I'm at the start of the road and need some advice on how to get help, and what to do

[tenderbuttons]

I really don't know where to begin with this, as there is so much history, but I will try and keep it brief.

My aunt rang me the other day, having had my mother to stay. She's worried that my mother isn't coping. The honest answer is that my mother - who has depression and alcohol problems and smokes like it is an Olympic sport - has barely been coping for years, but has been getting by. (I have a rather distant relationship with her that also gets by; she had a very difficult childhood and I didn't live with her from the age of 7). But I think my aunt is right, my mother is 75, getting frail, and has chronic lung disease, so living in a rickety three storey cottage isn't probably the best place for her right now. Oh, and she hoards, so won't let anyone in there.

The thing is is that my aunt and I are both bustling, organised, always on the move kind of people and if you do that around my mother she will sink into a depression and not call us or get out of bed for weeks. I've learned this over many attempts to cheer my mother up/construct a relationship/whatever. For now it's OK, as she's been phoning me every week.

So how do I do something now? If we suggest something directly to my mother, she'll just stop calling. My DH has suggested that he might be a better intermediary (she likes him and he is laid back, and not direct family, so that's good). Or what? I have no idea.

Apologies if this makes no sense. It's not at all clear in my head, and writing it down doesn't seem to have helped, and the whole family thing is so complicated that it defeats me most of the time.

As a first step I would call her local social services and ask for her to be assessed. I don't think she need know it was you. If she tells you you might say it was probably the GP and they might be looking at adaptations etc which will help her stay at home.

I would also have a good long chat to SS about options. Where my mum lives they are great and happy to talk "theoretically" with no names given. If you don't have POA they will have to be involved if there is a crisis, so you might as well have your mother flagged up early. (Really valuable if she subsequently goes into hospital as this will mean SS have to be consulted before discharge.) Also having professionals briefed and able to advise can be really helpful.

Other than that you sound really together, an achievement given it sounds as if you cannot have had that easy a childhood yourself. I think when you have someone who is determined to make their own, often poor, decisions, it is important to be clear what battles you can fight and win, and save your energy for those, even though it means your mother suffering the consequences of her own poor choices.

Good luck.

I second SS, but be aware that when they call her, if she says no to the assessment then it will stop there. They need her consent before they can do anything.

Is it worth getting some general info from her local SS, maybe printed out off the website or similar, and giving it to her to look over in her own time?

Can you approach her directly? If you say you are worried as she isn't coping, will she deny it and stop contact, or will she admit it?

Thank you. I don't feel together, I feel a bit as though I have had my head in the sand for sometime.

I will have a chat to social services then (although I do wish they were called something else, it would make the whole process so much easier).

What she really needs is to move out of her dangerously unmaintained rickety house into a mildly wardened flat, as she is mostly looking after herself. But doing this would mean addressing the clutter, hoarding and general decrepitude, which is I think just too much for her to even think about doing at this stage.

The approach thing is difficult. My aunt has got her to start the POA process, which is good. But then my mother went off radar for a couple of weeks, and my aunt got worried so she phoned the charity shop where my mother works to check up on her, and got one of her colleagues to call round. My mother had had a cold, but since then hash't contacted me or my aunt and doesn't answer the phone. But she is still going into the shop. It's either a depressive episode brought on by the checking up (making my mother feel inept and so sending her back over the edge) or her phone is broken. I need to send her a letter I think, just to see if her phone is OK.

I hope things are starting to feel a bit clearer.

It sounds as if you know where you want to go. Your mother in some form of more suitable sheltered accommodation where there is a warden arrangement. Someone your mother can turn to and someone you can phone. Plus a new type of relationship where essentially you and your aunt are the parents when it comes to key decisions, but day to day with some of the responsibility lifted, you have a more balanced respectful relationship. (Eric Berne's theories of Transactional Analysis ie Parent-adult-child, though dated, provide a starting point.)

However getting there, when there is a troubled relationship, is hard. For me it was three years of worry when my mother did not answer the phone. My mother was almost defiant in refusing to consider anything that would improved her safety, considering any "interference" as a threat to her independence. Even a cleaner, panic button or giving a neighbour a door key.

I reached a stage when I tried to stop worrying. Her decisions, her outcomes. Whilst waiting for the (inevitable) crisis.

I would:

1. Press ahead on the POA drawing in support from people she trusts. You might not need it yet but you almost certainly will in the future. Getting this done is crucial.
2. Build communication with SS, and other local avenues of support. Try to get her to accept SS assessing at least her home with a view to identifying potential adaptations.
3. If she does not own her own home, you might speak to the social landlord. If she has a reasonably large property (ie is an under-occupier) they may bend over backwards to identify something smaller and more suitable.
4. Identify what might be suitable properties and see if you and your aunt can get her to look, on the basis that these might be suitable in the future. Understand prices markets and waitlists so when the crisis comes you can move quickly.
5. Take as big a step back as you can emotionally. Focus on the big things that need to happen and let the rest slide. Try not to get involved in any game playing. Taking over the management of my mother's life was tough generally but emotionally very hard. At some point you may need to be assertive, which may be counter to way the relationship worked in the past. My mother hated this and so lots of shouting and screaming. Once she was settled I found that for about six months I really did not want to see her. Its better now. She accepts that I am in charge and I try to be gentle about it. We can now go out for a coffee without any obvious stress. Possibly a better relationship than we ever had. And both DC are good at taking their turn with granny, accepting the dementia in return for some glimpses of the person she was, but without the difficult emotional history.

I understand the clutter. It took me three months to clear my mother's flat. Park the problem if you can, and when she decides or needs to move, move her first, or find some form of respite care, then gather some friends and, like they do in TV programme, triage the lot, into keep, give away or bin. Store the first in labelled containers, the sort of crates you can get from B&Q, to be considered another day. See which local charity shops will collect, ask a friend who is a eBay whizz or head for a car boot sale. And either head for the dump or see if the Council will do a special collection. Friends help, it is a tough one to do on your own. I involved my mother in sorting personal things like clothes: she sat on the bed and said yes or no as I whipped things out of the wardrobe. Plus pictures and furniture. I also packed potentially valuable things like china and photos into boxes which are stored in her new flat. It is amazing how little you use on a daily basis and how you don't miss the rest. We have never had to delve into the boxes.

Thank you. That really is such a helpful post that I can't begin to tell you. I think I will be using all of it at various stages in the future. I'm also going to email it to my aunt.

Sadly - at least in some ways - she owns her own home so she'd have to move into temporary rented while we cleared it to sell (and possibly did some of the renovations, as it would only be fit for auction as it is). Which is less than ideal, and one of the reasons I would rather get things moving sooner rather than at the crisis point. But we will see.

The Eric Berne stuff is fantastically useful, thank you for reminding me of it. I think she gets depressed when I take on the parent role, which is why things are fine when I am hands off. So there may be some rocky rides along the way, but I'll try and stay adult rather than parental.