Relative refuses to move to a care home | What to do

Refuses to move to a care home

Making the decision that your parent or loved one needs to move into a care home is extremely tough. It can be even more challenging if your relative flatly refuses to move to residential care.

Many older people start off with a few hours of home care. They then up the hours as their health and mobility declines. Family members do what they can. But they often end up absolutely exhausted as they try and fit in caring with working as well as looking after their children.

When it all becomes too much and your relative is unsafe living at home, a care home is often the best option.

This can be a very emotionally charged time. People are often consumed by guilt as they try and persuade their relative or loved one to move to a home. This can be heightened if your family member does not want to go into residential care.

Signs your loved one needs residential care

There are various signs to look out for that will indicate your relative or family member is finding it hard to cope at home.

Your relative may start showing a decline in their hygiene. Or they may become withdrawn as they are not seeing people and having social interactions.

They may start struggling to keep the house clean and tidy as they become less mobile.

We have an advice article on signs your parent needs to move into a care home that will give you more information on this.

Talk to them about future care plans early on

It is a good idea to have that chat about what they want to do in terms of their care early on. This may also be easier as they will feel less vulnerable and more in control as their health needs won’t be so overwhelming.

If you wait until there is an emergency, you will not have time on your side. So you and your loved one may end up making a rushed decision.

Listen to why they refuse to move to a care home

If you suggest residential care to your relative and they reject the idea, you need to find out what their main objections to it are.

Find out what they are worried about:

• Is it a loss of independence and freedom?
• Are they concerned they will miss their belongings and their home?
• Do they feel anxious about meeting new people and moving to a new place?
• Are they worried about having to change their routine?
• Do they have certain preconceptions about what a care home is like?

They need to be given time to make this decision as it is life-changing. People’s homes contain so many memories. In addition they may have many long-standing friendships in their local community.

They may also be scared of someone giving them personal care. As they may worry it will make them feel uncomfortable. Getting in home care first can be a good transitional period before residential care. This can help to make them used to receiving personal care in a familiar environment.

Discuss different care options

• Talk about the different care options with them so they feel in control of the decision-making process.

• Talk about the pros and cons of home care, live-in care and residential care. This will help you both decide what is best for their needs.

• Ask them how they feel and highlight the positives of what they can do, rather than the negatives. This will make them feel empowered rather than disempowered.

• Bear in mind it will not be a quick conversation. It will in all probability need to be had a number of times. Be patient, empathetic and practical.

Reassure them

Visit the care home together if you can. So you can address their main worries about residential care.

You can talk to them about the many benefits of residential care. They may be quite isolated living at home and in the care home they will be able to interact with people socially again.

Talk to them about the activities they can do at the care home and the care they will receive.

They may be missing hobbies and things they used to do when they were more mobile. Being in a care home may enable them to do these again.

Try out respite care

Ask them if they want to do a taster week at a care home so they can see for themselves what it is really like before they make a decision.

Their reluctance may be due to fear of the unknown. But once they are actually experiencing residential care they may come to embrace it.

Get expert advice

It is a good idea to have a care needs assessment carried out. This will determine if the person would be better off living in a care home or whether they can manage for the moment with home care.

Get a health or care professional to talk to your relative or loved one so they can explain why it is advisable to move to a care home for medical or safety reasons.

Your relative may be more inclined to listen to an authority figure.

Get your wider family involved

Get the input of people they trust, love and respect. Do it in a calm and diplomatic way so they don’t feel they are being ganged up on.

What happens legally if they refuse to go to a care home?

If the person has mental capacity, they do have the right to refuse to move to a care home. You cannot force a person who is of sound mind to move to residential care if they do not want to.

The person will have to have had an assessment to show they no longer have the capacity to make decisions for themselves. Until this has been done, it must be assumed that the person has capacity, according to the Mental Capacity Act 2005.

If they do have mental capacity and they refuse to move to a care home, you are not responsible for their decision. You may feel you cannot provide enough care for your parent or relative. But you cannot force them to move to residential care.

If they lack mental capacity

If the person lacks mental capacity, such as if they have dementia, their Power of Attorney may need to take the decision on their behalf. Health professionals will often collaborate with the Power of Attorney. This will help them decide what is in the best interests of the person needing care.

If the person has been deemed to have mental capacity but is at risk to themselves or others, they can be sectioned in a care home under the Mental Health Act 1983.

If your relative or loved one has dementia, the thought of moving to a care home can be very distressing. They may not understand what is happening and why they are moving. You will need to try and convey what is happening through simple language or pictures if they are struggling to comprehend what you are saying.

Discharge from hospital

If a person has had a fall for example and is in hospital, a doctor will sometimes only discharge them if they move into a care home for respite care. This is if they do not have adequate support in their existing home and there are concerns they will not be safe at home.