Stubborn mother. Sibling denial.

[PandorasBag]

Can anyone offer advice.

My mother is 92. She lives in an owner occupied flat in a block for the elderly. She is comfortably off.

She has always been frugal and resistant to change and this is more marked now that she's older. Her mobility and balance are now very poor due to a) arthritis and b) curvature of the spine which has become very pronounced.

She does now walk with a stick when leaving the flat. However she'd really benefit from something like a Rollator, but has refused to get one despite being taken to a shop selling mobility aids. She also struggles to get out of the very low armchairs which she won't change. Last time I visited I had to help her up, because she simply couldn't rise after having fallen asleep. (I had arranged for a high backed chair with proper arm rests to be delivered, but she had this sent away.) I think she now needs a proper riser recliner chair. I think she may also have difficulty getting in and out of the bath. (She'd placed a plastic garden chair at the bathside.) I am sure that a walk in bath would help. She's definitely at risk of falling. Carrying shopping and cooking are also huge problem, but she refuses to consider eating in the communal dining room where lunches are served. She also won't pay a relatively modest service charge which would mean staff in the building would shop for her. She says she can't possibly order enough food to qualify for free online delivery.

My brother lives nearby and offers a bit of help. But in her view my mother is doing absolutely fine. He likes to feel that he is in charge and regards me as somebody who is a trouble-maker. We both - along with my younger brother - have Power of Attorney and can act individually though it is my mother's preference that we act jointly.

I know that if I try to invoke the PoA to get changes made both my older brother and mother will give me hell and make out that I am being completely unreasonable. But is it my duty to try?

You can only invoke p.o.a. for health and welfare once she loses mental capacity, if she is able to make her own decisions then you cannot force her to do anything. Is There a warden at the property or a nurse from the surgery who could pop in and see her. It sounds like she is very independent but also at risk, are there call bells at the flat. She could benefit from seeing a community occupational therapist or physiotherapist who could assess her mobility and arrange a rolator, riser chair, something to help her get in and out of bed and the bath. You can apply for a grant from the gov.uk site to have adaptations made like a walk in shower, it's very difficult isn't it, would she respond favourably if you just said you were worried about her falling and hurting herself. With the online shopping, could you add it to yours or your brothers for the heavy stuff and maybe she goes shopping because she just likes to go out and do things for herself. You have to be a bit bossy sometimes, refuse to help her get up, you could injure yourself or her.

The Public Guardian guide on capacity says "You can’t decide a person lacks mental capacity because you think they’ve made a bad or strange decision.". Elsewhere in the guidance around PoAs it says that the capacity to make a decision includes the capacity to make a bad condition.

As someone else posted here a few days ago "The control to make the situation much worse may be preferable to lack of control"

So, no, while your mother has capacity, you don't have a duty to force things upon her even if you believe it would make her life a lot easier if you did.

All you can do is suggest things to her, and don't protect her too much from the consequences of her decisions. For example, if you don't do her shopping for her, she may realise she has to try another solution.

Thanks for the replies. I think in the only other situation that I knew about the elderly person had moderate to severe dementia - and in any case it was possible to get their consent to decision.

Does she wear an alarm she can press if she gets into difficulties?

There are alarm cords in the flat, but she doesn't have a personal alarm.

It seems the way forward is to talk to both my brothers. If we can all broadly agree and try and get her to make a few changes, we may be able to do a little good... I also have a lovely and very sensible sister-in law - more sensible than my big brother who I think is in denial mode.

good luck with it all, it might also be worth talking to the warden if there is one just so they know you feel she could be at risk and also social services, at least that would put her in the system.

Yes, good idea. There's a manager at the place where she lives and yes, I'd wondered about a health and social assessment.

I wouldn't be too quick to install a walk in bath - my uncle had one and hated it as he had to lie waiting for the water to drain out before he could get out. A plastic chair in the bathroom sounds like a fair solution actually.

You don't have to make people do things. Having taken action about my mother's situation and made her very unhappy, my honest view would now be just to sit on your hands and wait for a crisis. But many people who did that wish they hadn't. There isn't really a happy solution i'm afraid.

For me the problem is that my mother's solutions are cheap, flimsy and ineffective. The chair is like this - and if she grabs at it because she's slipping it won't give any support. (Her balance is shocking.) Similarly she's put cushions like these in two rounded low easy chairs - which don't fit - and also means it's even less effective for her to push against the (low) arm rests. She has to bathe daily with emollient for a skin condition, so something to make this easier seems important.

There is also a lot of money available to pay for improvements and adaptations - but she won't spend it!

My father in law - though resistant to change - always ended up accepting an increased degree of support. My mother is a different kettle of fish!

No Co-op alas. The nearby supermarkets require £60 and £40 online orders respectively for free delivery.

It is vaguely comforting to know others are having the same struggles.

I was just rather shocked on my recent visit by how far she was ageing. The reluctance to accept change - though frustrating - was less serious when she could walk (and balance) rather better.

Nearest Iceland is some miles off.

I think one problem is that my mother's balance is so poor that she can't really carry more than a few items herself. (She refused the Rollator and with the stick she has only one free hand.)

I might try a word with the manager of her accommodation. I think her friends are also very elderly with their own struggles. Somebody trusted - with a bit of authority - might do.

This is going to sound harsh but you need to step back and stop trying to 'help'. It sounds as though your DM has the capacity to make decisions and you have to let her do that even if some of them are in your opinion poor choices.

I say this as I am going through similar with my own mother. It is very difficult.

And when she falls - as she will - and her bones take a long time to heal?

Then you are expected to have nothing but sympathy, and rush around sorting everything out, of course.

💐 For you

@PandorasBag yes sadly even then. DM has fallen several times in the last 12 months resulting in a broken hip and arm. I've had several meetings with Adult Services and the medical profession, the answer from them is that she still has capacity and can make her own decisions about her health and wellbeing. My DM has Alzheimer's but still has capacity.

It's truly awful and I ended up making myself unwell through the stress. I'm so sorry you are going through this

Thanks, Windgate. It really isn't that bad yet - it's just that having seen my father in law decline, I have a pretty good idea what's coming.

Actually in retrospect it's not been too bad with my father in law, because my husband and his brother worked as a team in collaboration with GP, warden etc - and my father in law would always end up accepting carers etc after ritual protests. Also he has dementia and it was clear that he didn't have capacity.

I'd say my mother's thinking is impaired - but that's more personality enhanced by ageing. But she would be judged to have capacity.

Speak to the GP and ask for an Occupational Therapy referral. They will come and look at how she is managing everyday living and suggest changes/adaptions to help her live a bit more comfortably (i.e. raisers for her chair, a bath board, lever for her bed,, etc.). They also show people how to do tasks differently but safely (i.e. getting in and out of the bath).

The OT will be able to order equipment so you won't have to worry about her coping with sub-standard equipment.

You'll have to get her permission for an OT visit - I haven't managed to get this from my DF yet.

There are lots of "bath steps" available, from small steps so that the step over the edge of the bath isn't so high, to slightly higher steps, and even steps with a handrail. Once she's in the bath, would a bath seat help as she lowers herself? - start on seat then lower herself to floor of bath? - depends on her arm strength.

Make sure she knows what's possible, so she's making an "informed" decision however misguided.

Maybe the home manager can discuss safety issues with her, an o.t. may be able to get her some aids for free if spending money is a but of an issue with her.

Ask her GP to get the community OT out to see your Mum.

All the ideas re bath stuff are very good. I think knowing what's possible/available out there helps - even if my mother digs her heels in.

Any chance that a friendly district nurse might call in and advise her to improve things. Someone in a uniform is listened to when the family's advice is not wanted no matter how sensible.
Oh, I see someone has suggested an OT. That could work too.
But she has the right to do what she likes even if it is a bad idea.

She's also got the right to refuse to see an OT. And certainly in our region they won't send them out on a relative's say-so when the person has capacity and hasn't agreed to seeing one.