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Elderly Mum - Care Plan

  • 14-09-2019 1:12pm
    #1
    James 007
    Registered Users Posts: 962 ✭✭✭


    Our mum has had a recent heart attack which seems to have now changed the way we need to take care of her. The heart attack occurred 3 weeks ago, she has since had two arrests, one critical so much so the family were called in at 3am in the morning. We taught we were going to loose her. Its a week since I had last seen her, but I have seen improvements to date. No walking aid, but has a crutch to use as a walking stick. She is still in hospital and as a family we are trying to discuss the next steps for her. Approx. 2 years ago she refused us to have her house upgraded with walk in shower, handrails etc. She is the sort of person who does not want to live in a home, I'm sure its the same for alot of elderly parents. My mum is 85, home alone, but does have 2 of my brothers quite close to her living within a minutes walk from her house. My mum is in the Kerry region, and I am trying to research options for her weather its homehelp, family scheduling care for her or going down the route of the Fair Deal scheme. I might also add that she has dementia, pershaps minor at the moment. If anyone could advise us the best possible route or their own experiences, much appreciated


Comments

  • #2
    looksee
    Registered Users Posts: 28,018 ✭✭✭✭looksee


    Is your mum still in hospital? Its very unlikely the hospital would agree to discharge her to live alone. Is there any possibility she could go to live with any of her children? I can't offer any really useful suggestions but you do have my sincere sympathy with your dilemma, its not easy to work out what to do in that situation.


  • #3
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    Thanks for the comments. One of our brothers works a 3 cycle shift. The other brother rents his farm out, but he has 4 kids to take care of too. An option is to schedule care amongst the 4 of us or try to have home help combined with our own care. I suppose we are looking at options that others out there feel work for them at the minute. Thanks for the comments thus far.


  • #4
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    looksee wrote: »
    Is your mum still in hospital? Its very unlikely the hospital would agree to discharge her to live alone...............

    Yes, we are aware of this. We are currently trying to research options that will suit us all, but it will have to be discussed in more detail too


  • #5
    Highroad12
    Registered Users Posts: 43 ✭Highroad12


    My nanny has dementia and grandad also just generally feeble. Both late 80's.

    At 1st the family decided it was best to keep them at home together and their children took their turns. It generally ended up being left to the same 2 or 3 people and the stress started taking its toll after a while and some of them had to walk away.

    Looking back it would have been best to get my nanny settled into a nursing home but it's too late now and she may aswell live out her time at home.

    Don't take her out of hospital without having home help in place. It's harder to get once they are home. Fair deal scheme forms take a good 8 weeks to be processed so no harm having the approval there just in case as things can go downhill quite quickly.


  • #6
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    Thanks for the comments so far. Yes we are looking into the Fair Deal option. How does anyone out there approach their parents & discuss putting them into a home, she will be heartbroken. Its a very difficult conversation to have with them I'm sure. Some old people still feel that they can be independent etc.


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  • #7
    CiDeRmAn
    Moderators, Category Moderators, Computer Games Moderators, Society & Culture Moderators Posts: 34,526 CMod ✭✭✭✭CiDeRmAn


    You certainly need to talk to the community care team about a package for her, the hospital can help with that.
    They'll need to ensure that she can be safely cared for at home prior to discharge.
    It might be the case that she simply cannot be at home, without significant risks to her health, in which case you may have to discuss a residential setting and Fair Deal scheme.


  • #8
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    Thanks, my thinking is that she will be fine healthwise, but we will wait for the assessment to be completed. She seems to improved alot following 2 late night arrests, 3 nites where blood pressure was 180-190 and all the trauma that goes with it. A carer or a nurse probably will be required with family filling in the gap to look after her. Has anyone used Alhomecare or Bluebird Care, what are the general costs for a carer or nurse, do you find the service good.


  • #9
    CiDeRmAn
    Moderators, Category Moderators, Computer Games Moderators, Society & Culture Moderators Posts: 34,526 CMod ✭✭✭✭CiDeRmAn


    An uncle of mine had to get additional care for a time from a company, but they were really health care assistants for hire, and even then were quite limited in their duties compared to those I know in work, my wife and I are Clinical Nurse Managers.
    Regardless of what they claim on their literature, be clear on what you'll get for the money, in terms of time and duties they will do, as it might not be what you want.
    I assume you've got some sort of pendant alarm system there as well, in case your mam gets into difficulty and needs assistance?


  • #10
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    CiDeRmAn wrote: »
    An uncle of mine had to get additional care for a time from a company, but they were really health care assistants for hire, and even then were quite limited in their duties compared to those I know in work, my wife and I are Clinical Nurse Managers.
    Regardless of what they claim on their literature, be clear on what you'll get for the money, in terms of time and duties they will do, as it might not be what you want.
    Yes, it probably needs to be written down, has anyone ever drafted such a list, what would be some reasonable expectations.
    CiDeRmAn wrote: »
    I assume you've got some sort of pendant alarm system there as well, in case your mam gets into difficulty and needs assistance?
    We have a certain type band that she wears with a button to press. We probably need to review this. Do you have a recommendation. She has the onset of dementia so we probably need something more reliable, any recommendations welcome, thanks.


  • #11
    looksee
    Registered Users Posts: 28,018 ✭✭✭✭looksee


    One point on these alarms. My mother had a fall, happily she was uninjured, she was not wearing her pendant and learned her lesson from this. She had another fall, again no injury but she landed in such a way that the pendant was pinned under her and she could not get at it. The suggestion being that the pendant cord needs to be short enough that if the person falls it will not be out of reach, while still long enough to pop over the head with no hassle. A wrist band may be a better idea, though of course nothing is perfect.


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  • #12
    Gael23
    Registered Users Posts: 12,086 ✭✭✭✭Gael23


    Bluebird and Home Instead are prohibitively costly in comparison to fair deal.
    I have a neighbor who until age 93 was able to manage only with someone to come and help with housework. An unfortunate fall changed that and even though she’s at home it’s not working very well. I think it’s perhaps easier for someone to go into a nursing home from hospital rather then go home and for it not to work out. She went in for a few weeks while an enhanced home care package was being put together and I think would have stayed at the time if pushed into it.


  • #13
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    looksee wrote: »
    One point on these alarms. My mother had a fall, happily she was uninjured, she was not wearing her pendant and learned her lesson from this. She had another fall, again no injury but she landed in such a way that the pendant was pinned under her and she could not get at it. The suggestion being that the pendant cord needs to be short enough that if the person falls it will not be out of reach, while still long enough to pop over the head with no hassle. A wrist band may be a better idea, though of course nothing is perfect.
    She had one on her wrist, not sure how it works but will need to find out from family. Dementia doesn't help as she probably most likely wont use it when she has a fall etc.


  • #14
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    Gael23 wrote: »
    Bluebird and Home Instead are prohibitively costly in comparison to fair deal.
    I have a neighbor who until age 93 was able to manage only with someone to come and help with housework. An unfortunate fall changed that and even though she’s at home it’s not working very well. I think it’s perhaps easier for someone to go into a nursing home from hospital rather then go home and for it not to work out. She went in for a few weeks while an enhanced home care package was being put together and I think would have stayed at the time if pushed into it.
    Home is the preferred option at the moment, but we will need to discuss all the options. My mum doesnt need nursing care but does need a certain level of care, its coming up with the right schedule to make it work.


  • #15
    CiDeRmAn
    Moderators, Category Moderators, Computer Games Moderators, Society & Culture Moderators Posts: 34,526 CMod ✭✭✭✭CiDeRmAn


    James 007 wrote: »
    Yes, it probably needs to be written down, has anyone ever drafted such a list, what would be some reasonable expectations.

    To be honest this is pretty subjective.
    It depends on what the person's capabilities are at the moment.
    If there are clinical issues, like dressing to change, drains to flush, then it might be a nurse led service.
    Otherwise the carer will probably bathe, do light housework and ensure the medication is taken, assuming it's probably blister packed to begin with.

    We have a certain type band that she wears with a button to press. We probably need to review this. Do you have a recommendation. She has the onset of dementia so we probably need something more reliable, any recommendations welcome, thanks.

    There is no replacement for company, but pendant alarms are pretty solid.
    Also, internet connected camera in key areas, that you can access from your phone/PC are also useful.


  • #16
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    CiDeRmAn wrote: »
    .................................There is no replacement for company, but pendant alarms are pretty solid.
    Also, internet connected camera in key areas, that you can access from your phone/PC are also useful.

    I agree regarding company. Regarding cameras what would you suggest type camera. I suppose in the kitchen, sittingroom, hallway would cover it for now.


  • #17
    Bannasidhe
    Moderators, Society & Culture Moderators Posts: 19,219 Mod ✭✭✭✭Bannasidhe


    James 007 wrote: »
    I agree regarding company. Regarding cameras what would you suggest type camera. I suppose in the kitchen, sittingroom, hallway would cover it for now.

    I'm in a similar position as you OP with my Dad.
    His consultant has recommended he be allowed home to live out what time he has left with his little dog so we are working on a care plan.
    I'd be very interested in knowing about cameras etc too.


  • #18
    CiDeRmAn
    Moderators, Category Moderators, Computer Games Moderators, Society & Culture Moderators Posts: 34,526 CMod ✭✭✭✭CiDeRmAn


    Something like this perhaps?
    https://m.argos.ie/static/Product/partNumber/9413966.htm

    You might look the model up, but it should work with the house WiFi and internet connection allowing you to log in and check on the video feed from wherever you are.

    Smart Cam or Interior CCTV seems to be the things to search for.


  • #19
    FutureTeashock
    Banned (with Prison Access) Posts: 439 ✭✭FutureTeashock


    Bannasidhe wrote: »
    I'm in a similar position as you OP with my Dad.
    His consultant has recommended he be allowed home to live out what time he has left with his little dog so we are working on a care plan.
    I'd be very interested in knowing about cameras etc too.


    The decision rests fully with your dad and no one else( unless he lacks mental capacity).


    It is a fundamental point of law enshrined in the Constitution that all forms of treatment can only be carried out with the consent of the patient.


  • #20
    gctest50
    Registered Users Posts: 9,605 ✭✭✭gctest50


    Bannasidhe wrote: »
    .........

    I'd be very interested in knowing about cameras etc too.


    These yokes work, have GPS, sent alerts to 5 etc etc


    https://eshop.v.vodafone.com/ie/v-sos-band


  • #21
    Bannasidhe
    Moderators, Society & Culture Moderators Posts: 19,219 Mod ✭✭✭✭Bannasidhe


    FutureTeashock wrote: »
    The decision rests fully with your dad and no one else( unless he lacks mental capacity).


    It is a fundamental point of law enshrined in the Constitution that all forms of treatment can only be carried out with the consent of the patient.

    Thanks for the unasked for lecture.


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  • #22
    looksee
    Registered Users Posts: 28,018 ✭✭✭✭looksee


    FutureTeashock wrote: »
    The decision rests fully with your dad and no one else( unless he lacks mental capacity).


    It is a fundamental point of law enshrined in the Constitution that all forms of treatment can only be carried out with the consent of the patient.

    Mod: this forum tries to maintain a non-judgmental, caring and empathetic attitude to responses. The tone of your post is inappropriate and lecturing, please have a little more consideration when posting.


  • #23
    CiDeRmAn
    Moderators, Category Moderators, Computer Games Moderators, Society & Culture Moderators Posts: 34,526 CMod ✭✭✭✭CiDeRmAn


    In truth, capacity is always assumed but it is not simply defined in one area and then untested in every other.
    And I'm speaking as someone who is working in the field of vulnerable adults, capacity and consent as well as the development of appropriate documentation to ensure consent is not just asked but also informed, through the use of easy read, tailored documents.

    A person can want something but it is not always possible to give them their desire.
    If someone wants to be nursed at home but their complex needs are simply too much for a care package to manage, some convergence between the wish and the available resources must be found.
    It's often best for this to happen with a clear picture of all the options coupled with a family meeting that will always include, where practicable, the person concerned.
    I know this all sounds quite clinical but that's kind of my field and I'm sure there's a more family friendly version of it.
    When I was managing an end of life case the family had all sorts of expectations but I was able to maintain the wishes of the resident front and centre, but I was also able to keep the family involved in every step, even if it was only to give them status reports and support visits.
    In the end, after the gentleman passed, the family were very satisfied with the whole experience and it all went on to support the development of our revised approach to end of life care .


  • #24
    FutureTeashock
    Banned (with Prison Access) Posts: 439 ✭✭FutureTeashock


    If an elderly patient states "I reject your residential care suggestion, immediately remove all consent to all your treatments, and demand to be discharged against medical advice.." , the hospital would be in severe danger of not accepting the wishes of the patient. I have personal experience in this area.



    And I'm trying my best to be as polite as possible!:o


  • #25
    4068ac1elhodqr
    Closed Accounts Posts: 9,586 ✭✭✭4068ac1elhodqr


    Phone: Amplicomms BigTel 50 (or newer model) with remote pendant is pretty good (automated message fastdial for x3 memory numbers). No fancy wifi/net required.
    Don't get a wireless doorbell lanyard as an alert, these often run on universal frequency settings, even car alarms can trigger them.

    In 10-20yrs it'll all be ai-robots and autobots, to replace much of the (more basic) care service industries. Some countries may be looking at 33% over-65 populations.


  • #26
    looksee
    Registered Users Posts: 28,018 ✭✭✭✭looksee


    Mod:There is a potentially very interesting discussion starting here but it would take the op's question too far off topic, so I will start another thread and copy salient sections into it, if no-one has any objections?


  • #27
    Bannasidhe
    Moderators, Society & Culture Moderators Posts: 19,219 Mod ✭✭✭✭Bannasidhe


    FutureTeashock wrote: »
    If an elderly patient states "I reject your residential care suggestion, immediately remove all consent to all your treatments, and demand to be discharged against medical advice.." , the hospital would be in severe danger of not accepting the wishes of the patient. I have personal experience in this area.



    And I'm trying my best to be as polite as possible!:o

    However, your wee lecture quoted me and I was merely asking about cameras so we could monitor my father while he is at home - which is his wish. A wish we are trying to respect even though he does have diminished mental capacity. A wish that will result in great financial expense paying for carers and disruption of the lives of his children and grandson as we roster overnight shifts to care for him.

    I do not disagree with what you said but I never mentioned residential care so I don't know why you decided to aim your comment at me and I honestly found it irritating, irrelevant, and unsupportive during a very trying period for my family.

    My father is dying. I don't need lectures on constitutional rights when I ask for advice about a specific thing that will help us follow his stated wishes.


  • #28
    FutureTeashock
    Banned (with Prison Access) Posts: 439 ✭✭FutureTeashock


    Bannasidhe wrote: »
    However, your wee lecture quoted me and I was merely asking about cameras so we could monitor my father while he is at home - which is his wish. A wish we are trying to respect even though he does have diminished mental capacity. A wish that will result in great financial expense paying for carers and disruption of the lives of his children and grandson as we roster overnight shifts to care for him.

    I do not disagree with what you said but I never mentioned residential care so I don't know why you decided to aim your comment at me and I honestly found it irritating, irrelevant, and unsupportive during a very trying period for my family.

    My father is dying. I don't need lectures on constitutional rights when I ask for advice about a specific thing that will help us follow his stated wishes.


    This is the part of your post I was commenting on, "His consultant has recommended he be allowed home to live".



    My point was about not letting medical consultants dictate terms to you.



    No good deed goes unpunished and all that.


    My best wishes to you in this difficult time.


  • #29
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    Bannasidhe wrote: »
    I'm in a similar position as you OP with my Dad.
    His consultant has recommended he be allowed home to live out what time he has left with his little dog so we are working on a care plan.
    I'd be very interested in knowing about cameras etc too.

    This is what i would be thinking of getting, but family need to have the discussion first. 5 cameras set up would cover most of the areas in the house. Would love to know if anyone uses these. Cost is 309 in catologue, online is 389:rolleyes:


  • #30
    Bannasidhe
    Moderators, Society & Culture Moderators Posts: 19,219 Mod ✭✭✭✭Bannasidhe


    James 007 wrote: »
    This is what i would be thinking of getting, but family need to have the discussion first. 5 cameras set up would cover most of the areas in the house. Would love to know if anyone uses these. Cost is 309 in catologue, online is 389:rolleyes:

    I really hope it all works well for you and your Mam James.
    I'm sad to say that my Dad will never be leaving the hospital.


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  • #31
    James 007
    Registered Users Posts: 962 ✭✭✭James 007


    Bannasidhe, sorry to hear about your Dad, hope you have some precious moments with him for the remainder of his life. Probably this month & I think this date just on 20 years ago I lost my Dad & found it hard, especially when I was the only one not to see his last few moments, I was on a train on the way down home, but never made it on time. Only just over a month ago now I was doing the same journey, driving this time at 3am in the morning thinking I wouldn't make it again to see my mum, I bawled my eyes out several times during that trip. I kind of accepted it now that I will loose her eventually, so my take is to enjoy those final days, months etc. with my mum, in your case your dad with your close family/friends. Life is precious & none of us will be around for ever, but with time loosing those around you does seem to heal one with the progress of time if its any consolation, you can take solice from that.


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