Question

I am the main caregiver for my grandmother. Following a fall at home, she broke her hip, and now needs so much care that she really needs to go to a nursing home. But she does not want to. What alternatives are there?

Answer

We fully appreciate your dilemma in that you feel there is no alternative for her but to go into a nursing home and yet that is where she does not wish to go. There may be much more to going into a nursing home than just entering a place. For example, having to leave her own home and all her belongings may be much more of a wrench than actually going into a nursing home. Has she been to the nursing home and seen for herself what it is like, or has she just got an abstract concept of what nursing home care involves. Does she have a complete grasp of the situation or has she some confusion? Although you are the main caregiver, do you have power of attorney over her affairs and can you make decisions for her?

What are the alternatives? Well that depends on her financial situation, and her medical and psychiatric conditions too. Where did she live before she had her fall? Can the home be adapted so that she could manage with help which she might or might not have the finances to buy in. Alternatively, is the social care provided by the government in your area sufficient to support somebody who requires a lot of help within their own home. We assume that she lives alone but that may not be so and if it is not so, what is the medical and physical condition of the person she lives with.

As you can see, there are so many "if's and buts and possibilities and maybes" in everything we have suggested to you, and it is impossible for us to advise you specifically. But perhaps there are a number of stark alternatives which you must either reject or accept, depending on the local situation of yourself and your family and your grandmother and her situation. For example, she could remain in hospital, she could go to a nursing home, she could return to her own home with support, or she could come and live with you or another relative.

Overall, a decision must be governed by what is feasible and also what is the prognosis of your grandmother for recovery and her future care needs.

Finally, providing she has the mental facilities to do so, it is always important to at least take into account her wishes and needs.