Crisis has come, sooner than we thought

[tenderbuttons]

Sorry if this is all a bit incoherent, but I am not really thinking straight at the moment.

My mother has had a fall and is in hospital. The house is uninhabitable (she hasn't let any of us in there for years) and she cannot go back there. And she lives two hours away from me.

I'm going up to see her tomorrow, but if anyone can tell me what I need to know and who I will be dealing with I would be very, very grateful. She has been flagged as a vulnerable adult by the police and has been passed on to their support team, and apparently the hospital will be making referrals.

And I am going to do everything I can, but the thing I am least looking forward to is being disapproved of as a bad daughter by everyone. I can't, couldn't make her do anything, couldn't make her stop drinking or look after herself and she wouldn't change, she was too depressed to. But they are all telling me things - the house was in a far worse state than I knew - like I should have done something about it by now. But how? So if anyone has any psychic armour tips, I'll have those too please.

Oh you poor thing. You are NOT a bad daughter of course and the professionals will all know that. Because they know what dealing with elderly/stubborn/frightened/confused/determined people is like. They see it ALL the time. No practical advice - but thinking of you.

I work with mainly elderly people arranging hospital discharges
Don't worry, no-one will judge. Its not an unusual situation
She will be allocated a care manager or social worker
Can she not return because it is uninhabitable or because it is an environment she cannot manage or both?
If she is in a proper hospital she could likely be moved into some sort if rehab bed once medically fit and have her social needs assessed
Then could be residential or sheltered housing
If she wasn't coping then its a good thing but I understand a stressful time for you

How old is she?
One point to mention which families struggle with
So long as she is assessed as having capacity, the ability to understand and make her own decisions, then she can make choices which are considered unsafe by the professionals working with her
Make sure she gets a full assessment of her needs

Hang on in there.

It sounds as if in some ways this is a blessing in disguise, if as I assume you are hoping she might be moved to somewhere with more support.

I am absolutely no expert but I would have a word with Age UK and Adult Social Services. Ask the former what might be done, eg having the house declared unfit for human habitation etc, and then with the latter to ask what is likely to happen and whether, rather than moving her back, she might be moved first to some form of rehab/convalescent care. I assume there will be all sorts of complications around whether she has capacity or not, but either way I would be tempted to use this as a chance to get her the support she needs. I would try to insist that before she is discharged SS carry out a home assessment.

Also be firm. She is not your responsibility. You have presumably always had a strained relationship, in part because of her drinking and are not in a position to provide practical care/support.

No smiley for psychic armour......

Thank you for the answers, they are very much appreciated. I did talk to one lovely nurse this evening who said that sometimes it takes a crisis like this to make the right things happen, so yes, it is a good thing in a way.

The house is both unsuitable (tiny winding stairs and three stories) and in such a state that it is uninhabitable by anyone right now. Apparently there are floods in the kitchen with electric heaters standing in them.

I think she will probably need residential care for a bit - she has stopped cooking for herself; I suspect that sheltered housing may not ever be the answer as she's not looking after herself that well down to depression/hoarding/drinking so I can't see that being much better even in a sheltered flat.

x post with the last two posts.

Stillwearing. I hear you, but the police officer has put a flag on her file saying that she should not be allowed to return home. He put his foot through the floorboards on the top floor. So I am hoping in a way that she will not be allowed back.

And needmoresleep, yes, I haven't lived with her since I was seven, so our relationship is at best non-standard, and she's more often than not too depressed to be bothered with me (and I make her worse I think by being busy and doing things).

I will see the nurses tomorrow and am hoping that they will be able to give me the contacts for social services. And I have a contact no for the Police side of things, but they won't be dealing with it until Monday.

And really, just being able to talk about it without being judged here makes such a difference, thank you.

If you have time i'd also say you could go to the house and sort it out a bit. Even if she can't go back you might want to put any valuables somewhere safe and make sure nothing else is an immediate hazard. I don't know if you are the only child but you may well want to think about what happens to her house next if she is unable to live there.
I'm only posting as a friends parents have recently had to do this for her father's brother and his wife - she had a fall and social services contacted him as next of kin as the husband couldn't drive to visit his wife in hospital and they weren't happy for him to live alone without assistance. My friend's parents have been over and de-cluttered and cleaned and generally got it back to a relatively habitable state. They found large sums of cash and were very scared that someone else could have come in and found them. It is unclear whether they will be allowed to live there when she comes out of hospital, but at least there is one less thing for everyone to worry about.

Funnily enough, I was just thinking about that. I'm going up tomorrow on my own and I think it is the one thing that I am not going to be able to bear to do and I kind of half know how awful it is, but I don't want be faced with the full awfulness of it without someone else there. But it does need to be done - there is food out and all sorts. I may get some specialist cleaners in and try and do something with them.

Hospital should make all the referrals and liaise with social services
Social worker can sort out re housing options and, once assessments are complete, likely a case conference for your mum and all involved to make a realistic plan

Thanks, it really helps just to get a sense of what might happen - it's a new and unfamiliar landscape.

I feel for you OP. All the very best for tomorrow. With my own mum (bit of a different situation, but still mental health issues) I find it helpful to remind myself that "it" is not her, it is her illness.

"It" being anything from the names she is calling me to the chaos in the house to her OCD to her treatment of other people including my Dad. Some days I have to remind myself constantly.

I'm doing the same thing on Sunday, dm 's house not exactly uninhabitable, but is a hoarders paradise, and dm is not safe to live alone now. I have been "no contact " for 8 years, but am now communicating with the assigned social worker and a solicitor who is going to be appointed to manage the house and dm 's finances.

Its hard as it all happens at once, and you / I are at a distance. I've rung Age UK advisor today she was great. And you have to be clear with everyone what your boundaries are, and the extent of what you are or are not prepared to do.

Amiga - that does sound like we are in the same sort of boat. What happened to get you to this stage?

HTD - yes. On a good day I can think like that too. I will try and remember it as much as I can.

You should be able to find an emergency number for the local adult social services via Google. When DM had her fall the hospital completely failed to communicate with them, so this was how I got in touch with them. The lady was very switched on, and indeed had been very helpful three years previously when my dad was dying and I thought I would need to organise carers.

Hopefully police involvement will mean that the hospital wont be tempted (as they did with DM) to simply patch her up and send her on her way.

Take lots of photos as soon as you get into the house, so you have something to show social workers etc when you meet.

Possibly take down a suitcase so you can stuff paperwork into to sort out either in your hotel room or later at home. It really helps to know how much money is there and how much comes in each month.

The police have passed it on to the Vulnerable Adults Team which I think is within the police- or is that social workers?

Will take photos- good call, thank you. And I do know about the money, fortunately, so that's one less thing to worry about for now.

Vulnerable adults team is social services

I would be wary about doing anything in the house at the moment. Believe it or not you may have a fight on your hands for them to assess her as not able to live by herself. You may need people to see the state she was living in to help your case.

Similar situation here although I am 6 hours drive from my Mum.
Yes to adult social care via the council.
Occupational health will assess her capabilities before she can be discharged anywhere.
Money, your Mothers capabilities and her wishes will play a big part in where she goes now.
My DM has dementia and epilepsy but now manages at home (after a similar crisis) with meals on wheels,4 care visits daily and a brilliant falls monitor. We blitz it every few months and reorganize everything.
Occupational health and social services should help you access funding and support.
Which local authority? I am quite knowledgeable regarding East Sussex.

dm had a very minor stroke at Xmas. She went to the doctors who sent her in to hospital. From there the doctors saw her confusion, and would not discharge her back home.

Though the social worker has made some dubious financial suggestions, she has been entirely fair and kind re the NC situation, no judgment at all. They are the professionals who deal with this all the time and I get the feeling she is somewhat squeezed between hospital pressure (beds) and the local authority finance team once a care assessment has been made.

Thank you for all of this, it's unbelievably helpful.

I'm assuming that nothing's actually going to happen tomorrow, and that I will have to come back for meetings next week. So I'm just going to listen to what everyone has to say, and go home and think about it, and then talk to more people on Monday. The nurse has said that she will be in there for a few days at least, so hopefully there is time to think.

stayathome- sadly she's not in sussex but worcestershire, but thank you anyway.

Amiga - thank you, that's reassuring to know.

give them your email address, its really helping me sort things at a distance, and having to be at work where I can't always take a phone call.

I'm back, she's in a dreadful state but I'm not really able to think about that too hard yet.

But the nurse in charge of her was lovely, and kind, and not at all judgemental, and said that I'd be amazed how many old people manage to look like they are coping for a long time even when they are not.

Amiga - thank you, will do that, although I am freelance so a bit more able to do things during the day.

It sounds really hard. So sorry. Try and take a bit of time out.

The hospital has a legal duty to arrange a SAFE discharge. They definitely cannot send her back to live in her home and they will know that. It will involve capacity assessment, probably referral to psychiatry, social work involvement and probably some kind of financial assessment. Does she own her home, how much does she have in savings. If it is her home she may need to sell it to move into residential care or sheltered accomodation. If it is council (but doesn t sound like it) they would have a duty to upgrade the home or re house your mum. If on the other hand she has capacity and absolutely refuses help it is a lot trickier. But they should try and work with her to allow improvements to her home/ re housing.
As for being judged: my Dad was a hoarder then developed dementia, people (friends of Dad, people from the church, his siblings) were on the phone to me all the time expecting me to sort everything out. I felt very pressured. My dad's sister was an alcoholic and i remember after she died (of alcohol related causes) her siblings' bile against my cousin, who they felt should have done more to help. God knows my cousin tried, but at the end of the day my aunt wasn t going to stop drinking. So I think families can expect a lot of the daughters of the vunerable older person, and be quite judgemental. You have to develop a thick skin, you know your relationship with your mother and did well to build your own life. Some people are not very well suited to being parents.

Thanks again, everyone.

Yes, Bob, she owns her own home (and has savings as well). So I think what I would like to happen, if she can be persuaded, is for her to go into some kind of respite care for a while to build herself up a bit. During which time we sell the house at auction and then - when it's easier to tell what she'll be able to cope with - find some other kind of accommodation for her, whether that is sheltered housing, or a home, or whatever.

The hospital social worker rang me yesterday, and - thanks for the warning - started talking about sending her back home with carers Because this is what my mother thinks is possible. I tried to explain, and she did then start talking about a 'discharge to assess' bed via social services, which I think is a good thing anyway, as my mother is currently too weak to look after herself under any circumstances.

I'm going back up again next week, when I'll get a locksmith to secure the house, cleaners in to remove the worst of the food and take photos of the chaos just to make sure they don't try to send her back. I'll also hopefully get to meet the social worker.