Home not too far away from home
When William Cook chose his mother-in-law’s care home, location was everything
Choosing a care home
My father-in-law always enjoyed The Oldie and looked forward to each new issue.
So it felt sad returning to the familiar house he’d so recently vacated, only to find the latest edition lying unopened on the mat. He’d died suddenly a few weeks before, at the grand old age of 85, and his sole concern during his final days was what would happen to the wife he’d loved with all his heart for the last sixty years.
My father-in-law had been my mother-in-law’s primary carer, and it wasn’t until after he died that we understood how much he’d done for her.
At first, my wife and I thought she could come and live with us, but we soon realised that’d be impossible. She has Alzheimer’s and even looking after her for a few hours was exhausting. How her husband did it round the clock, God only knows. We knew we had to find a care home for her, and fast. But how to choose a nice one like the north London one where author Diana Athill (pictured) lived? She referred to it as ‘a snug little nest’.
This painful process hasn’t made me an expert. I still know little about the whole business and have much more to learn. However, my wife and I have found out a few things – mainly by trial and error. So, if you’re going through something similar (or if you think you may go through it sooner or later, and I’m afraid there’s a good chance you will), then I hope it might help to share some of the stuff we’ve discovered along the way.
When we went to look at care homes, I asked loads of probing questions. Most of them were pretty pointless, but there was one that actually hit the mark. I asked one of the nursing staff what was the thing that mattered most to her residents.
‘Frequent visits from family members,’ she told me. ‘The more frequent, the better.’
That invaluable answer gave us a proper focus for our search. Clearly, we needed to find a place as close as possible to where we lived.
If you have a relative who’s hale and hearty and lives a hundred miles away, you can visit them once a fortnight and spend a day there.
Once your loved one is in a care home, they probably won’t have enough stamina for such lengthy visits. Little and often is a lot better – for them and you. Half an hour every day is far more helpful than several hours once a week, and that means you need to live nearby.
Once we’d decided proximity was paramount, our search narrowed to half a dozen places. Four of them had vacancies. We visited all four. There’s lots you can find out online (particularly the results of recent inspections) but naturally there’s no substitute for a thorough visit. Any decent care home should make time to give you a comprehensive tour.
Initially, my wife and I were preoccupied by the setting of each prospective care home. Was it in a smart location? Were there lots of amenities nearby? It didn’t take us long to realise that these factors aren’t so significant. They’re the sort of things you look for when you’re buying a house, but choosing a care home is completely different. You’re not buying into the surrounding area. A nearby park is a plus, somewhere you can go for outings; but what matters is the place itself – what it feels like on the inside.
Some of this is dictated by the basic layout of the building. The larger places can feel cold and institutional and the smaller places often feel cramped and claustrophobic (the one we chose eventually was somewhere in between). The quality of the bedrooms is crucial but the shared spaces are also vital: and a nice garden is a must. Check whether the garden is well-maintained. I reckon that’s a handy clue. If they can’t be bothered to keep the garden tidy, chances are they’re not so bothered about lots of other things you can’t see.
The place we liked best had an attractive, secluded garden, several small communal rooms rather than one big one and a couple of compact dining rooms rather than a single cavernous refectory. The bedrooms weren’t the biggest, but then again we didn’t want my motherin-law to be cooped up in her room all day. We especially liked the music room (my mother-in-law loves music) but although architecture and mod cons are important, the main thing you’re buying in any care home is the staff.
The thing that makes a good care home is if the staff really care about the residents. Is there a precise way to work this out? Of course not. You have to trust
your gut. The woman who showed us round the place we chose was passionate about her job and full of affection for her patients. If you’re not getting that sort of feedback, look elsewhere.
Another thing that stood out for me was all the information on the walls. It’s not a foolproof guide, but it’s a useful indicator. The place we chose had timetables for all sorts of activities: everything from discussion groups to singalongs, and photos of recent events.
I didn’t compare prices until after we’d been to see all four places. I thought this would help me make a more objective choice. It turns out the one I liked least was cheapest and the one I liked best was most expensive. The fees are about five grand a month. Thank God, we can find the money but only if we sell her house to pay for it. It all seems terribly unfair.
She’s been in the care home for six months now and, on the whole, we’re pretty pleased with it. But it’s
a situation that requires constant monitoring, like putting a child through boarding school.
Indeed, another good reason to find a place nearby is so you can drop in unannounced at different times of day.
What’s it like at mealtimes, and bedtimes? Are residents encouraged to take part in activities, or are they just left to their own devices? Do the staff engage with them, even when there are no specific jobs to do?
As you can imagine, it’s been quite a haul, for my wife more than anyone. And it’s forced us both to reflect on what will happen thirty years from now, when we’ll both be in our eighties, like my motherin-law.
Chances are, at least one of us
will end up in a care home. Would either of us be happy with the level of care we’ve provided for my mother-in-law? Hand on heart, I’m not so sure. She lived through the war and her generation is more stoical. My pampered generation expects something a lot cushier.
Whether we’ll get it is another matter. Somehow, I doubt it. The way I see it, more and more of us are going to end up in care or nursing homes with less and less money to pay for it.
But that’s quite enough doom and gloom. The big picture is always grim. It’s the little things which make life worth living, which give us the courage to carry on.
My wife drops in on her mother almost every day. I average about twice a week. Although she’s more and more confused, she seems fairly happy, all things considered.
Yesterday, one of the nursing staff told us they heard her singing along to the radio. I think she’s going to be OK.
‘Thank God, we can find the money but only if we sell her house to pay for it’