How to find a nursing home - not self funded / no hospice available

[tigerbear]

Hi all,
My MIL has a fractured pelvis after a fall, cancer of the intestines, dementia, rectal problems, septicaemia, several infections - inc recurring bladder infections, diabetes etc and has declined massively in the last week. She can’t stand, and is having difficultly eating, breathing issues etc.

GP advised it would be too taxing and distressing for her to be taken to hospital, as would likely be on a trolley in casualty for up to 48 hours.

Shes at home, with carers visiting three times a day, plus family support of someone going in every day, but this is becoming too much for the family to deal with - eg her daughter and sons are having to clean her up if she’s had a toileting incident, change her pads, etc Understandably, distressing for everyone.

the family have been told she needs 24 hour care.
Such is her decline, that people from the local hospices visited today, but there are no beds available, and they said she’s not technically critical enough to take in, and recommended we look into nursing homes.

Theres also 95 year old FIL at home, who is disabled and needs help, so the house can’t be sold to self fund care for MIL.

I’m trying to research what the options could be - I believe they’ve been assessed by the LA, and that their savings are only about £2k

How does one actually find a nursing home who will take patients who can’t self fund?
I’m searching online, but it brings up homes that are extortionate.

At a loss of what to do next.
any help much appreciated.

In my experience (DM and MIL), it's Adult Social Care that choose the home if someone isn't self-funding. With MIL, we had a choice of three homes but that was about fifteen years ago. With DM, there was no choice as only one home had a space. The exact procedure might vary between councils but you do need to speak to ASC about this.

Have you looked at the AgeUK website? They have a few guides to explain. This is a good place to start

ageukig06carehomes_inf.pdf share.google/815CH92IgCCOTHc9a

If she has carers coming in I presume they have already had an adult social care assessment, get onto them and explain the situation that you are not coping. They and GPs have the ability to access nursing home beds directly, in my area called crisis response beds. Unfortunately as not self funding there is no point in looking at them yourself as you won't really have a choice where the bed is.

1. She well be eligible for CHC funding if she is considered to be at end of life. Do you have a social services contact to ask about it? Or Google how to apply for it for your area. The hospice people may know more. You may then get a limited range of those who will accept it.
2. Just try googling nursing homes for your area - pick a place which will be convenient for your dad to visit - and start ringing round asking if they will take people on local authority funding.
3. Put the word out on any WhatsApp groups for people of your sort of age for local recommendations.
4. I don’t have any connection with them but you may find the Lottie app helpful - but I didn’t actually end up using it myself and I do still get constant adverts…

Sorry to hear you are struggling . Sadly there is no quick move into a state funded care home .
You will need to contact adult social care who are more than likely already extremely busy . This is obviously a b/ h so contact them Tuesday . When you get an appointment an assessment is made on the persons needs and not really the carers so be prepared for them to say they are not at the point of a care home .
They then go away and review their findings .
All this can take weeks / months .

if she’s not self funding you need to get on to adult social care.

expect a fight

Thanks for the suggestions so far.
Ive been googling to look at options, but as @Mossstitch said, will we even get a choice as to which home she could get put in?

I’m confused, as the hospice people said we should start researching nursing homes.

to be honest even if you are self funding these days it often comes down to where has a space.

if you are state funded then it may be worth having a look but there’s very little point doing detailed research.

if she is end of life to the point the hospice are involved it may get tricky.

Bear in mind that all nursing homes are extremely expensive. Round our way when we were first looking four years ago, the minimum was £1000 a week, maximum £1900 a week and they’ve only gone up. I have to say the £1000 a week one was truly awful but even at the cheaper end there are nicer ones.

Very unlikely. With DM if a self-funded space hadn't been available, ASC would have started to contact other councils across five or six counties that they have arrangements with, to see if they had space. And if a space is found, you would need seriously good grounds to refuse it.

I’m confused, as the hospice people said we should start researching nursing homes.

Would the hospice know that you're not looking at self-funding?

I was caring for my family member and they went into a coma and I wasn't coping with that . There was not a place available at the small local hospice but they came out to assess them and called out an extra visit from a district nurse , they decided my family member needed extra medical care and they phoned the hospital for admittance . They got to speak to a Dr who refused admittance as agreed probably actively dying and what was the point of them going to hospital .
I found the whole experience very distressing .

If the local authority have assessed, and agree a nursing home is needed, they should offer the family a couple of different options. You could request one yourself but it won’t be agreed if there is a cheaper one or one the LA has block beds with that would be suitable. If it’s a time critical situation it’s often just whoever has space. The care home themselves then get sent info about the person and come and assess them themselves.
if it is end of life care there may the situation of arguing with the NHS trust who funds but hopefully that won’t hold things up. Best to call the team who did the assessment. Or go through the care agency, they will know who to talk to.

God, it sounds like there’s no easy or quick solution 🥺

@LaDoIceVita i don’t know tbh. Just spoke to SIL, who is going to speak to social services again on Tuesday to ask what to do.

Everything is so fast moving, and whoever we speak to has a different opinion, so it’s hard to know which way is up. Poor SIL is dealing with the majority of the care, plus all of the paperwork, assessments etc

I'm sorry, there absolutely isn't. Getting agreement that your MIL needs to be in a home will be like fighting a war. ASC will try to guilt trip family members into continuing to provide care, or pressure the family to pay care home fees. There have even been cases where family members have heen told that they are legally required to pay the fees. They will use every underhand trick in the book. I was pushed to the brink of a complete mental collapse fighting for DM. I wish you and your family luck with this.

Editing to ask: Does your MIL have capacity? And does someone hold Power of Attorney?

Just to throw another horrible spanner in the crappy situation, if there is a house with enough equity they will put a charge against the house for the costs and claim it back when the time comes that it’s sold after FIL passes.
sending you love as it’s a horrible process 💐

Social services will have someone on duty over the weekend. As they won’t be making calls, having meetings etc they may be more
time for a chat than at
other times

You need a community nurse from GP surgery to complete a CHC checklist. I think suicidal services will not get involved until this has happened as they will want" health" to fund and not them if she meets the criteria. If she does not meet CHC criteria and had no savings then a social worker needs to assess urgently.

@LaDoIceVita no, MIL does not have capacity. She’s delirious most of the time, and extremely distressed. POA are in place for health and finance.

There is equity in the house, as they bought it outright over 30 years ago

SIL is having another talk with SS on Tuesday to see what can be done.

I’m sure I read somewhere that if a person is terminal, and for end of life care, nursing home care was free, but maybe I’m getting confused.

we seem to be getting conflicting advice from different medics, SS, GP etc, but as others have said on this thread, maybe it’s all a ploy for the family just to be expected to keep going at home as things are, and for her not to be taken into hospital, a nursing home or hospice.
We’re all fully expecting that every day is her last, but I guess this could all go on for weeks.

@tigerbear Glad you have PoA in place - it's one less problem. I don't know about terminal illness but when MIL went into a nursing home, the nursing fees were paid by the NHS and the care fees by the council. I really hope that your SIL can get some advice and clarification on Tuesday.

To get free NHS paid care,a nurse needs to complete a continuing healthcare assessment at home. I would have thought the GP could arrange this. Social services do not fund patients who met CHC criteria.

You can request the GP completes fast track funding for end of life care, you don't need the chc for this, then a nursing home can accept.

If she has cancer and is at end of life Marie Curie might be able to provide a hospice nurse in your home

GP doesn’t complete fast track assessment. This would be a nurse

Fast track is fast track CHC as usually CHC is a long process