/117796406#Comment_117796406

You suggested moving someone in with the elderly person for care services in lieu of accommodation, and I outlined the pitfalls in that (both legal and illegal).

The rest is just ranting on your part.

Its ironic you talk about "compliance" within nursing homes, yet apparently you are quite comfortable recommending people ignore all our employment laws in relation to domestic workers, and the risk to potential abuse to elderly vulnerable people.

The best advice is medical advice, and yes, I do believe there comes a time when the decision may have to be taken from an elderly person's hands, in the interest of their own safety. There comes a point when staying at home is not always possible, either. That is for the family to discuss with health care professionals and their family member.

Not all nursing homes are dumps and its also up to the family to do their research on available places before choosing one.

I was very happy with the nursing home my mother lived in for nearly four years, she was exceptionally well taken care of. In fact, I jokingly asked them to reserve a room for me when the time comes.

Ace2007

The OP asked a question and instead of providing a suitable answer you attacked my post. The OP clearly states that the mothers wishes are to stay within her own home - again you have ignore this. The OP is not at the stage of the mother needing to go into a home - yet you bring it up - why?

You brought up the term domestic workers - not me.

I never said all nursing homes were dumps - i merely pointed out that half of those inspected by HIQA recently were found to be non compliant - that's factual - read the news this week. Your comment about someone potentially taking advantage of a vulnerable person is hypothetical and scare mongering. I've heard more cases of family members taking advantage of elderly loved ones than of people co-living with elderly people and helping out in return for cheaper accommodation. But don't let that get in the way of your attack and idea of abuse. If the mother is of metal capacity to make decision and states clearly that she does not want to go into a home, nor is not medically needed to go into a home, and the family decide because they are not around to put her into a home - is this not abuse? But it's ok because she is elderly, or it's ok because their her son/daughter.

If you want to ensure everything is legal, why have you not suggested that the OP gets a power of attorney and an enduring power of attorney written up in advance - that is something that is extremely value and needed if say you need to get a home loan put against the house for a fair deal. Any reason why you didn't suggest this when talking about what's legal and what's not?

Finally why should it be up to the family to do research of nursing homes - there is legal requirement that they should be up to standards is there not?

[Deleted User]

https://www.boards.ie/discussion/comment/117797017#Comment_117797017

You need to cool your jets. I obviously hit some kind of nerve.

I didn't attack your post, what I did was point out the potential pitfalls in your suggestion to find and move a "foreign national" / "south american" into the home to "co-live" with an elderly person in exchange for reduced accommodation costs and now you're going off on one because you took offence to it. That's basically what your follow up rants are all about.

I brought up domestic workers / migrant workers and their rights as its clear when you were offering your "advice" that you were unaware of what is classified as a domestic worker in this country, and the employment laws that are in place to protect them from the kind of exploitation you were offering up as a "solution" . I also provided a link to the appropriate information on Citizens Information.

You are ignoring the legal hot water your "solution" could land a family in with Revenue and/or the WRC if a claim is made against them, if for any reason, this "co-living" arrangement didn't work out. Think it wouldn't happen? It does. Anyone who would leave themselves open to that legally is a fool, in my opinion.

I did not ignore the OP. I suggested moving in with family, or a nursing home as they stated their parent has become increasingly feeble and suffering a lack of appetite over the last few months - and in my experience usually once an elderly person starts to decline, its simply delaying the inevitable.

Indeed, anyone who finds themselves in this position with a declining family member should engage with HCPs and absolutely look into POA (or EPOA as POA becomes useless once there is a diagnosis of mental decline e.g. Alzheimers or Dementia).

And finally, yes. Of course it is up to the family to do research on the nursing home places available. You're just being argumentative with that statement.

Ace2007

You've taken a suggestion by me and ran with some theory of not legal etc - i noticed that in other thread where a poster openly admits to organizing cash in hand care - you make no comment - surprisingly...

You jumped the gun and automatically assumed that the person who co lives with an elderly person is going to be a slave and doing all the house work, which is clearly not what i stated.

What i suggested is a possible solution to a problem, that is currently happening in Ireland - whether you want to believe it or not. The OP clearly stated that the mother does not want to go into a nursing home nor does she want to be around young children and hence moving it with family is not an option - but you chose to ignore these two statements and suggest them anyway.

Everyone's situation is different, so we'll agree to disagree on the matter and move on