How do you know when you need help? Long.

[Littleover]

Hi, been awake since 01.30 thinking about this and would appreciate it if someone would point us in the right direction. My 95 year old nan lives with my parents, moving in 12 years ago after my granddad died. My mum has a brother who visits a couple of times a week and a sister who lives about 6 hours drive away. Grandparents chose to live in our town as mum and dad were "settled" and mum's siblings had no kids/good jobs and travelled a lot. Mum and dad are early 70's now and are struggling with my nan's behaviour which changes according to the audience in the room!. Mum and dad get out most days and see friends. Nan won't go anywhere where she has to socialise or "sit with old people". She is frail but able to potter around indoors, tries to do too much by helping with housework to do her bit. She has ruined several washing machines, boiled kettles dry because she doesn't put the lid on correctly and left taps running. We have all put our heads together to work through these physical changes without making her feel like a danger to herself.
The biggest problem is helping mum and dad and how they react to her behaviour. She accuses them of taking money/hiding her stuff etc, and recently has suggested to them that they are trying to slip her tablets to finish her off. She also said that she woke up in the night to find my dad holding a pillow over her face ( that really hurt mum and she wouldn't tell dad about that). Mum feels that nan wants constant treasuring and reassurance whilst having the freedom to be as nasty as she likes about anyone. My dad refuses to tolerate this and this is causing a lot of tension. She has upset most of us in the last few years mainly by saying what she really thinks about us. She idolises my uncle who regularly visits but he can't really do anymore. She wants to live with him but after telling his partner what she thinks of her I can't see that happening! My mum's sister rings every day and nan changes back into a sweet old lady. When the phone goes down the venom starts again. Mum's sister knows about this. Nan goes on holiday for a month in the summer to visit mum's sister but she moans before during and after. Nan had a long but not very happy marriage, lost her mum when she was a child and has worked herself to the bone. She is very resentful of anyone with a better happier life and drags you down with the bitterness of it all. She regularly "sees" her deceased relatives and sometimes angels who try to give her messages about when her time will be up.
Sadly she ruined Christmas for numerous reasons, mainly around her obsession that we are all putting her in a home. When we arrived on Boxing day she hid as she thought we were coming to assess her. A lot of this sounds funny as I write it but my mum is holding back the tears most days. Don't know what to do next. Got to go, kids are getting up!

Has she had a diagnosis of dementia?

No, how do you go about getting that? She has blood checks (osteoporosis) at the GP surgery with a nurse but is rarely ill enough to see her doctor. Sorry for the long post, sleep deprivation ( 2 under 6, poor sleepers and a husband on call last week ). I try to offer help but I feel like I am interfering in their life, they often refuse my suggestions. Bit frustrating as I love them all but I feel they are being pulled down with her, a bit like when kids play one parent off against the other. Meeting mum for coffee now as she wouldn't tell me yesterday why she rang in tears asking us to come over earlier than arranged. Thanks for replying.

All of this will sound very familiar to regular posters/readers of this section.

The accusations, especially to those who are closest, the putting the favoured son on a pedestal, the reversion back to being a sweet old lady.

You would not have posted if you had not felt things had to change.

1. You or your mother phone the GP and ask him to see her. He should do a memory test. (Mini mental state test.) Ideally someone go with her so they get to understand the process and also to be able to describe what is actually going on. Diagnosis by internet, but it does sound like dementia.

1. Based on what the GP says you might contact social services and ask for an assessment. It sounds very odd, but really you are on a journey and will almost certainly need their help and advice at some point. Even if you are in a position to pay they can be very helpful on what is out there, including adaptations, perhaps a carer to sit with her whilst your parents go out, day centres, befrienders and other volunteers, respite care to allow your parents a break. etc. It is very useful to have her already assessed as potentially vulnerable should she be admitted to hospital. If there is no Power of Attorney granted (and really this needs to be a priority) and she is no longer capable to grant one, SS could be crucial.

1. Once you know what the mental health issues are and perhaps with advice from SS, your parents might have a family conference to agree the way froward. None of the decisions that might have to be made are easy, but everything is worse if family disagree amongst themselves.

Good luck.

Agree with all the above, but also get a thorough medical check done. My Mum would not tell anyone how ill she was or how much she was hurting because she was afraid of going in hospital. Then make sure she is taking her meds and not hiding them because she thinks they are poison.

Thanks pudcat and needmoresleep,
Yesterdays meltdown started with nan getting a letter from our surgery asking her to come in for a check-up and blood test, also to bring urine sample. Mum's brother was called over to speak to her as he is the only one she'll listen to and she was ok after that. Mum didn't seem keen to involve outside help but she realises that it can't continue as it is. I'll show her these responses too.
Thanks again x.

That's good that she is having a check up. Will your Mum go with her because I know from experience that the truth is not always told. Your Mum needs to tell the dr just how things are. It does not mean that your Gran will have to go into a home, but that the right kind of help will be given. Are your parents claiming Attendance Allowance for your Gran? If not they need to.

And indeed another reason for your mum to see the GP with her (or call in advance is she is likely to object to anyone gong in with her - GPs can vary but many are very pleased to know there is family support and to do what they can to keep this support up to speed and involved.) The GP needs to sign the Attendance Allowance form.

I might also add that there are a range of possible outcomes. "A home" is not the only one. Things are clearly getting more difficult. With support, including practical things like adaptations, or help from volunteers, lots can be done to make your parent's life easier at a time when they should be enjoying an active retirement. This in turn will help them help your nan.

I have found it really useful to have access to sensible informed professionals who are able to give me advice. Things are OK now after a crisis a year ago. However there continues to be a slow and steady deterioration in my mother's capacity, and each loss of ability needs me to respond in order to ensure she continues to be safe. It is soooo important, particularly when facing abuse from my mother at what she perceives as me interfering or curtailing her independence, to have others who can confirm that I am doing the right thing.

Thanks, mum's brother will be going with her and nan to the Dr's. Not sure about attendance allowance, will ask today when my parents come over. Nice to know that there are volunteers/befrienders as an option, I think nan is understandably bored with the small amount of family that visit. I think that while mum and dad know and hear of people going through this situation they haven't had any professional advice to help them make choices. I am going to suggest that mum and dad go away at half term and we will move in and take over for a few days. Will discuss these options with them today. Thanks, will report back. I wish mum would join mumsnet!

MumofLittleover would be welcome. She might also try the Alzheimers Society "Talking Point" forum. Its a pretty broad church, not just Alzheimers, and lots of practical financial and legal advice.

I've never posted, but find the glimpse of the twilight world some carers are forced into, quite moving.

Your mother might also find Hugh Mariott's "Selfish Pigs Guide to Caring" useful, as it acknowledges just how emotionally difficult it can be.

You could phone the local Social Services anonymously, describe the situation and ask them about the support, either paid or voluntary that is available locally. Even if it is true that their main interest is to keep people at home as it is cheaper, this means they can be expected to be helpful at least in signposting to existing support. They will also send someone around to look at the physical environment and can then help pay for needed adaptations.