Mil living alone ?

[Picklesbaby]

Hi this is a long one so please bear with me .
Dh mum is 82, doc said early onset dementia a year or 2 ago (but we are now waiting for a brain scan for a proper diagnosis)his dad died of COVID in November and ever since she has gone terribly down hill . Dh oldest son currently lives there but has now decided he wants to move out. I do and will continue to do 3 day visits a week and we have her over here once a weekend. When he moves out he’s suggested a schedule which involves him going round one evening a week and careers doing one hour per day in the other evenings to ensure she gets a good meal and is set for the night.. how do I broach the subject with her can she refuse to have home help ? Is she going to be able to stay at home without it ? If she agrees will one hour be enough ?
I’ve no idea what I’m doing so any advice would be welcome thank you x

Yes, she can refuse if she has capacity to make the decision. An argument you can use is that it'll help her stay in her own home for longer.

Are you going private for care rather than through social services? Social service care is usually based on 15 min or 30min visits. They'll put something in the microwave but not cook from scratch.

Is she able to get herself to bed?

Incidentally, there's more traffic in "Elderly parents" than in this thread.

I think starting off with an hour is good but be aware you may have to increase it. Post covid things like daycentres are good for people to go to during the day for extra support. Alzheimers society has befrienders who can call every week or other week to provide additional support.

Look into direct payments where the government pays you instead of sending carers so you can employ someone privately.

There are lots of telehealth devices to help you supervise her from afar if she needs it like door exit sensors and falls sensors, heat mats above cooker, magiplug so water drains out etc. It's a bit of a big brother situation but if staying in her own home is important its worth it.

These conversations are easy if the person has insight into her condition, if she thinks there is nothing wrong with her it can be difficult. But I always think honesty is the best policy. Just be honest about your concerns and why you want to get the carer.

Does she have capacity? If so she can refuse outside carers. If she still has capacity I would suggest looking urgently into powers of attorney and talk to her about what she would like to do if she can't look after herself, would she like to live with other people or have people care for her at home. It's tough for everyone, many of us can offer you advice as we have been there though. Do get a social services assessment once you think she needs help, and if care levels increase she might be eligible for nhs continuing care, not easy to get but it's available for more severe dementia.

For now I would look into providing meals she can microwave if you can't be there but consider safety of gas in particular, my grandad nearly blew up the whole block, turned the oven on, didn't light it (this was years ago when you lit ovens manually) and went to bed! Next door neighbours smelt gas through the wall and called my dad, we disconnected the cooker.

@MereDintofPandiculation yes she can get herself to bed and dressed! We would pay private for as long as we can afford yes she switches between please don’t get rid of me and f you all I’m selling up and going in a home. It’s sad most days she says wishes she was dead . Dh thinks she will never agree to carer or a home yet but I am at a loss

@Twylar
thank you I will be honest with her , she knows there is something as she has phases of asking but other days it’s there’s nothing wrong with me . She won’t start to remember it until we’ve been over it for months so do I approach it now or wait until later ?
@moochingtothepub
she definitely does . She still does the gardening and ironing (supervised)!But can’t remember the grandkids names or who I am. I can spend all day there and she forgets I’ve been and calls me saying how lonely she is 10 minutes later.
Oh god that’s awful.. We have got rid of the chip pan and put an electric oven in,Heating is on a timer . She is going through a phase of forgetting she’s eaten and eating again , the same with drinks she’s going through so many tea bags and milk! She could microwave meals yes thank you ,We have applied for power of attorney, do we wait for the results of the Brain scan (we were referred in December)or for her to get worse before getting an assessment ?

Thanks for all your responses x
We didn’t want to have to go down this road but I’m unsure if she could live by herself do we let her try it out first or use a carer straight away? I do 3 visits a week as dp is self employed and works all over the country ,but I’m going back to work next week &We have a 9month and 4 year old too

Don't wait to apply for power of attorney.. she has to be deemed to have capacity in order to do this.

If you guys do not have a welfare power of attorney get that put in place asap. As others have said, if she still has legal capacity she can dismiss carers anytime. I'd also chase the dementia dx for the associated support. If your mum is 82 this is not early onset - do you mean early stages of a dementia?

We have submitted the document for complete power of attorney to the solicitor,we are waiting for him to sign and send back to us..

@TheDaydreamBelievers yes sorry early stage was diagnosed when fil first took her , he was a very proud man and never took her back, we didn’t realise how bad it was but Now he’s gone

I understand @Picklesbaby. Unfortunately dementia can increase in pace over time, and people can also go downhill faster after loss (especially if the person they lost was helping look after them).

Some basic tips - it may take a lot of repetition to have her understand she needs help. It can be good to have a big, clear calendar and score off days, and mark when you are coming over and when carers are. Only write down what you will definitely do

It would be better if she was in agreement, can she help you recruit the carer and pick someone she feels happy with? Approach it now though and have regular conversation about it on your visits and each time you see her ask her does she remember the conversation and see what she recalls. With something as significant as this there is a higher chance of her recalling it as it is very distinguishable from day to day conversation. And have a clear list of things the carer would help her with e.g. meds, dinner and general company aswell. She might really like them.

it may not be the best thing to keep asking her if she remembers xyz.
she will not be able to live alone eventually.
this is a progressive disease. it will become unsafe to be unsupervised.
don't overload her with the situation.
try to get her to sign the POA docs.
look around for a good carer, maybe a local middle aged woman.
if you could get her to come first time with you and just be helping you tidy up, make tea and toast etc. do this a few times, and then gradually leave the carer there alone.
make it clear to carer that it would be a time to see if the two of them are suited. so much depends on personalities. if your MIL doesn't like her, try someone else.
i wish you all the best.
i have a lot of experience, unfortunately.
never correct someone with dementia. try to steer conversation away.

My father accepted carers but always referred to them as "home helps". Would she accept a cleaner? it would be company and someone to keep an eye on her for a while.

I wouldn't worry about her drinking too much. Constipation is a real problem in the elderly and a good fluid intake helps.

never correct someone with dementia - it's unproductive. They will come up with more an more fantastical beliefs to avoid admitting to themselves their brain is falling apart. Don't challenge their understand of the world. It's really difficult!

She has signed the poa before we sent it to the solicitor so no problem there . We have brought a big whiteboard for the wall today Thank you for the suggestion !I did broach the subject today . I told her when he moves out I will be up in the day and will take over the bills good shopping ect. She said she would be frightened by herself so I just suggested we just give it a try and review our options after a month or so . I did mention someone could come and have dinner/ a cup of tea with her . She pulled a face but didn’t respond 😄 She has started to ask what will happen when he leaves so we will carry on with that answer I think
@MereDintofPandiculation I’m more worried about the sugar , the doc made a few comments about her blood sugar level on her last blood tests. But at least she is eating well! She often thinks it’s her dad that’s died I never correct her it would take up all of our time together .I think suggesting it to her as “home help” may be a good way to go about it actually , I’m going to get in touch with an agency see what they recommend thank you x

I’m more worried about the sugar , the doc made a few comments about her blood sugar level on her last blood tests. Yes, good point. I'd quite forgotten about that it's so long since I had sugar in tea.