A good percentage of us will reach the rather sad stage when we have to put one, or both, of our parents into a care home or nursing home. Usually this happens over a period of time when you're persuading them for their best interests. The unfortunate reality is that most old people do not want to go voluntarily into a care home but they reach a point when they cannot safely look after themselves any more.

They worry about the loss of independence and privacy, plus they can think its "God's waiting room", and this must be so depressing to face, so you've got to pull out all the stops to reassure them. It can be extremely difficult, especially when you may have all your own concerns that everything will be all right.

Add to your own doubts the sense of guilt that you are not offering them a roof over their head and care with you in your home, and this can make it such a stressful time. Many couples do have an elderly parent living with them very happily and successfully. I think you know yourself, and you know your parent, as to whether it will work and whether you can do it.

Respite Care

A good idea is to first test the water and perhaps when you go on holiday use the respite care that many homes offer. This will only be temporary, and your Mum or Dad will know that, so that will give them a little peace of mind, knowing it is not forever. In fact, many elderly people have gone into respite care and liked it so much, they've decided they do want to be looked after and are then keen to make the first steps. It obviously depends on which home you choose, how the staff treat them, their interaction with the whole situation. Of course, it can have the opposite effect and discourage them for life!!

Making a short-list of potential Care Homes

Once the decision to place your elderly parent in a care home is made, you have to move fairly quickly, or maybe they have to go into a home as a matter of urgency e.g. after a bad fall, or after a stay in hospital. You can obtain a list of care homes locally, for example private care homes in Birmingham or county wide, such as residential care homes in the West Midlands from a directory such as TrustedCare, most private homes also deal with the local authority. Some residents are full fee paying and the Local Authority partially or wholly funds some. However, it is practice to ensure that none of the residents are made aware of which category they all fall into, thus saving any ill-feeling between residents and caregivers.

What to look for when visiting your short-list of Care Homes

You can visit as many care homes as you wish, they will usually be pleased to see you and show you rooms they have available, what activities and facilities they have, how many staff to resident ratio there is, costs, which doctors, chiropodists, hairdressers serve them. It is an expanding business now and many homes are in chains, owned by the same family or person. They are inspected on a regular basis by the Care Quality Commission (CQC) and you should try and pick one that has been awarded "Excellence" for care, food, cleanliness and the day to day running of the home. Of course, in every walk of life there are some bad ones, which are not always noticeable straightaway, but if there's a smell or bad feel about the place, plus the residents are extra quiet or do not look too happy, or if they are withdrawn about answering questions or disclosing certain criteria.

The office administration has to be efficient also, it is a business after all. Usually you will pay into an account ‘spending money’ for your parent and any expenses they incur will be deducted from this and topped up as and when necessary. Residents usually spend very little, hairdressing and chiropody, being the main charges.

The rooms must be en-suite, as an elderly person cannot be expected to go into a corridor to answer calls of nature in the middle of the night. Enough wardrobe and cupboard space is essential and it is a well-known fact that the elderly like to hang onto personal possessions and favourite things. Consider if there is somewhere for them to put photos of family, any flowers that are bought for them and other memorabilia. Basically, you are looking for a comfortable area in which they can spend their twilight years. Although the average length of stay in a care home is unfortunately only eighteen months!!

A good working lift, well-equipped kitchen, efficient laundry or laundry service are necessary. Look at the breakfast, lunch and dinner/tea menus to see if there is a good variety. Ask how often drinks are served as old people can get easily dehydrated, do they serve fruit and snacks too throughout the day, as little and often is the way old people eat, not being able to digest large meals.

To promote a sense of good mood and well-being the communal rooms should be well lit, or light and airy and not have chairs in a circle, as is the picture we have of old peoples' homes but more a feel of a hotel atmosphere, where the guests are all in their dotage. A good mix of men and women, although you are likely to find the ratio weighted towards women, as they do outlive the so-called superior sex!!

A pleasant outside area is also a must for warmer days, with comfortable seating and flowers and shrubs to look at. Having a minibus on hand for visits to theatres, days out, hospital visits if relatives can’t oblige, is another important benefit of a good care home. As is having a good supply of wheelchairs so no-one has to struggle or wait to visit the toilet in the day, and if relatives wish to take their loved ones out for a local walk and a visit to a coffee shop, or for use to take them further afield.

Check out details of events, residents' birthday parties, musical entertainment, keep fit in chairs, as all this all goes to show it is a caring and stimulating environment. Also, check visiting arrangements, as being able to visit at any time unannounced is important, so they cannot "get ready" for your arrival.

There are a lot more pro's and con's you can look for and will see for yourself. Of course, there is no guarantee when all looks good on the surface, unsuitable
practices may be uncovered and hopefully a move to another care home will be avoidable, as this is too much for our gentlefolk to take in their stride and can often be the last straw.

I would recommend that talking to the other residents to see if they like it and are happy there, is an essential element of evaluating a care home. In addition, talk to other people with aging parents, elderly care agencies and support groups, and go on recommendations from others, often this is the best endorsement for a good home.

Good luck with your search. One thing to remember is that older people can suffer delusion and dementia and imagine events that have not happened. During visits they may tell you they are being hit, force-fed or bullied. You must obviously investigate any allegations which may or may not be true, as I am afraid if you read the press, this does happen in a small minority of homes, but often this may be attention seeking, a cry for help if they're rebelling from being in a care home. Most residents accept their life and do become institutionalized but content enough. It all depends on their attitude, state of mind, even age. I found the younger they were on entry, the more adaptable they were.

We must always remember, "It might be me one day".

Caring for our elderly is an important social aspect of our society, and our aging parents and relatives should receive the respect, dignity and devotion they have given us in caring for us in our early years.

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