Vulnerable adult

[MochaShots]

Hi, I was wondering if anyone could give me some advice.

I am a mobile massage therapist and I am concerned about one of my clients.

She is elderly, has COPD and is house bound and reliant on manual oxygen and mask to help her breath.

When I first arrived at her house, I was astounded by her conditions. The house was messy and filthy with thick dirt. I had to make some sort of space for the bed, and obviously asked her if she had carers etc. She said yes, so I had kind of hoped that maybe it had just been a while since they came and that the situation would be rectified. Before I left, I asked her if she needed me to do anything for her before I leave. She was adamant she was fine.

The second time I visited, it was the same if not worse. She seemed overwhelmed and apologised. She was upset and asked if we could not proceed with the massage because she wasn't feeling mentally ok.

After a chat, I asked her more about her care and it transpires that she has been paying through a scheme for her help, but the carers hardly visit. Her food in the fridge was out of date also.

I made her a cup of tea, then with her permission, I cleaned her room, changed bedding etc.

She was so grateful, but seemed to struggle with the idea of someone helping her. Obviously I didnt charge her, and I told her that she shouldn't be living like this, she is entitled to help and that I was more than happy to contact the relevant people on her behalf. She thanked me and said she will send me details that evening.

The whole weekend I couldn't get this off of my mind. She has no family or friends, cannot talk for more than a few seconds without her apparatus and quite frankly, her environment is a complete health hazard (wires all over the place, awful smell in the house, wrappers, thick dust and dirt).

I messaged her and said I have some new bedding for her (hers is thin and ripped) and a few home comforts for her that I'd managed to rally round and get from friends and family. She thanked me, but later messaged to say "why do I find it hard to accept help. I'm so sorry but I feel like I cant accept help even though I need it"

My dilemma is that if she were a child in need, it would be a no brainer, but as an adult I'm guessing I can't contact authorities with my concern without her permission? Plus she seems to be resisting the help that she so clearly needs. I don't know if its because she is too proud, or because she feels it's her responsibility? I have made it very clear to her that I do not want payment of any kind from her and that it is her basic right to get the help she needs and deserves. She is such a lovely woman and I'm struggling to think of her getting through this winter living as she is.

What do I or can I do in this situation?

Thank you.

Adult services in her local county council should have a number you can call and an
online form to report your concerns

Is the house council or HA ? They might be able to help her with a deep clean or find a property more suitable for her needs.

Report all you've said to her local council/authority. Out of interest how did she find you to procure your services?

Before you get too involved have you seen any evidence that she actually has carers? Is it possible that she may not be allowing them to clean the place? You said she struggled with the idea of someone helping her.

It's not unheard of for people living in conditions like this to reject help or when help is put in place not to allow them access to certain rooms or to move certain things. I would initially establish that there even is anyone helping first and refer her to adult social services.

If she's on manual oxygen with serious health issues then they are probably already aware of her but these situations where people live in squalid conditions can be a little more complicated that they appear to be. It may not actually be that the help isn't being put in place but her reluctance to accept it is hindering it.

I think you should ask if you can pop round for a cuppa and have a good, gentle chat with her.

Explain you're concerned for her health and you'd really like to see her quality of life improve and you think there are ways to do that.

Ideally you'd like her blessing to talk to social services but even if she doesn't give it, I think you have to do it anyway. There are so many ways they can help her, whether she has means or not. She is obviously not coping and she needs help.

You sound like a kind and compassionate person. I bet she's so grateful for your support. But defo involve SS.

If she's on home oxygen she must have a respiratory nurse or district nurse involved with her care.
A lot of these services have been doing more telephone reviews since covid so may not know how bad things are for her.

Could you see if she would share their details with you? Put it that you'd like to help her get a bit more help at home?
Then you can pass all your concerns into the nurse and let them organise appropriate help for her.

Thank you for all your replies. I'll respond separately after, as I'm heading out, but in summary:

There was a carer who left just as I was entering her property the first time. Who had apparently given her a shower.

She lives on a council property.

She acquired my service via leaflets distributed.

Despite maybe not accepting help, I struggle to believe anyone in a caring role would deem her conditions safe. I think I will have to contact SS, even at the risk she may be upset with me. :-(

If she's in a council property speak to the safeguarding lead. They have numerous things they can do to help snd access to other agencies.

They may not deem her condition safe but you can't force people who have mental capacity to let you interfere in their domestic affairs. All they can do is try to persuade her to allow them to clean up a bit or wash her but they can't force her. You'd be surprised how often people in the care sector see challenging cases like this. Not everyone wants help and so e see it as interference, and when people see it as interference they are much more resistant to accepting outside help. Often these are people who have always been fiercely independent and forced by ill health to give up that independence unwillingly then become overwhelmed. I know it's a shock when you've never seen this before but most carers will be able to tell you about clients just like this.