Advice about caring for MIL and family disagreements

[GinIsMySaviour]

Hello all

DH and I are in a bit of a quandary and I was hoping for some views from folk more experienced in caring for people with dementia than we are.

Quick background: MIL has dementia. She has lived in a lovely two bedroom flat in London for 40 yrs and can function pretty well. She has a lodger who helps out a bit making sure she has food etc and she couldn't live entirely on her own as she needs to be reminded about Drs appts and things like that.

DH visits every week or so and she is usually settled and cheerful. She also comes to see us and our DC every now and again.

She knows her way around the area and knows her flat inside out so feels very secure there. She knows all the local shops and cafes and some of the shopkeepers and cafe owners know her.

Friends drop in quite regularly and she goes to a church just across the road where there is a friendly congregation and she seems to really enjoy this.

DH's siblings visit once a month or so but don't live in London - although it's not a huge trip for either of them to see her.

As well as her lodger, friends and DH, she has a carer who comes in once a week - MIL really likes this woman and was very involved in choosing her.

We have recently had her assessed for additional NHS support and it looks like she will be eligible for some help getting to some support groups near her and some help with transport to and from the GP, dentist etc.

So here's the issue. DH's brother wants to move MIL firstly to live with DH's sister while MIL's flat is sold, and then to a three bed house nearer BIL. He believes it would be better for MIL to live somewhere where she could see more of BIL, SIL and their kids.

DH and I think MIL is better off in familiar surroundings for as long as possible. As and when MIL declines, we think we should get a live in carer until MIL needs to be in a care home - if we get that far.

What BIL is proposing involves two moves and will take MIL away from the people and places she has known for 40 yrs. BIL seems to think that being closer to him will outweigh this. He also doesn't really have a plan for her ongoing care. Presumably we will have to pay for a live in carer there as well only MIL will be living somewhere she doesn't know.

MIL has also consistently said she doesn't want to move as she feels safe and at home in her flat.

I am a bit out of my depth here as I genuinely don't know if being closer to some of her children and grandchildren is better than staying in her own flat. I know what I feel is right but I don't know enough about dementia to be sure. I am happy to be told I'm wrong btw!

Any and all advice gratefully received and thanks for reading my long post!

[AlexaAmbidextra]

Call me an old cynic but I’d be asking what’s in it for BIL.

[EthelHornsby]

If you move her from her familiar surroundings she will deteriorate very quickly - can you get someone to explain this to your BIL? This would be very cruel and counter-productive

[Buckingfrolicks]

My MIl is cared for 24 hrs a day in her own home. She has signs of dementia

Even live in carers have a mandatory 2 hour break each day. As MIL is not safe alone, my DH goes to see her every day for those 2 hours.

This is a huge burden that DH and his 2 DSs had not envisaged.

Just saying, as it seems to me your DH popping in for 30 mins a week longer term is possibly hugely insufficient

I think your BIL is acting in his own interests although he may very well be denying that to himself.

Good luck. It sucks.

[Unktious]

What an awful situation. I hope everything works out. Dementia and Alzheimer's are terrible things aren't they.

[Mrsramsayscat]

You're definitely right. When people with dementia are moved suddenly, they can deteriorate very quickly.

[mrsmalcolmreynolds]

Glad some sense seems to be prevailing. The one thing PPS have mentioned that I'd reiterate is to think very carefully about whether your MIL has capacity to make this decision herself. If she's managing ok with good support in her flat then it is entirely logical for her to want to stay there and she should be supported in that wish. An Attorney under an LPA doesn't have carte blanche to do what they want, they are required to get and properly consider the views of the donor - sounds like your BIL needs to be reminded of that.

All other things aside I think staying where she is if adequate and reliable support is in place is by far the best. My DM and I jointly decided last summer that she needed to move into assisted accommodation near to us from her home 150 miles away but that was due to distance, difficulty in getting reliable care and friends not really sticking by her. She started to feel very vulnerable where she was and that was a key factor in the decision.

[GinIsMySaviour]

Thank you all for your advice and comments - really helpful.

SIL is coming around to the idea of not selling the house and looking into proper care either in her own flat or at SIL's house. I find this quite encouraging especially as I think she finally realises that caring for someone with dementia is not just something you can do in your spare time and actually requires patience and dedication.

Thanks for all the points about on the legality of selling. I hope BIL comes to his senses!

[Needmoresleep]

And if he does go ahead (and there has to be a silver lining in him assuming responsibility, even though he may not be aware of what it entails) he should not be allowed to set the ownership up in a way that has him simply taking over the property, should your MiL need to go into a care home (which could happen surprisingly quickly after a move).

Google "deliberate deprivation of assets". The proceeds of her flat should be available to pay for her care. If they are not because they have effectively been gifted to your BiL in the form of a secure tenure or home equity, the Local Authority will probably take steps to recover the money. My understanding that POAs agreeing to this type of action might well be guilty of a criminal act. If he does insist on trying to push this forward, you might find allies in the Local Authority where she is supposed to be moving to. If you asked you might be able to get SS to consult their lawyers at an early stage and get a sense of their likely response should he go ahead.

It might also be worth looking at the legal bit of the Talking Point Forum run by the Alzheimers Society.

[SeaToSki]

I think some private conversations between your DH and his sister are called for regarding the brother’s intentions or irrationality and how to talk to him from the same song sheet and block him if it becomes necessary

[FinallyHere]

Good luck to you, and MiL, too.

Would it be an option for BiL to move into her existing flat, in the room formerly occupied by the lodger? If he really wants to become her carer?

[GummyGoddess]

It's good your SIL has started to realise her mum needs more care than she initially thought. Also good that it's shown your BIL to be unreasonable to both his siblings. Surely SIL must also be wondering if he's just after a house now?

Good luck to your husband (and you!).

[GinIsMySaviour]

Hello all sorry for radio silence. It's been a bit stressful!

Thank you so much for all of your advice, I really appreciate it.

A community nurse is coming to see MIL soon for a check up and we have asked if she would also express her opinion on MIL's mental capacity and, if she thinks MIL is able to, to talk about her thoughts on moving.

She said she's happy to do that so hopefully that's a good start.

DH is also going to contact the Court of Protection for advice and to understand how to block the sale of the property if needed.

The conversation with DH's siblings took an interesting turn today: SIL started to talk about having MIL live with her instead of in a strange new house and BIL lost it. Clearly a reaction to that option not buying him a house.

Awful situation.

Thanks so much for all your advice, poor MIL is bewildered by it all as she has always said she doesn't want to move ... and I feel we're a bit closer to being able to stick up for her on that.

[Fortysix]

Your DH's 'window' of opportunity to help your MIL is now.

If there are only three siblings and your DH's brother and sister side together to out vote him then you and your DH need to ac really quickly while MIL has adequate capacity to refute a move. The legislation is absolutely for people like her.

Thinking further ahead. Should your BIL get his wish and force the sale of her property and moves in, his life as full time carer is significantly going to change if by that stage she needs care 24/7. From what you've posted the reality of this might be something he hasn't taken into consideration.

[Needmoresleep]

Read through the Court of Protection website, then speak the the Office of Public Guardian.

It might be that you have to apply for Guardianship anyway, or rather to have him removed as Attorney.. It might be possible for you to do this yourself, perhaps with advice on forms from Age Concern or someone, and some form of assessment from SS, so you just pay the standard fee and no legal costs. And it might be that getting up to speed on options that would allow you to block your brother, might cause him to rethink. This might cause him to withdraw completely from supporting your MiL, but it can be easier to pick up a bigger burden than to use up emotional energy squabbling with unhelpful siblings.

Note the Land Registry have cracked down and POAs may find it difficult to sell her property without permission from the Court of Protection. In a straightforward case it would simply be the conveyancing solicitor filling in a standard form. But in this case your brother will need active agreement from the other Attorneys.

I also agree with other posters. When DM was hospitalised with a UTI last year, I arranged 24 hour care at her home so she could be discharged as soon as possible. Even a week in hospital might have caused her to lose her orientation/independence. As it was she recovered quickly at home with antibiotics. By the third night she was demanding that the carer paid rent.

[Fortysix]

Yes, I'm pretty sure you can challenge. I'd get in touch with a duty case worker at the Office of Public Guardian and ask for advice. Or else maybe an Advocacy Officer at her local Council?

Not got first hand experience of 'challenges' however there was scope for a dis-agreeing family member to have their say at various points in the process.

[BreakfastAtSquiffanys]

Your SIL might think it's a good idea to move embassy her now before MIL declines further, but in many cases by the time dementia is apparent, Thr "right time" to move them has passed.

My mother was coping in her care home environment albeit with a poor short term memory. Older memories were strong and reliable.
She came to stay with me for 2 weeks, and her cognition went to pot. Asked me if this place was MY care home. Asked where my (long dead) father was. Asked how long I'd lived here in France (I live in Essex)
She returned to her care home in her home town where the above level of confusion took another 2 years to reappear.

[junebirthdaygirl]

My friends dm has dementia. She managed in her own home. Unfortunately due to illness she ended uo in hospital. The decline was remarkable immeudiately. It was like she lost 10 years in one swoop. She never returned to the way she was at home. She had to go to a care home.
But l think she needs more support at home. Possibly someone coming in everyday especially if yhe lidger is at work. Maybe get her apartment checked out for hidden dangers eg is she turning on a cooker she make forget to turn off.
Quite definitely she must remain where she is. One move and she will be in a nursing home within a week. You will only notice how bad she is when she moves out of her own environment.
The vultures are circling l fear.

[MixedHerbs]

I'd arrange a meeting with the social workers and all the siblings present. I feel quite sure that the SW advice will reflect what you are reading above. Your BIL may feel differently hearing it from a professional, the fact that it might not be as slight forward as he thinks (ie there will be opposition) may make him think again, and someone could also 'accidentally' bring up whether it's time for some a court of Protection involvement. If he has any less than honourable intentions, it may make him think twice.
We have a similar situation with DH's very old aunt who is 350 miles away (and has no DC) but we are all of the same mind that we won't move her even if we end up pawning her telly to keep her comfortable! (And we probably will at this rate!)

[kalinkafoxtrot45]

The last thing you want to do for someone with dementia is move them away from familar surroundings before it becomes truly necessary. I think BILs motives are highly suspicious.

[CPtart]

She'd be better staying where she is and stepping up care as needed which she pays for. You shouldn't be paying anything

[AnnaMagnani]

Great, so his motivation is that he is going to be homeless, he can use MIL's money to live in a 3 bed she doesn't need and then benefits to claim to be her carer instead of working - and presumably not pay maintenance to his ex.

What a shit.

As above, if she has capacity still is doesn't matter that they have PoA - she makes the decision.

If she doesn't, they all have to agree but they have to agree in her Best Interests and taking into account what she would decide. Not just go ahead with what they want.

[GinIsMySaviour]

Gummy, great idea about writing her wishes down, yes I think she could do that relatively easily and maybe a video too to show she has an awareness of what she's talking about and not being coerced

I really never thought we'd be gathering evidence like this

[GinIsMySaviour]

Thank you so much for all your replies, it's really reassuring to know that our instincts weren't completely off.

It's all gone a bit stressful tonight though with a big row between DH and siblings. SIL doesn't really understand much about dementia and thinks it is easier and kinder to move MIL now than to wait until she has declined further ... which I think, given what you have said isn't the case.

BIL has just kicked off saying DH doesn't do enough, care enough or know enough to have an opinion

He's basically going to try to railroad this all through against DH's wishes.

Poor MIL, I have to admit, I was never her greatest fan before she got ill but even though we weren't best mates, I think she deserves more respect and support.

Interestingly, BIL's latest rant mentions that he will have a lot more time to spend with her as his wife has kicked him out of their home ... so I guess that could be a reason why he wants a three bed house nearby. Not sure how he's going to earn any money while doing all this caring though.

This is just miserable, poor DH, poor MIL.

Does anyone know if it's possible to block BIL forcibly moving MIL against her wishes? All siblings have joint and several powers of attourny which suggests that they don't all need to be in agreement but I think we can challenge via the office of the public guardian?

Wow, this is not something I had foreseen.

FFS it doesnt take much to bring out the worst in some people...

Thanks for all your comments and support, sorry to have dropped off the radar this evening, I was helping DH deal with sibling awfulness...

[GummyGoddess]

Do you think that she still has the capacity to grant your DH Power of Attorney? You both clearly care a great deal and are closest to her, it would make things easier in the long run for you to get additional help for her when she really needs it.

Is it possible to at least get her wishes down in writing or on video now while she is mostly herself if she doesn't want to or can't grant PoA?

If she was not coping well with the last holiday, perhaps she shouldn't go on any more of them. She could always have some lovely days out in London with family in lieu of holidays.

[LanaorAna2]

moving dementia patients from familiar surroundings often brings on a rapid decline.

This. Oh, and why does BIL want her to buy a 3-bedroom house near him all of a sudden? Does one of his DCs want a free house?