MIL constantly falling - we are at our wits end

It's all very well having the diagnosis of dementia. It's being able to do anything to improve the situation that's the difficult bit whoever gets involved. Especially with someone who lacks the insight.

One of these questionnaire things about my father, his life and things he enjoyed was completed when he had some care at home before he was deemed to have lost capacity and before he was admitted as an emergency into a Care Home. I think that was somewhat helpful but unfortunately the carers had very limited time to read those notes due to time constraints. One thing that was incredibly helpful was when a new Social Worker was assigned to my father and she signposted me to a local befriending service I was unaware about and offered a referral. Because she referred, although there was a contribution to pay, it was subsidised by Local Authority. You could apparently self-refer your relative but cost was a bit higher (but still would have been affordable out of his Attendance Allowance). I got a bill approx monthly and paid the befriending organisation direct. The befriender visited twice a week. Occasionally, she'd ring me and ask to change the day but always turned up, sat and listened to my father reminisce, got to know him well, phoned me if she had a concern (eg, he kept losing his glasses and it was during covid. She offered to make an appointment at local Optician, I suggested he needed two new pairs in case one went missing and she asked the Optician if they'd accept a payment over the phone from me, which they did). This woman was an absolute godsend and, even after my father went into the Care Home at very short notice, she was genuinely interested to know he was ok and sent a condolence card when he died. I remain grateful to her even though naturally we're not still in touch. I've gone a long way about a shortcut to say, if there's a befriender service in the person's area, it may be something helpful to investigate. It was particularly helpful in my farher's case - he lived alone.

@WinterFrog I do understand how tricky elderly people are, I’m dealing with them daily. But you can go to a doctor’s appointment with the patient and request an assessment; you can also speak to their doctor without the patient’s consent to request an assessment. Doctors can’t share with you information about the patient, but you can share information with them.

If your mother didn’t have dementia it’s not relevant, but I got 3 elderly diagnosed by those means. It’s often the partner or relative or carer who request assessments as dementia patients can lack insight into their condition. And the same principle applies to other health conditions.

@WinterFrog good update. I hope you have been able to find nursing facilities you and your mother are happy with?

The facility we had to find for Dad gave us a ‘My Story’ pack for us to compete so they had a profile about who Dad is and his background. I really wish I had had this sooner as with everything else to organise I feel like I rushed it. We tried to get our mother to complete it but she chose to not engage with it. She mentioned herself, being a war baby. Not a mention of Dad or his 3 kids and numerous grandchildren.

With hindsight it was her burying her head in the sand about the whole matter.

We cobbled together what we could, well my sis and I. Again brother utterly disinterested, or on reflection his utter refusal to do anything ‘admin’ related. It’s amazing what you learn about relatives in these strange times.

Anyway if you can perhaps look at using this template from Age UK which is sort of similar but actually linked to a campaign they were doing it might get you started getting some things down on paper. https://www.ageuk.org.uk/bp-assets/globalassets/oldham/new-content/documents/life-story-form.pdf

Hope it is useful.

I do wish it was as simple as 'just ask the doctor' regarding dementia. I'm here, very tired after three years of attempting to keep my mother engaging with her support system, fighting to get doctors appointments, their refusual to discuss her with me despite having poa as she still had capacity. I'd attend appointments with her and they would only talk to her. We've called paramedics when she's fallen. She did, finally, reluctantly, sign a permission slip allowing us to talk to her surgery regarding her health. Thank goodness she did as we've needed it just to get hold of her medical summary for the nursing home. Departments do not talk to each other in the way that we imagine.
And my mum is quite charming, and generally very polite. So we have it a great deal easier than many on these thread.

She's still extremely obstinate and we have found, through lived experience, that it takes a lot to protect her from herself. We are endlessly grateful to the OT who didn't just say how lovely she is and how she's as bright as a button, but paid attention and realised she's not as capable as she believes herself to be.
Finally, my mother is going to a nursing home and I'll be able to stand down, but there's still a whole heap of admin and organisation to deal with. I'm shattered and it's not over yet. And this is a lady who did put some effort into her future planning.
So my point still stands about the wisdom of looking ahead ( not necessarily downsizing but considering the home you have, and how it can be made suitable) Not just expecting your family to pick you up when there's a crisis with no idea of your wishes because you're refused to discuss it. I really worry for the people who have nobody to advocate for them.

Glad to hear that your update @FeralNun and that your MIL is understanding now that she is not safe to go back home. Sympathies to your husband and you, it sounds like it was a very difficult situation, I hope it gets easier now.

We have issues at the moment with my MIL. She probably won't have a fall as lives in a bungalow she does absolutely nothing for herself. FIL is still alive and she sits in an armchair all day while he does everything for her and she has always been a very demanding person. Now he is physically and mentally exhausted with looking after both of them, he's in his late 80s himself. She is practically immobile and really needs to go into care but refuses to even consider it. She also upsets every carer they ever have so it's a job finding new ones all the time.

Ironically he is the one who is having falls, maybe not surprising as he is always on the go. I can see a situation where he will eventually need to go into hospital and then won't be allowed to return home as she certainly wouldn't be able to look after him. If he goes into care then she would need to as well, anyway so that is probably what it will take.

Stair lift?

Wouldn't a bungalow be a better option for you than a leasehold flat?

Early 70s isn’t that old but in my opinion it is the time to start thinking about will my house still suit me when I’m in my 80s or older. Because by that time I probably won’t be able to cope with a house move.

My house doesn’t have a downstairs bathroom, just a loo. So I’m planning to downsize when in my 70s to a house with a downstairs shower room. That will also release capital and will be nice to help my kids a little financially ( gifts not deprivation of assets!)

But they don't. Even if the bedroom is downstairs friends drop off because they just don't feel comfortable. Even a spouse living in the same house will spend less time with someone in bed. Here is very little mental stimulatio - what can you do all day? When wheelchair bound MIL was still at home she took to refusing to get up during covid when there were no visitors and was just withering into her shell. Then she moved into a home and they could spend more time encouraging her to get up. She couldn't talk but had her favourite spot where she could see who was doing what and that social interaction hugely perked her up.

Something that occurs to me is, we are talking about our elderly "loved ones" having capacity, being allowed to make decisions that may be unwise etc and having to live with the consequences. However, the family members, potential or actual carers, also need to make decisions that make sense, as hard as it may be. Otherwise what's the difference?
I still don't believe that being lodged downstairs near the kitchen is always a better option because visitors will be more comfortable or likely to visit, like they can't go upstairs????

@GranPepper I think you have taken my posts more personally than they were intended. I have not suggested you didn’t do the best for your father or that your action wasn’t effective. I do find you rather over-sensitive tbh so happy to end the conversation here.

Capacity is a tricky thing, but the principles are very clear, and available to read up on.

Principles are clear but general still very hard to assess. People can have capacity in some areas but not others and on some days but not others depending on variable confusion levels. I don’t envy you trying to make assessments when you don’t know the person.

Well, I'm sure you feel you know best and may well have done in the case of your obstinate Aunt, but other people know their own circumstances and those of their relatives best. I do politely request that you refrain from messaging me about this matter any further. I find some of your comments unnecessarily snarky. For instance, you have had a go at people who "farm out problems to Social Work, GPs, Fire" but you don't know other peoples' circumstances. Most people do their best, often at the expense of their own health. I note the OP's update and wish her well in coming to a resolution which works as well as it can for all involved in her family.

I’m not judging you - I’m making a general point. Elderly people are commonly very obstinate. When my obstinate aunt started turning on the gas hobs in the middle of the night, I don’t need the fire brigade to tell me that’s a fire risk and even if I’d got them in she would have just denied what they said. So I still had to take charge of the situation.

Anyone can be assessed for dementia, you just have to ask the doctor. A fragile grasp of reality could signpost a dementia or mental health assessment.

What you do when a relative refuses to call a doctor depends on the nature of the complaint. If it’s a head injury say one is obligated to intervene.

Because he was a very obstinate man and something had to be done to take the decision out of his hands. And it worked so it was the right course of action to ensure his safety. I mean to be polite but you weren't in my position and I will hope you don't intend to be judgy but it comes across that way unfortunately

Thanks for the update OP. Sometimes it does take things to approach a crisis point before a significant change will happen. I'm glad to hear that your MIL has made a decision which does seem to be in her best interests. That's a brave thing for her to have done. And relieves your poor DH of having to explicitly say that he has reached his limit, which can be such a difficult thing for loved ones to do. There are still decisions to be made though, so having a good think about your boundaries is worth doing at this point.

The task now is to help her find or create the right environment so that she can rebuild her confidence and remain as independent as possible, whilst being safe and comfortable. That will keep you busy! Use the team. OTs are good at this kind of thing (but I am biased) and hopefully you will have access to a good social worker too.

Capacity is a tricky thing, but the principles are very clear, and available to read up on. It came as a revelation to me in my early HCP days that it wasn't my job to rescue everyone (thank goodness!) and that adults are allowed to make unwise decisions. I have spent a lot of my time though going through options and scenarios with people so that they can have the info they need to make good decisions, and putting in safety plans for the inevitable times when 'I'll be ok' turns out not to be the case. And celebrating the successes too of course, sometimes unexpected ones.
Wishing you all the best OP.

Crossed wires here I think. I was pointing out how hard it is to make that case when your 'person' manages to convince everyone around them ( except family who know them well) that they are of sound mind. I totally agree that we should ( and most of us do) try to influence them to make wiser decisions than they do.
It was only when the OT paid attention to me and my mother over the course of over an hour, that she realised that my mum did indeed have a fragile grasp on reality.
I would have had no chance of getting my mother assessed for dementia for example.

It's just so much easier said than done to get professional help when a person doesn't want it, and that is why exhausted and frustrated posters take to this board for a bit of advice, or to have a rant. None of us want our parents living in unsafe surroundings, but what do you do when they keep sacking their carers or refuse to call a doctor? You generally muddle along the best you can, knowing that sooner or later a crisis will occur and they are forced to accept help ( like @FeralNun's mil) Mine did have a couple of fall which caused hospital admissions, after which she accepted a bit of help. And we were 'lucky' in that she was safely tucked up in bed where her carer found her after her most recent stroke. No actual injury, thankfully. 'Just' her brain.

The Mental Capacity Act (2005) does mean that people can make decisions that other people deem to be unwise

No shit. So not the point of my post.

No-one can be over-ruled by an act. They can be overruled by a person who still has the ability to make their own decisions, but if that person continually makes decisions that put themselves in danger, a case can be made for not understanding the consequences of those decisions and lacking capacity in that area.

Capacity is not cut and dried - people can have capacity to make one type of decision but not another.

This is a bit if a ramble, but I just want to say I often read the Elderly Parents topic to get different perspectives as I get older. This is such an informative and thoughtful thread. I hope I’m not derailing. I totally agree with the idea of thinking of ways of adapting the house and making life easier, and getting affairs in order as I approach my seventies.

I’ve noticed some cognitive decline over the past couple of years. I don’t retain much of what I read online. I shop online, but can’t face online banking. My memory for passcodes is very poor, and using keychain just seems to make me more forgetful, as I don’t then practise my memory.

As far as falls are concerned, about ten years I fell down the stairs at home. I didn’t “have a fall”, I was hurrying and hadn’t bothered tying my shoes. The long-lasting damage to my mobility has increased isolation which in turn has taken its toll on my mental health.

I didn’t think I would really feel old, but now I’m doing my best to declutter and get everything in order. I often ask my adult children if I am asking too much of them, and I feel both guilty and relieved when they say it’s okay mum.

DH and I have promised each other to say “unsafe discharge” if anyone tries to persuade a child to take on care of either of us.

@Mirabai The Mental Capacity Act (2005) does mean that people can make decisions that other people deem to be unwise. I feel that it can be difficult to get a person's capacity checked. There are threads on here where people are desperately trying to encourage their loved ones to make sensible decisions, but are overruled due to this act. We've seen this play out in the hospital recently with my mum, and I know there are other current threads running about this very thing.
Sometimes it takes a committed professional to talk to them, but it's extremely difficult in many families when the parents just won't be told by their offspring. @WTF99 has commented above, as an occupational therapist.
The Act is a mixed blessing as we do want our elders, and us when the time comes, to be able to make their own decisions when possible. But it can make those of us looking out for them feel very unsupported when we're trying to look out for those we love. It can make us vulnerable, or feel vulnerable, to allegations of neglect if despite our best efforts, our stubborn loved one does something we would deem unwise, and gets hurt.
It's a very fine line.
And this is why these robust discussions are so useful. And as the pp said upthread, we do need to be opening conversations about our sunset years, and stop ageing and death being taboo subjects.

This is what happened to my mother . She had almost 6 months in hospital and rehab and then 2 years on a care home after her last fall. She was in a wheelchair for all that time and never walked again. She was 90 though

She had had a long life of gradual frailty though as she had developed osteoarthritis reasonably young and started falling reasonably often from when she was about 70 years old. She went on to live until she was 92 though and was able to be reasonably mobile with a couple of ususally minor falls almost every year , although one was down a flight od stairs where she miraculously recovered but it took almost a year. This went on until her late 80s with falls happening more often and when her mobility really became very poor. My mother also regularly did exercises to improve her strength and mobility and was very very motivated to keep as strong as possible. So this can go on for a very long time with some people depending on the reasons for lack of mobility

Being in the bedroom is socially isolating. People are more likely to visit someone in a living room than a bedroom.