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.

There's no judgement about these things. I think hcp's see so many 'challenging' elderly patients that it's understandable how things have got to bad levels.

Although I will say that although it is our legal duty to arrange a safe discharge, it sometimes is 'as safe a discharge as possible'. If a patient has capacity (and being a hoarder and having depression does not necessarily equate to not having capacity) then the hospital cannot override her. I've been in a few situations where I really didn't want to discharge a patient home as it patently was a bad plan, but the patient wanted to go home so there was nothing we could do.

Taking lots of photos is a excellent idea. I work on a ward and a few weeks ago a nephew came in with pictures on his iPhone of the old boys home. Lots of junk ( but still short of channel 5 documentary territory). The patient had maintained he was fine to go home and didn t need any help. The pictures precitated a home visit by OTs an d referral to social services and a care package.

Thank you for both of these.

I haven't put all the details of her house on here, in part I think because I am ashamed of the state it is in, but just one part of it the kitchen is flooded unusable and with electric heaters standing on newspapers in the floods. There is no proper back door. I think it is at the extreme end of Channel 5 documentary territory.

The policeman has put a flag on the file saying that under no circumstances should she return, and I am really hoping that this will count for something.

I suspect the house is uninhabitable by anyone, never mind an elderly lady, whatever she might say. But I am also hoping that they don't do anything before I can get up there again. I may have to go up earlier if they do.

Oh, and has anyone had any dealings with the Police Vulnerable Adults team? Apparently she has also been referred to them, and I have no idea what this entails, whether they actually do something or whether this is just another way of referring to social services? Or am I able to use them as a way of preventing her returning to utter squalor?

Usually the police vulnerable adults people are only involved if there is suspicion of abuse / crime against them / neglect, but there is something In the info about them re risk to person or local community, but I'm no expert, (just read a document about the work they do) so hopefully someone who knows more will comment.
Must be hard for you and you have my sympathies. If you do go into the house, be very careful as sounds like it may be structurally unsafe if officer went through a floor board. Might be best not to go alone for your safety and in case of accidents

You are right it really sounds totally uninhabitable and a real hazard to anyone entering it. I would have thought that the police statement would carry a lot of weight and you could use this with good effect to make sure she does not go back to her home. They will know that God forbid, if your mother went back there and came to grief, you could sue them and they wouldn t have a case if they'd gone against police advice.
I know what it's like to not want to mention everything, my father has alzheimers with "challenging behaviour" and for the sake of his dignity I haven't mentioned all the stuff he's done on the elderly parents board.

Thanks for that, I really hope that's the case.

But the capacity thing is really difficult. I think my mother is, in general, entirely capable. With the exception of the fact that she thinks it will be OK to go back to the house. I was talking to a friend today and she said, it's like anorexia, and that's exactly it, she just has this one massive blind spot about what is actually happening, even though she can still do the Telegraph crossword every day.

This is sort of what I was referring to in my earlier post.

There is something whereby a property can be declared unfit for human habitation, but this seems only to apply to rented property. I dont know what happens with homes that are owned, though think there is some scope for council intervention if things are awful.

(I too watch too many C5 documentaries. Indeed one of my secret desires is to change the channel on my mums TV. She can only turn it on and off, and believes she is watching SKY (because she can afford it, and for a very long time we could not so it was one-up-man-ship) but in fact watches BBC1. I like to wonder if she would notice if instead she spent her life watching C5.)

Anyway back to topic. Many Councils have someone responsible for Private Housing within the housing department, though the job and title might be more focussed on private rentals. If you can find the right person. probably via the switchboard, and if you can email photos, they may have ideas of what can be done to prevent her returning on the basis that no one, whether vulnerable or not, should be living there. This in turn will force the hand of both social services and the hospital and, in effect, your mother. Shelter may also have some advice.

I appreciate your mother has some serious alcohol/MH isses and has withdrawn, but once my mother gave up the fight to remain independent she has been so much better physically and mentally. In lucid moments she will confess how grim it was on her own with no working oven, heating and more. A good cooked lunch, helpful people at reception, a handyman, and indeed film night on Wednesdays, has reallyhelped her well-being. .

Most of us have not been able to do anything till there was a crisis. You now have your crisis, which is a chance to make sure she gets the helpn she needs whether she wants it or not. Getting the house effectively condemned is a bit nuclear, but perhaps that is what you need.

(FWIW from what you have said, the house is an auction job anyway and needs complete gutting, so you should not be reducing the value.)

Similar...vulnerable mother unable to look after herself due to copd and dementia..sent to hospital in crisis...social workers initially wanted to send home. I kept resisting citing 'unsafe discharge'...they are the magic words to get the care needed. Now my mum going into residential care, you just have to insist and insist, otherwise you're back to square one, which infuriatingly, costs more hours and resources than it ever needs to.

And my mum is deemed to have capacity, but after a spell of being looked after, she realised despite her dementia, life is better in care than struggling at home.

Thank you both, it all really helps.

I think you are both completely right too, and that she will be much happier in a smaller, safer place with her meals being cooked for her. But it will be a fight to get there.

needmoresleep - yes, I had been wondering about doing up the house (have done major renovation job here) but I think it is too far gone and not in a nice enough area, as it has gone downhill quite a bit since she moved there thirty years ago. But auction is the only real way, I think, especially as we just need things to move on. If she agrees of course. And yes, shelter is a good call and I will speak to them tomorrow.

serengelly - copd here too, combined with a fungal lung infection which means that she can hardly walk. So a tiny three story house with twisting stairs wouldn't be a good idea, even if it was structurally sound. And thank you for the right words, that's really useful.

If she's initially reluctant then I'd push for a rehab/respite bed. I've found that most will accept a measure which is initially sold as just temporary "to help them get back on their feet". Once there they can see how much better their lives can be so are more willing to go somewhere else permanently.

Just to say someone I work with has an in law who is a super hoarder, the council finally took action because he was at huge risk to himself mostly from fire due to vast amounts of newspapers in his home. Also the home was becoming structurally unsafe and has had to be secured structurally, sounds like it was bursting at the seams. The neighbours were in despair. I won t be able to get all details as I'm not that close to the colleague in question, but i am sure she said he is a home owner. The council temporarily re housed him in respite accomodation (where he continues to live as a hoarder, sleeping not on the bed but on a chair).

Well the good news is that I spoke to the social worker today, and they are going to recommend that she gets a respite bed in a home for six weeks, which gives us a bit of breathing time. I am going to sell this to her as convalescence, so I think she will go along with this. Then we can see how she feels about everything else.

I'm going up again on Wednesday, and will have to go into the house to photograph it, which I am dreading. My brother is coming too, though, so at least I don't have to do it on my own.

Interestingly, there doesn't seem to be any kind of mechanism for getting a privately owned house labelled unfit for human habitation, although I did find a checklist and it fails, mainly through not having a functioning kitchen.

But I'm finding it really hard to get my brain to stay still - there is so much to think about and consider for the future but very little i can actually do right now.

Glad to hear that you have a respite. It is hard to stop thinking-write everything down and put it to one side. And treat yourself- this is a long haul. To you.

tender just read through this thread today - sending you strength to deal with all this. twentyten is right - write stuff down, make lists of things you think about, to try and stop it whirling round in your head. Keep posting your thoughts and worries here, I've found it really helpful to vent / document things (rather a lot recently) as it helps to make sense of whatever's happening.

Really pleased to hear SS are recommending respite - hopefully this should provide you & your family time to discuss things, talk issues through. And perhaps with a comfortable, clean, safe place to stay, your DM may start to see things more clearly, that living where she was is simply no longer sensible or practical.

Well I went up yesterday. The house was about as bad as I thought, although the lovely cleaners (recommended by the hospital social worker) assured me that they see far worse on a regular basis. They've taken all the food out, and cleared about 20 bags of junk paper and stuff, so it's kind of safe to leave for the moment. And I met four people who asked after her, including two neighbours who are now keeping an eye on the house and have my contact details. Weird thing is, though, that the rest of the house is a slum, but the sitting room is pristine, like a normal room.

My mother herself, though, is not good. She's hardly improved at all despite five days in hospital and is very frail and still on oxygen. She has COPD and the outlook isn't very good at all in the long term. But I can't quite write about that just yet, and they are still not entirely sure what is going on.

But she's still talking about driving again (I have taken her car keys, the car is covered in dents and scratches) and going back to the house. I wasn't going to have a conversation with her about selling it, but a rather blunt hospital social worker came in and started talking about discharge plans (when my poor mother can barely stand up to put her own pants on) so we ended up having that conversation anyway. She is persuaded for now that she will go in to somewhere to convalesce and then we will find her a sheltered flat. But to be honest, I can't see her looking after herself anywhere.

Other things: she's not eating and the hospital food is vile, but she will hardly even eat the treats I am bringing her. Oh, and the social worker asked to see the photos I had taken of the house in front of my mother, which I thought was pretty poor.

So I'm here for the long haul, i think.

So sorry Tender.It must be really difficult. cant advise but sending support.

We have been through similar last year with my husbands parents (who live 300 miles away from us). Mil has severe Parkinsons and extreme dementia and Fil (who cared for her) had strokes, extremely damaged feet, ropy eyesight and dementia (to the point where he became incapable of cooking, fell over every day, blood everywhere, medicine completely mixed up, not washing or changing clothes, eating mouldy food...etc) Both of them stubbornly refused to leave their home.

So after a severe fall and hospitalisation we suggested that they go for a 'respite holiday' at a care home. They are still there a year later, being properly cared for and with some company & visits out to local sights. Now we are in the process of selling their house as they have finally said that they don't want to go back!

How about dressing up the idea as a holiday?

We also took away the car keys after Fil had over 20 accidents which were 'never' his fault! Wise idea to do that.

Thank you. Yes, I think that's what will happen for us though, but it's a bit early to tell.