How can I care for my mother?

[difficultmother]

Have namechanged.

My mother is in her 80s and lives alone about 25 mins away from me. She is widowed and has been for many years. She has a narcissistic personality and we've always had a rocky relationship. Unfortunately I no longer feel we have any relationship to speak of at all but I am the only sibling in this country and I just need some practical ideas to care for her.

She hasn't been registered with a GP for many years although she may be now. She is very unhappy/depressed, her self care is very poor, she smells very strongly of urine. I haven't been inside her house for many years (because she doesn't let anyone in), I suspect the condition of her house is probably very bad. She is quite isolated, doesn't know the neighbours and has very few friends (she doesn't like or trust many people).

I have tried social services twice over the past 10 year or so, they tried to visit her, she wouldn't let them in and they said without her consenting to help there was nothing they could do.

I have suggested meals on wheels to my mother (which I would pay for) but she flatly refused saying the food was 'rubbish'. I have no idea what she is eating, I have suggested that I shop for her and leave it outside but that was refused too.

Does anyone have any ideas? I do phone sometimes but she often doesn't answer or leaves it off the hook. When we do speak, she is cold to me, says how awful/selfish I am and goes on about all her past hurts.

As much as our relationship is pretty much over, I don't like the idea of her being alone and at risk of being taken ill or falling and no-one knowing.

Sorry I don't know what to advise you but thought I'd bump your post.

It sounds to me as if all you can do is continue your telephone contact just so you'll know if there's anything seriously wrong.

Goodness, what a difficult situation to be in. It sounds as if she's in a downward spiral of depression, loneliness, lack of self-care, leading to more of the same. Once you're there it must be difficult to admit you need help if you've always 'managed' to a greater or lesser extent for a long time.

I think I'd write her a letter, explaining your concerns and saying that although you've had a difficult relationship in the past, that you'd like to offer her some help now. She will probably be concerned for her own welfare, but too proud or ashamed to admit she needs some help. Tell her you'd be happy to deliver shopping to her door and that she doesn't have to let you in, or even see you if she doesn't want to.

Sadly I don't think this is very uncommon, but all you can do is offer her some assistance. If she chooses not to accept, you'll have to leave it for the time being.

Thank you. I have now found out where she is registered. I phoned a surgery where I thought she might be this morning with the excuse of making an appointment, she is definitely registered. Now I have an appointment for next Monday, I could cancel it now I know she's registered, but I'm wondering whether to just go along myself and talk to the GP?

The GP wont walk to you about your mother, but obviously can listen. I would be tempted to write expressing your concerns and asking if they could see your mother to look at possible depression/dementia. You should also say you have not had any traction with Social Services so it would be useful if the GP could also flag up concerns. Give your number and say you are happy to speak. They may phone you. My mother's did.

I would also talk to your siblings. I dont know if any are favoured, or if there is anyone else (friend, neighbour, priest) that she does listen to. Then work together, ideally with POA forms completed and encourage her to sign.

Honestly you can't do much unless:

1. She lets you, or
2. If she has granted you POA, or
3. Authorities find that she does not have capacity.

If none of these, then you offer her help, and then sit back and conserve as much emotional energy for the inevitable crisis.

I would also write quite formally to SS. The sort of letter that suggests that if things go pear shaped there will be questions about why they did not do more.

And obviously in the previous post is is "talk" not "walk".

Can't talk to sibling, she has poor health herself and a number of other issues.

There's no way in the world she would sign POA forms.

If I do and see her GP and discuss my concerns, can they contact SS on my behalf?

The GP could go and try to assess her and/ or refer her to mental health services (who I work for)

We don't have a magic wand but I am often amazed how a good, persistent community nurse can eventually get someone's trust and start to get things cleaned up and some services in.

Mental health or the community matron will do a lot better than social services who just take no for an answer.

Have you tried Age UK?

The phrase that you want - and that cola frosties used up thread - is vulnerable adult, which has significance for social services etc, and are words that will make them sit up and take notice. Use this to both the doctor and social services, and keep using it until they act.

We found ourselves in a very similar situation, although we had no idea how bad it was until my mother was taken into hospital (she was looking after herself better but the house itself was awful beyond words). And vulnerable adult was the key word that stopped them sending her straight back to the house.

And I do know how difficult it is to feel that you should be doing something when you can't and you're not allowed to, and everyone else thinks that you are a bad child for not sorting it out. I felt appalling about it, and still do even after her death.

But as everyone else has said, you also might not be able to make things happen if she is really obstructive. In which case you have to just make the efforts you can, when she lets you, and be ready, as needmoresleep says, for when the crisis comes.

Does she have capacity in making decisions about her personal care? Does she think that she is self neglecting? These will be crucial questions when engaging with services. If she does have capacity then under the mental health act she is allowed to make unwise decisions about how she lives. However under the new care act you can raise the issue of self neglect with safeguarding adults.

If you think she may be lacking capacity to make this decision then more support can be given but capacity has to be assumed until proved otherwise.