Elderly parents and grandparents

[OogieMcBoogie]

Hi. After some advice please, not sure where else to turn. My mother, who is 68 and disabled, is a carer to my 89 year old grandmother. My grandmother is a very difficult woman to care for, she refuses help from anyone but my mother, who is struggling not only with her physical disabilities but now her mental health. Yesterday my gran got the diagnosis of mixed dementia, which has just sent my mum spiralling downwards, she’s so frustrated and worried about who will care for her. For context, my gran is housebound (no physical reason, she seems to have given up) refuses carers, cleaners, any help at all, but expects my mum to wash, cook, clean, shop and be there all day to entertain her. Its becoming unbearable and I hate seeing my mum under so much pressure. I help where I can but my gran actively dislikes me and refuses to let me clean up, for example. She has refused respite and sends nurses and hospital carers away telling them she’s fine. She’s far from able to care for herself anymore but will not allow anyone but my mother to do it. She has four sons who she adores and wouldn’t dream of asking them for anything, but her daughter is and always has been seen as a servant.
Does anyone have any advice as to what we can do to relieve some of the immense pressure from my mum? She feels an obligation to help as otherwise my gran suffers.

She needs to try and say no more, can she speak to her brothers. If this is affecting your mum so badly it's just not fair
Who diagnosed her dementia, if it was a doctor you could tell them your concerns and ask if gran has had a capacity assessment. You and your mum can call a dementia association for advice and support and also grans adult social services safeguarding team, say gran is vulnerable, refusing help and that mum cannot help at the moment. Does anyone have power of attorney.

It’s down to your mum to flag when ‘enough is enough’. Only she has the power to put a halt to this. Your grandmother has taken advantage of her good will; now she has dementia your mother and her family are the only ones who can call ‘time’ on this situation. As a family she and her brothers can then together investigate and plan what to do what is best for all for her future care. The power of decision-making needs to be taken away from Grandmother.

Thanks Wiggly, mum has power of attorney. I think it’s making things worse as gran is accusing her of taking money (she really isn’t) when drawing it out for my gran. She’s always given receipts and bank statements but gran takes no notice of these and to be fair often forgets she’s asked for cash in the first place.

Gran had tests at the hospital for dementia, I gather someone is coming to speak with my mother next week so I’m planning to be there to explain that mum cannot cope. In all honesty though if gran is refusing help, saying she’s fine and my mum will do it, what can we really do? She won’t go into a care home, respite or even out for a coffee with carers. We can’t force her into anything but this has my mum (and me) on our knees.

Slugslasher I agree, this needs to be something mum simply refuses to work with on genuine health grounds, but she isn’t strong enough to say stop. My uncles have little contact with my gran and are also of the opinion that this is my mum’s problem. I honestly think mum has to simply refuse to help... it’s getting her to see that gran will have to accept help from others that I’m struggling with.

If she is found to lack capacity and your mum has health power of attorney you might be able to force her to have care or move, if she has capacity then all you can do is tell social services and the doctor that mum cannot cope and wait for the inevitable fall or self neglect. Sometimes you just have to e tough, your mum is entitled to a quiet life, I would also speak to your uncles, they need to be helping out.

"I honestly think mum has to simply refuse to help."

yes. Even to the point where the first time, it's a lie. So she could phone and say she flat out unwell and cannot come, is sending a carer and if carer is turned away, then mum still can't come and help.

I am horrified at this situation. Is it anything Adult Social Services can help with? Or would you gran listen if a doctor said to her that she was massively endangering the health of her daughter?

"For context, my gran is housebound (no physical reason, she seems to have given up) refuses carers, cleaners, any help at all, but expects my mum to wash, cook, clean, shop and be there all day to entertain her."

actually something else occurs to me here - you say there's no physical reason, so what would actually happen if your gran was left to herself? It sounds like there wouldn't even be any danger.

Does your mum stay overnight in her own home?

Sometimes we have to take responsibility and seek the help they don't want. The court of protection can declare that your grandmother is no longer able to make her own decisions and adult social services can assess her her assistance, possibly continuing care too but she probably doesn't meet the threshold yet. As hard as it is to override a loved ones wishes, if your mum can't cope she needs to put herself first. We had to do this (we had power of attorney thankfully) and it's hard but necessary

I recently assessed a situation in hospital where a demanding older lady was insisting that her daughter be with her from 7 am to 6 pm and assist with everything from helping legs out of bed, assisting off toilet and chair,meals etc etc. Daughter had not had a holiday for several years and was desperate. I asked the question what happens from 6 pm to 7 am and was told that she manages on her own. Gets to and from toilet every few hours, makes a cuppa if thirsty. Daughter was too exhausted to have worked out that if her mother can get from her bed to toilet and back several times at night, she does not need constant supervision all day. I told the daughter that she HAS TO SAY NO and then others can help if the mother accepts that. In your scenario OP, your mum needs to explain that she is not coping and needs to consider her own help. Hopefully post recent assessment and diagnosis some advice will be forthcoming via dementia services. See if you have a local Carer Support organisation who will help your mother specifically. If she stops doing all she is and your gran is at risk and refuses carers, if she is assessed as lacking capacity a decision will have to be made in her best interests about what then needs to happen for her safety. It is very very hard for families and in my experience as a health care professional in this area, the hardest thing is getting family to say they cannot do it any more.

Consider her own health not help!

Sadly unless your DM steps back and lets a crisis develop nothing will change, except your GM becoming increasingly frail and demanding.
It's difficult, but your DM is living her life as a result of the choices she makes. And she does have a choice. Your uncles are choosing not to be carers. I would make that choice too. Your DM has to be strong enough or nothing will change. People live many years with dementia, often outliving the carer!

This isn't uncommon. We see a lot of it on MN. The answer has to be that your DM goes sick and refuses to do it any more. Otherwise she really will be ill! Then it'll be down to the OP.

Your mum might find some helpful info on the carers UK site

Thank you all. You’ve been amazingly helpful, it’s kind of a relief to know other people have experienced similar and proves that gran is not to simply be obeyed and indulged to the detriment of everyone around her. I’m going to show mum this thread. Sadly my gran has no interest in my mother’s health or needs so it’s got to be up to mum to sort this out. I will speak to Adult Social Services (hadn’t even realised this existed) to see if we can get a capacity assessment.

OP the main reason I mentioned Adult Social Services is that I was thinking, if they think your mother is too fragile to care for her mother, that might help your grandmother see sense.

but from what you've said it might not be a case of her seeing sense, but more just being forced to accept things.

I should say, I am not in anything like your position. But I spent a long time - still do! - being anxious about the parental situation because I wanted to avoid a crisis for myself - the drama, the unpleasantness, time off work etc etc.

It took me a while to understand that daily involvement doesn't necessarily mean crisis avoidance anyway.

We’ve just gone through exactly this but with two ageing parents and a daughter insisting on doing it all herself. We had to draw our own lines in the sand and watch sister eventually fail under the sheer strain of it all. Your mother needs to toughen up and find her own limits. It’s not all about Granny is it?

When you speak to s.s. tell them that your mum is also vulnerable and at risk of failing mental and physical health, she may be more at risk than granny.

I think your mother should clearly tell everyone that her own health is suffering and she can't continue any longer.

This must be true - if she is caring for your grandmother all the time, when does she have time to do anything that she needs in order to maintain her own health?

She can tell her brothers that her health is failing and they need to help their mother to accept alternative care. I have recently been in a similar situation and family did step up and explain to our elderly parent that I was not robust enough to continue.

It has to be the same to Social Services etc. Make it clear that your mother is at her absolute limit and is not coping.

Then your mother needs to take a period of rest away from grandmother so that she has a chance to recover and allow grandmother to adjust to working with others. She will have to be strong and keep away - otherwise grandmother will refuse other help. If she doesn't have a period of rest to recover now, she is going to end up seriously ill herself.

The new diagnosis of dementia changes things albeit if she is early dementia may still be seen as having capacity to make decisions. Good luck my Mom is caring for my Dad and getting them to accept help is damn near impossible

Your mother can ask for an assessment of needs as a carer. Perhaps the combination of having her needs assessed and having a professional person tell her she can't carry on as she is might persuade her to start saying "no".

Make sure your grandmother doesn’t deceive them. FIL answered ‘yes’ to can he wash himself, make a meal, wash his clothes. We had to show adult social services that he couldn’t. For example, we put a piece of toilet paper in the bath. Although he said he had a bath every night, it was still dry a month later. Horrible having to do it, and he possibly thought he was having a bath, but it had to be done, as he was convincing.

Other tips: get grandmother assessed for attendance allowance (not means tested). Tell carers to say they are popping in for a chat/ bringing a meal/ been asked to do a spot of gardening as your mum can’t manage it. The first few times maybe they just chat and gain her trust. Do not say they are costing anything.
Make sure you have both the health and the wealth power of attorneys before it’s too late.
Get a key safe drilled into the wall in case of emergencies and put a front door and back door key in it. Don’t tell grandmother if you don’t have to. Make sure you have next door neighbours numbers.
Because of the age of your grandmother you hopefully shouldn’t have such an uphill battle as we did.
You can get: fire brigade, occupational health, mental health, befrienders involved via adult social services.

Thanks again all, your help has made me feel as though there is light at the end of this tunnel.

Also, if she has a diagnosis of dementia and she lives on her own, she should be exempt from council tax. Our council were surprised as no one have ever claimed this let alone a rebate but we got it back dated to the month FIL was diagnosed.