I have been working in a nursing home for the past year and it’s given me a rare insight into the world of elderly care. There’s so much I didn’t realise, despite my Nana going into a home when her Alzheimer’s progressed. Now that Barbara Windsor and particularly her husband, Scott are raising the profile of Dementia, it’s becoming less of a taboo subject.
I’m almost ashamed to admit that I couldn’t visit my Nana in the late stages of her disease, because I didn’t want to remember her like that. I know she wouldn’t have recognised me anyway, but I would know. I don’t beat myself up about it, because I did what was right for me at the time.
It was a difficult time for me, my daughter Amy had been diagnosed with Tay-Sachs disease, and it was like I couldn’t cope with the two traumas at the same time. They did get to meet each other though, which I was grateful for. If there is an afterlife, Nana and Grandad and Granny are looking after her somewhere.
It can be so frightening when a loved one either develops dementia or has physical disabilities or frailties meaning they need the supportive environment of a residential home or nursing home. What’s the difference between the two? Well, a care home is run by a manager and carers. Any nursing care is done by a visiting district nurse. In a nursing home, there are registered nurses alongside carers. Some homes have a mixture of residential and nursing areas, which is something to think about if they have a progressive disease like dementia, they may need nursing care at one point and will need to move homes if they don’t have nursing care.
Funding for care
The most shocking thing I’ve learned has been the whole way that care is funded. I had a vague idea but it’s been a real eye opener. In basic terms (and things can change, so do check), if your loved one has £23000 in savings or more, then this money can be used for paying for their care. If they have a property that no one else is living in, then this is sold to pay for their care. Whilst waiting for the sale, care is paid but then when it’s sold, you pay it back. If you don’t have power of attorney for finances and you know your loved one has the early stages of dementia or a life limiting illness, start the process now, it will make it much easier when the time comes.
If they don’t have any savings or property, their care will be part funded by social services. There are two elements of care – health and social. You would think that dementia comes under health, right? Wrong! Mental health and dementia care doesn’t come under health (NHS) funding. There’s something called continuing health care payment (CHC), which they may be entitled to to get funded nursing care. The trouble is, it’s very hard to qualify for. We have to fill in a CHC checklist, which is worded so that you have to tick high up in most boxes to get the funding. This payment isn’t means tested. Even if a patient is bedbound, can’t communicate or feed themselves, can’t remember things, they won’t necessarily qualify for funding. This is because the majority of their care can be done by carers.
This creates a feeling of unfairness, meaning two people in the same care home receiving the same care, but one has to sell their property and one has no savings or property. Both have likely worked all their life though, and contributed to society.
Another thing that has surprised me are the visitors, or sometimes lack of. You never know what goes on in people’s lives, or how that person treated their family and friends, but on the whole I was surprised how some residents were very rarely visited, whilst others had daily visits. This isn’t a guilt trip by any means, remember how I couldn’t bear to visit my Nana? There’s no right or wrong here. A visit means so much to them. I think they can tell the difference between a visit from a loved one and a carer or nurse, however caring they are. The best gift you can give your loved one is your time.
The final thing that I didn’t realise happened at all, was that nursing homes are used by the NHS as relief for bed blockers. A bed blocker is someone who is medically fit for discharge from hospital, but can no longer go home to where they were before. Perhaps they were living alone and now cannot manage, or their carer (often a husband or wife who has reached the end of their capabilities) can no longer look after them. Perhaps their residential home cannot look after them anymore as their needs have changed. The NHS needs to pass the case on to social services to either get them a care package in place in their home, or find them a permanent residential care setting. This takes time, so they are placed in a temporary nursing home pending assessment, funded by the NHS until alternative arrangements are made.
We have several beds we kept free for these NHS patients and they were only ever empty for a day or two. Often after the assessment process they remained with us. If the funding couldn’t be worked out sometimes they moved on to a cheaper home or somewhere nearer family. It’s almost like elderly people are a bit of an afterthought, and once you’re over a certain age people no longer care. But of course, we do care and I’ve also seen tremendous compassion, love and tenderness towards the residents.
Our nursing home has a high proportion of Nepalese carers, who are the most hardworking people and gentle and caring. They told me that in their country they have very few nursing homes, and if you put your loved one in one, it’s frowned upon. They look after their own. I can understand both sides of the story, if you’ve never had to deal with somebody very frail and often aggressive, could you cope? Some relatives are still working, still have their own children to look after, so looking after an elderly relative simply can’t be done. It’s made me think about my parents in a different light. They’re currently 73 and absolutely fine, but I’d like to think I’d look after them myself – who knows what the future holds though?
Gifts for residents they really want
The last part of this article is something positive you can do for your loved one. There are many things a resident doesn’t need and a lot is provided, but it’s the little things that they notice the most. I’ve made a list of gifts and ideas to bring your elderly relative in a residential or nursing home that will lift their spirits and make their environment better.
Other things to consider are contributing to their fund via the care home for things like toiletries, haircuts, newspapers etc., an iPod with speakers loaded with their favourite songs (or CDs), stamps, tissues, cuddly toys, audio books. Why not organise a takeaway or fish and chip supper you can share together? Check what they already have first. Women who have dementia but are still active like to have a handbag and purse with them, even if it has no money in. I do wonder if in the not too distant future there’ll be mobiles and laptops with parental controls on in nursing homes, I know if I lose it, I’d be ordering the same thing over and over and posting really weird stuff on social media!
I hope this article has been useful to you, if it has please share it, it makes my day.
Disclosure: collaborative post