V concerned about elderly neighbour

[NoFrills01]

We have a new neighbour, she is 91 and just got here from America, no family or friends, and she is renting the three story property which is over £1000+ a month.

We live in a rural area, there are buses, but still its a long walk to get around to anywhere, she obviously has no car.

She has no internet to set up a food delivery (what she wants to do) no phone, no bank account, and is struggling to work the gas cooker ect as she is from the states and things are a little different within the home.

I have a background in care, I find it a very odd situation. She seems frail, and she seems like she has early dementia to me.

I feel she is very vulnerable, I've offered to help all I can when I'm not working but she declines.

The house is the same as ours, and the stairs are steep. I'm worried we are the only ones who basically are checking in and would notice anything.

I'm not sure what to do. I think I need to gently ask a little more information, I'm worried about her health and welfare, and I'm not sure how she will keep up with bills or even pay them? It all seems so strange. She wasn't aware the bills are going up here, and she doesn't know how to work the heating and is currently just living off the microwave.

Obviously she needs a referral (well technically she doesn’t if she goes privately) but her dementia should be overseen by a consultant not a GP who are not dementia specialists. It’s the specialist who should determine the stage of dementia. The GPS tests are only very rudimentary.

Jeez
Humane Euthanasia would be far kinder.
If my DC ever felt they never wanted to see me again, I’d prefer euthanasia.
Dementia seems such a cruel condition-
People are living far longer so that dementia can set in.
I can see a day when “ Living wills” are a thing just to save people from suffering, unvisited and uncared for by their adult children.

Hahaha! If only it actually worked like that!

Sorry if I missed it - how long since she arrived? Has she managed to do anything or go anywhere in that time?

No. But u need to let them know in case they get ideas....
Lol

My mumhas dementia. The consultant diagnosed alzheimer's and then that's it. On going care is GP.

Diagnosis by a consultant is precisely what that poster’s mother apparently lacked - she said the GP insisted her mum was fine.

My dad and aunt have dementia. Their consultants did the initial diagnoses and as their conditions progressed they reviewed them and assessed their stage of dementia.Through the consultants they accessed speech and language therapy, day care, social services assessment etc.

@IrisVersicolor No, incorrect. Consultants do not manage ongoing care of anyone with dementia in old age.

My Dad died from dementia.

There are a few assessment stages.

The mini memory test which can be done by a GP (it's simple to administer, or someone on the care team.)

If that shows up anything for concern, a CT scan of the brain.
That result is looked at by a neurologist. They will write to the GP/ patient.

There is very little drug treatment for dementia, especially in the very elderly.

My dad was cared for (?) by the GP.
That amounted to nothing and my mum looked after him for 3 years till he died (and she was doing it at 90.)

They could have paid for carers to come and assist with his personal care, but he didn't want that and neither did my Mum.

He died in hospital of comorbidities, after a fall.

.Through the consultants they accessed speech and language therapy, day care, social services assessment etc

Not with my father.

All of that was done via the GP. He never even saw a consultant.

He had one woman come to the house (I was there) to discuss a care package of social outings, help in the house etc and these were not what he wanted or needed.

It's clear that @IrisVersicolor is accessing a gold standard of dementia care that very few do. My mum's social services referral was a our request supported by the GP. Any other support has been arranged by us based on info supplied by social services and our own research. Other than that we are on our own with GP appointments for specific issues. I bet that is the most common scenario.

the safeguarding law does cover self neglect but this is around people putting their lives at risk due to significant issues around hoarding, not caring for themselves, refusing medical input etc after multiple offers of support

This is absolutely not correct. I'm a social worker in adults social care and have had direct safeguarding involvement with older adults who do not hoard yet place themselves at risk in other ways.

It is true, however, that mental capacity is considered. Capacity is assumed as a starting point, unless there is reason to suggest people do not have it. None of us on here can make the decision that this lady does or does not have capacity to make unwise decisions on the basis of what we've read here. Social workers are trained to assess this in situations like the one you're describing.

OP, I would call Adult Services and express your concerns that you think she's at risk of self-neglect. They will ask specifically why you think this and triage the information you provide and make a decision to progress or not. Is she in danger of running out of food and not being able to get to the shops? Her microwavable food will disappear at some stage. Is she able to access toileting/bathing facilities in her home? (this will become very obvious very quickly). Is she able to do her laundry? Get to the shops?

Just refer in. You don't need her consent to express safeguarding concerns. Let the professionals make the decision.

You sound lovely and caring, OP.

I dont no where half the people posting live.but access to care is noon impossible.
And granny dumping,hmm I think rather a lot of families are advised to tell and make sure the hospital knows there is no-one to look after the patient.if social service or the hospital get a with that fanily can look after them you are left.
We were told repeatedly by those in the know to make sure everyone knows there is no-one at home to look after her.
To get a care team and help at home you basically have to look like the patient has been dumped,is alone,and needs care team at home.
Also that in itself is impossible in current times.the amount you have to push to get adequate care or appointments or anything is shocking.and I can see why do many people die left alone and fall thrpguh the cracks.
Mental health and social care system is on its knees.it shit.help is NOT there and those that have managed to get it are lucky,pating more and d3ff not the norm.

What a good neighbour you are OP!

@NoFrills01 Thanks for your update of yesterday afternoon - that sounds like a sensible approach. You are so wonderful and caring, the lady is lucky to have you looking out for her. Just make sure she doesn't become overly reliant on you. You might need to be insistent to ensure you don't get fobbed off by her landlord and the statutory services.

I am interested how you first became involved op.

did you go around or she come to you?

Don’t know why you’re telling me how dementia care works given that I have clearly said I have 2 close relatives with the illness. (And PoA for both).

Nor am I sure why you think that your parent’s pathway is the same for everyone.

I did not say the consultant manages ongoing care, if you read my posts more carefully. I said the consultant who does the initial diagnosis can review them as their condition progresses and assess their dementia stage. That is what I did.

My relatives pathway: GP memory test, referral to neurologist who flagged dementia, referral to neurologist specialising in dementia who did MRI scan and organised 3 hour neurocognitive assessment. Referred on also by the Dementia and Delirium team for speech and language therapy and local daycare. My father is one type of dementia drug, my aunt on another.

For good quality healthcare you do have to do your research but this was all NHS.

London NHS 🤷🏻‍♀️ But I did my due diligence to find the best local dementia services available in their area and ensure they were referred.

I wouldn’t let a GP deal with it in their own because it’s a serious and complex condition and they’re not specialists.

Well, in most of the country it's take it orleave it. There isn't even a choice of GP practice in my parents small town.

That’s why people live in cities. To me access to good healthcare is key particularly for elderly people.

That's really interesting. Why just older people? Does the law specify age? Do younger people self neglecting have a different threshold?

What a strange situation 😕

Your neighbour is lucky she has you as a neighbour.
It is very odd.

Did the op ever clarify how she first came to be involved with the neighbour? What was the trigger

Any updates op?

@NoFrills01 Hi, any update? How did Friday go?