Elderly mother wanting hospital discharge against advice

[TheoriginalLEM]

My mother is difficult to say the least. She is 85 and has complex medical needs. She is self neglecting and just over a week ago was admitted to hospital at deaths door, she has carers but was refusing food and water.

She agreed to stay in hospital with a view to a transfer to a cottage hospital for convalesence and rehab. She has MH issues and is under the useless psychiatrist.

The self neglect has been going for a long time.

I don't want her to go home, yes she is better than she was but is frail. She was vile to me yesterday (she always is)- apparently the Dr said she could go home but the nurse said this wasn't true.

I'm going today to hopefully speak to the dr or nurse in charge.

She wants to self discharge but i kniw this will just start the cycle of self neglect and quite frankly, running me ragged, and I think it would be a huge mistake.

The issue is I don't have power of attorney (big mistake) and she has capacity - surely though the medics can step in if someone isn't self caring and refusing care?

It must be very strange for you to not appease her, but you don't need to. She is unwell
She doesn't make good decisions therefore you only assist in assuring her primary NEEDS are met in the correct priority which is food, medication, warmth the nice to have such as stimulation and company etc can be worked out later when she has somewhere suitable to live.

Eating well and taking her medication is highly likely to make her feel more well and hopefully less abusive.

She is probably sulking because her strategy for manipulating you isn't working this time...

OP is you get a chance check out this site: Out of the FOG online, there is a toolbox area and a forum for parents and elderly parents like this. It might be really helpful.

there are lots of others going through it too, it is not easy.

Normal service is resumed- last night she was in a foul temper. Basically said I had done this to her. I explained there was to be a meeting on Friday and the decision to keep her in hospital wasn't mine. She said if I didn't take her home she would kill herself and that she wants to go home to be left to die.

Turns out she had pneumonia

I feel like a cunt

Why? It’s not like you attacked her with a Petri dish of pneumonia bacteria.

Because she is desperate to go home and I am vetoing it because I can't cope

Your very well trained aren’t you?.

This is why I went nc with my parents, I was never supposed to have my own life.

I know we’ve chatted on here before about my relationship with my mum which was an almost identical dynamic to the one you have with your mum. My mum died in March following a battle with copd and bowel cancer and honestly the last 8 weeks or so of that were horrendous - the hospital kept sending her home and expecting me to drop everything to care for her (despite me being unwell and having a disabled child to care for), Mum kept telling everyone she could manage (she couldn’t even get back into bed if she got out to use the commode next to her bed), she would be rude to carers, shouting at me - she was a total narcissist and was horribly abusive to me when I was little. The whole thing was hell. In the end I got continuing healthcare in to assess her and told them I wouldn’t be providing any more care and she would have to go into a nursing home - she died there 3 weeks later. I still feel guilty about that decision now which is ridiculous because it was the best I could do in the circumstances!

You really MUST put yourself first and say no more. The nhs and care services are so understaffed and under pressure that if they see you there and doing things they won’t help. That’s my experience. They will assume you will step in so you mustn’t.

As hard as it is if your mum wants to be sent home to die then that is her choice. You tell the services you can’t provide care and you let them deal with her.

It sounds horrible but when my mum died I felt nothing but relief. I still have nightmares where she is shouting at me.

I would seriously consider a care home. My father went into one last February, and although he'd obviously rather be hale and hearty and back home, he knows that can't be as he needs 24 care and attendance these days. (He has osteoporosis and a history of falls and fractures.)

My brother and I must have looked at 15 care homes in persona, and many more online, before we found the one that suited him. Key things - use the CQC site to find them, and don't ever go below an all good rating. (The excellent ones I saw were amazing but sadly one had no vacancies and the other was near me but not his friends!)

www.cqc.org.uk

The other thing to always ask when you visit is what percentage of Alzheimer's patients they have. If your parent is mentally well, then you want them to have similar company. The CQC site helps with this, as you can find homes that don't take them.

In person, ffs. We didn't dress up in clown masks or anything.

Op, we've spent the last 9 months going through this with my MIL. She had stents fitted a couple of years ago as she had a heart attack. She also had COPD. When she came out of hospital she had short term carers for 6 weeks and then things started to deteriorate. She was readmitted to hospital last year as she started falling a lot. We were called out all hours of the day and night to get her back up.
She was assessed as being capable of going back home with 4 carer visits daily, to get her up, put her to bed and see to her lunch and tea, against our wishes. The hospital SW had assessed her as having capacity. Sure enough within a week of her being back home she had fallen 10 times! On the final time, I went round and there was an OT who'd just happened to pop round to see how she was doing, two carers who'd found her and two paramedics dealing with her head injury. They were doing their best to get her to hospital but she kept refusing saying she be ok and would stop trying to walk. The OT said she was not safe at home. Eventually we got the GP round who said she wanted her to go for an X-ray, which she agreed to.
From that, she went to A+E, was admitted, then transferred to an assessment unit. She was moved again to a short stay rehab unit where she was supposed to be for a maximum of 6 weeks. She stayed there for 4 months and eventually passed away at the beginning of January.
My DH struggled throughout all of this with the frustration of not being listened to, but until the SW agreed she now lacked capacity our hands were tied. BTW, that decision was made based on her lack of understanding about her not being safe in the home. We visited her in hospital every other day, then every third day when she was transferred to rehab. My DH had to put his mental health needs before his mother, who was being looked father very well by professionals.
Your need to let go. Stop visiting daily. Your DH is right! Don't put yourself in a situation where you're offering to do everything for her if she goes home.

She's being abusive to you, threatening suicide like that...it's horrible behaviour.

I would tell her you are not going to speak to her if she talks to you like that. And then not visit her, let her see there are consequences for being that that, rather than you cowing to her like in the past.

Maybe even confide in the doctors she is being emotionally abusing and threatening suicide / self neglect, not sure though.

You really need to protect yourself and your mental health now. She is trying to manipulate you by behaving like that, and it is working.

And in not visiting / rescuing her, this may have the added benefit of an assessment giving her more care.

She is having a tantrum!!!

Just because she is your Mum does not entitle her to treat you like shit.

Yes she is unwell, that does not entitle her to treat you like shit.

She doesn't want to go home to die she wants to go home and have you running around after her whilst she treats you like shit 🤷🏽‍♀️

You can be kind and firm and fair without letting her treat you like shit.

Because she is desperate to go home and I am vetoing it because I can't cope

NO!!! She can't cope with being home on her own. Because her way of 'coping' involves YOU doing everything for her that she chooses not to/can't do AND to accept abuse from her for any perceived failings on your part. There is nothing in the aging parent/adult child 'rules' that says that abuse (from either party) is an acceptable part of the dynamic. You have the right to decide what level of care you wish to provide for your mother taking into consideration your relationship with her and the care she needs to be safe.

My mum was a dream mum, she really was. And when my brother retired he lived with her and was her main carer. I did 'respite' care for him. Things were fine for years. But it got to the point where her dementia got so bad that he simply could no longer cope with her. She wandered around at night. She refused to bathe. She started calling 911 on him in the middle of the night saying he was 'keeping women captive'. She went to her neighbours accused both of us of 'drugging her to steal her money/silverware/valuables'. It was horrible!!

So in the end the only choice, the right choice, was to place her in a secure assisted living facility. It was so hard for us to take Mum out of her home, but we had to realize that her home was no longer a 'safe place' for her. She settled in well. DB and I visited her frequently (the home is close to us) and we took her out for rides and to our homes for meals and visits. Now that her dementia is advanced (she no longer knows us when we visit) and she's wheelchair bound we are secure in knowing that they have the staffing to safely see to her physical care. She is clean and well cared for, 24/7.

Don't be afraid to make a decision that is right for her, and for you. If she is no longer able to care for herself safely in her own home and/or if caring for her opens you to abuse or damages your mental health then the decision to move her to a care facility is the right decision.

So the meeting was today and they have said that interim tests show a lack of capacity and they are recommending a care home. I struggled with this as did DP but we accept it is for the best. The initial plan is to try temporary respite but i think they were honouring me.

Mum wouldn't speak to me and says that i am worse than her sister who she has accused of trashing her house and stealing from her. What she did to her is nothing compared to what I've done, apparently.

I am devastated, the guilt is immense.

They have diagnosed a personality disorder and dementia, i am unsure about the dementia but apparently when asked what she would do if there was a fire at home she didn't know about 999 and said she'd look the number up in the phone book.

Interestingly the dr said that she felt my mum was manipulative and controlling and depended totally on me. This is someone who is very much looking from the outside and has drawn the same conclusion as many of you, without much input from me.

I am heartbroken, i never wanted this for my mum. She's a fucking old bag but she's still my mum.

Drs have seen it all before & are very perceptive.

Just because your DF ended up in awful care home doesn't mean it will be the same for her.

ExMIL has a PD and died in a secure unit in the end. Apparently she was well aware of her behaviour but felt totally entitled to behave in that way.

@TheoriginalLEM she will be safe and cared for.

She will be fed, bathed and her meds administered.

She may not like it, but she needs to be in an environment where she can’t manipulate.

@TheoriginalLEM
You really need to get yourself some help to separate yourself from this woman. Why are you struggling with her getting help? Do you enjoy being a martyr? getting treated like shit?guilt? She should be feeling guilt; for treating you so badly.
Majority are desperate for a care place for elderly relatives and you’re devastated 🙄

sometimes calling it a respite break is a way of getting a patient to accept placement and often once there they realise it is not as bad as they thought. You will be more relaxed when you visit as no jobs to do. Try and encourage others who know her to visit her when there. Hopefully she will like it but it kinda sounds like she will try and be miserable wherever she is.

You don’t see it now but this is the best thing that could have happened to you. Once you start setting some boundaries you’ll realise how crazy this all is.

I'm sorry you are feeling so awful about it. From the outside it is a relief to those of us 'watching'. This is why the decision comes down to the doctor, not to you.

You haven't done anything wrong. Not a thing. But there's no way not to feel what you feel. I would continue to have low expectations of the situation - not of the care home, expect the best from them, but of your mother's reaction. She will never make it easy for you. But at least she will be living, frankly, the best life she can lead now.

Your feelings of guilt are somewhat extreme. I guess you've been conditioned and manipulated all your life. I'd be very angry about that. Not good parenting. Now is the time for what she needs. Not what she wants.
Time for you. Reclaim your sanity.