Really need your advice:elderly parent with angry depression refusing to get help

[Bluemeanie]

Anyone with any experience either professionally or personally - please can you help. I didn't know whether to post this here or in Mental health.

Father is 81 and has depression - but will not discuss this or go to the doctors.
Is making life a misery for my Mum. Recently got much worse -shouting at me on the phone (never done this before) . Spends hours in bed or just doing nothing. Not eating. Aggressive and moody. Can't cope with anything going wrong. Can turn on good behaviour when he needs to. This has been going on for years but seems to have reached crisis point
Mum has talked to her GP but they just tell her he has to come in himself.
I live miles away and can't be there. It 's a terrible situation.

what can I do ? are there any groups or bodies who could help us? Any advice very gratefully received

Is she a recognised Carer for him? If so she needs to contact social services and ask for a carers assessment She could contact the local mental health team however they would need a gp referral, however they may be able to talk to her about some practical things she can do. I would suggest she contacts social services adult services also and says she can't cope, they may have some solutions.

Have you talked with your dad at all and attempted to make him realise what his behaviour is doing to your mum. Maybe attempt to get him to open up and if all else fails a hard line with him may be the way forward. Has your mum considered what her options are if he does not access help as obviously the situation will become unmanageable at some point.

If his behaviour escalates and he is a danger to her or himself then you need to contact MH crisis team ASAP.

Thank yo so much for your helpful post. She isn't a carer for him ; she is 82 and has a myriad of her own health problems He doesn't appear to care one jot about what its doign to her - in fact it has an element of vindictiveness about it all.

COuld I contact social adult services for her -?

THing is he woudl react rally badly if anyone turned up at the
house to 'help' him. THis is bloody awful and I'm 200 miles away

The anger outbursts sounds less like depression and more like alzeimers type behaviour with the suspicion regarding outside help and vindictiveness etc. Which given his age is not completely unlikely.

A call to adult social services in their area can do no harm although your Mum may need to admit to them she is not coping (a big step if she has been living with this and hiding it for some time).

Good Luck

I would most certainly call adult services about them both and the situation as a whole.

I think the fact he will react badly has to be recognised but not as a deterrent, I think the fact they are very vulnerable and you are 200 miles away means that someone needs to be alerted.

If he reacts badly he reacts badly, the problem with not acting is that he will inevitably hit crisis point at some point and with no support you mum is going to be very vulnerable and having to deal with this alone, at least with some help and support if it comes sooner rather than later she will not be dealing with it on her own.

It could also be that he has an infection uti or chest that has gone untreated and that is causing problems, is there any confusion or dementia type stuff going on other than general old age?

Another solution if adult services are not helpful, which I doubt then your mum calls and asks gp for a home visit. She can lay it on that there is a change in mood and she is concerned about underlaying health problems, ie infection. And that he is unable and unwilling to leave the house but his health is deteriorating. I think they may be duty bound to visit. Has he talked about harming himself or your mum? If he does then the gp very much would be duty bound to visit if called out.

GP or SW can be contacted and to a home visit in support of your poor mother. Your father can then be involved in the conversation wrt to his wife's health and needs.
Any experienced GP worth their salt knows how to assess a person who does not want to be assessed but in whose best interest it might be to get some help IYSWIM - I know this sounds very 'Dr knows best' and that is not what I mean, but the situation sounds dire and is unlikely to improve in its own.

I am a GP and much as I cannot visit anybody who point blank refuses and is of sound mind (has capacity to refues), I welcome hearing from family member who have inside knowledge on what goes on. Most older people will let a trusted GP in when they turn up 'for a check-up as I was just in the neighbourhood'.

I agree that your father's behavious suggests something more than simple depression. If your mum is reluctant to speak to GP honestly, maybe you could?

District Nurses could visit 'for routine flu vaccination'?
Or to check you mum's blood pressure?

I know all this sounds v sneaky, but the last thing in anybody's interest is for the situation to reach crisis point when everything goes pearshaped.
Sadly, this does happen, which is why I think you have to ignore how upset he might be and do what is in his best interest, NOT what he wants.

Absolutely agree with pacific that with best planned approach then it may be resolved without your father reaching any crisis. Very well put pacific, well planned then your df may not be distressed by a gp visit.

Thank you - you have all been so very helpful.
He will either be as good as gold on the day if someone sees him or he will refuse to come out of his bedroom - where he spends an inordinate amount of time. I feel I should be there - but its so very difficult with 2 Dc's and working etc just to drop everything.

he has a particular hatred of Christmas and its always such a farce buying him gifts that he doesn't want. HArd to explain to DC's though he generally puts on a good face when needed.

It is hard when you live far away - my parents are elderly and live in another country from me and it is really worrying me.

If your dad is able to modify his behaviour when it suits him, then it would seem that he has a degree of control over what he does. In which case I would suggest treating him like an obstinate toddler tbh. Your mum should be encouraged to look after herself, get a SW assessment for her, accept any potential support offered: homehelp, befriended, day centre - anything.
Often people who behave in a challenging manner get away with it because they don't get challenged and in fact those around them enable the behaviour by tiptoeing around them.

Now bear in mind that nobody here can diagnoses your father or have any kind of acurate idea of what's going on, but it does not sound to me that doing nothing is really an option?
Again, huge sympathies from me, I am a working mother; whenever the inevitable Crumbling of my parents comes, it will be a nightmare to manage - but could you not take a couple of days off work, sort out some kind of childcare solution and do a surprise, unannounced visit to your folks?? Or do you have siblings? Maybe someone who lives closer to them?

diagnose, no idea where that extra s came from...

HI again
I managed to have a talk with my DAd as he answered the phone yesterday. He won't go to the GP but won't explain why, other than he can't put it into words.
I tried hard to reassure him that the GP's see lots of patients with his symptoms and I kept saying " it could just be so much better for you".
I offered to travel to see him and go with him if that helped.. Nothing works.
He said " I don't deserve you". Heartbreaking.
At least we talked , but I just wish he'd get some help.

Hi Blue. Whatever else may be going on it so sounds like he has severe depression and could benefit from an antidepressant. I work in hospitals and have seen elderly, isolated, poorly eating persons be transformed by a course of ADs. Of course it's easier to start once they're in here. And it can take from 2to 6weeks to see a difference. Engineeering a GP's home visit could be the way forward. Speak to the GP, paint an accurate picture and descibe the impact it's having on your mum. That may convince them to go and see him as it sounds like he's just not going to get himself there. Unless maybe you make the appointment and take him?

Blue, IME people in the very depth of mental illness cannot perceive that a. they will ever be better, b. that anybody can possibly understand what they are going through, c. how their behaviour is affecting others.

I know you are far away, but would you consider speaking to your parents' GP on the phone?

Age UK have been brilliant support to my parents, they are very good at dealing with awkward customers

Hmm, don't know if this is totally nuts. It could be a bit of the narcisstic personality disorder (google it). They'll be nice and charming to strangers and acquaintances and brusqe and contemptuous to immediate family/circle. Not unlike the celebrity pop star type, later you read a bio and find what horrible fellas they are. Peter Sellers, John Lennon, David Niven, charmers to a man.

Challenging the behaviour is all very well, but these types can react with astonished fury and play the victim, take it from me.

Suggest some vitamins? Vitamin D3 can be an antidepressant.

All you might say is, 'Better men than you have gone on anti-depressants'. Frame it like it's a pick-me-up or something. But even these can come with a myriad of problems.