Am I right to call 111?

I'm so sorry to hear whAt you and your mum are going through. I can't offer much in terms of advice at the moment, but I really do know what you're going through. Your mum's confusion sounds so much like my Mum and the memory of how terrible things were for her will never leave me, or the memory of just how helpless I felt. I was a similar distance away from my mum as you are from yours and used to either get 20 phone calls a day or my mum would lose the phone and not answer. In her case, the hallucinations were largely due to dementia, but were always much worse when she had UTI. One of the first signs of her dementia was that she kept forgetting to take her medication and that she was very suspicious of anything newly prescribed, and in complete denial that anything was wrong with her. Like your mum, she was horrible to me at times, but lovely to everyone else, and it took a long time before people generally realised that she had dementia. I was able to speak to a very kind doctor at her practice, who got things moving in terms of assessment, but I found that there was very little support available for day to day problems like UTIs.

Its good that your mum's friend is able to help out and hopefully she may listen to the pharmacist if she goes there. But the driving is another worry for you and it's so hard to stop someone from driving when the time comes thst they are no longer really safe. My mum was told to stop driving due to an worsening eye problem, and it broke her heart when her car was sold, and I think it added to her decline very significantly.

I do hope you are able to get some support.

https://www.mumsnet.com/talk/elderly_parents/4967638-so-bloody-exhausted-waiting-for-someone-to-die-2

The trouble is that when elderly people get this delirium as a result of an infection, they don't make rational choices, nor can they such to decisions made.

OP come and join us on this thread:

What a nightmare, sounds like she may know the pharmacist, would she take advice from them over the phone?

@JamieFrasersSassenach huge sympathy.
Might it be worth ringing social services re safeguarding as GP surgery suggested?

That's ridiculous. What does she expect you to do, strap her down and force her mouth open? A receptionist isn't qualified to give advice like this.

@JamieFrasersSassenach deep breath! I know this seems like an enormous crisis, but, those of us that have been doing this a while…this is how it goes. If they are unwilling/unable to accept things need to happed, medication, hospital visits, carers, and are deemed to have capacity. There really isnt anything you can do. I tied myself up in knots when i had young kids and an elderly who wasn’t awkward, just their idea of not being a nuisance was to pretend everything was fine and dandy, when it really wasn’t.

My advice is to let the crisis happen, however hard that is to watch from the sidelines. Only then will the authorities (and in our case relatives who visited regularly every 18mths!) see and believe.

Dont know how old your mum is, but you could be just starting on a decade or more of this. It’s definitely a marathon not a sprint.

Ok, so make sure to say you feel she does not have capacity right now.

https://assets.publishing.service.gov.uk/media/5f6cc6138fa8f541f6763295/Mental-capacity-act-code-of-practice.pdf

page 41 is helpful.

guessing her answers atm would be:
Impairment to brain function? Yes
can patient understand the info? No
can they retain the info? No
can they weigh the decision? No
can they communicate the decision? yes

she would be deemed not to have capacity in my work situation.

I have only once taken in someone against their will and it was not pleasant. But she failed the mental capacity act questions.

if your mum was asked the basics, like,
where are you right now?
what year is it?
who is this person (you or ambulance crew or someone familiar)?
etc

what would she say, would she ‘pass’? If so then they can’t override her wishes. But she will eventually fail. It’s horrid for you to sit back and watch though so I sympathise.

i had similar but different with my mother who would refuse to eat and drink as she wanted to die, until she started hallucinating through dehydration and a carer would ring 999. Ambulance crews would take her in, get a drip running and she’d recover. And repeat. I tried telling her that this method of suicide would not succeed many times!

Why do you think she'll never come out of hospital if she's admitted, OP?

She can be treated then discharged - possibly with a care package.

Really hope you are getting things sorted.

@JamieFrasersSassenach how worrying for you and frightening for your mum.I really hope someone steps up for you both x

That sounds utterly shit and frustrating. I do know from experience that paramedics are super reluctant to use the powers in the MCA

Do you think she would be receptive to talking to 111 herself if you arrange the call? Is her friend able to be of any practical help to you?

I obviously don't know the ins and outs of her history but I’ve had some nightmares trying to get someone, anyone, on board when the person next to me is loudly refusing. It’s a very high threshold to override a patients stated wishes. My DP had 02 stats that kept dipping into the 50’s, never getting higher than 80, and was horrendous with his treatment of me/others and the paramedics wouldn’t take him when he refused them. I questioned why hypoxia doesn’t mean decision making is obviously impaired and was basically told I’d have to wait until he was unable to advocate for himself.

im not sure, however thought it would be useful info for you to bear in mind if gp etc is not helpful
I think you should phone 111 tonight and say she is refusing the medication and getting worse and more confused. Hopefully they will say this meets the threshold for ambulance as if it's a UTI waiting 12+ hrs untreated will just make it worse

One thing to bear in mind is that medical professionals have the power to take people in under the mental capacity act for these exact scenarios. Eg someone is so unwell they aren't capable of making a decision re treatment. Ambulance use it quite a bit as sometimes we go and assist (I work in the police control room). To make it clear this is a completely different scenario to "sectioning" under the MHA or a DOLS and is just temporary for the best medical interests at the time to get treatment in a life threatening situation.