What can you do when one parent isn't acting in the best interests of the other?

[MissisBoote]

Mil is being medicated for Alzheimer's. No diagnosis as of yet. Has had a MRI to rule out a certain type of dementia. Hasn't been seen by a health professional since January last year.

A new appointment has come through to see a doctor at the memory clinic as the current medication isn't very effective as she's deteriorated over the last few months. I had to chase up the results of the MRI and this triggered the new appointment as something had got lost in the system.

Mil is aware that something is wrong with her and can get quite upset as she doesn't know why she's so forgetful or confused. Pil says that he wants to wait till they're both vaccinated, but I think he's making excuses to delay facing up to the inevitable diagnosis. I feel it's really important that she's seen and her appointment shouldn't be delayed because it's not convenient or because pil is worried it's going to be too stressful.

Any suggestions or ideas for the way forward? There's no PoA in place.

Have they not had one jab yet? Could a video consultation be arranged? Dm had one yesterday which was very good and thorough.
May be more tricky with dementia but worth asking about.

Who prescribed the medication, I would contact them and say you are concerned that she has deteriorated . If it was her g.p they might suggest a nurse home visit or video call.

Sorry - yes both had jabs a few weeks ago.

We're sorted now after firmly reiterating the importance that she's seen and have an appointment booked for a few weeks time. It seems to be a recurring theme though.

I think dh might need to have a conversation about shared PoA with fil. Fil can't cope with dealing with mil's stress/confusion/upset when it comes to medical appointments so just puts it off. I had to chase up the scan results from 6 months ago as he wouldn't do it.

Medication was through the dementia clinic. Fil isn't very good at dealing with formal stuff. I completed an attendance form nearly a year ago and and asked him to collect some supporting documentation and to submit it. Nothing has been done with it nearly a year on.

Mil hasn't yet had a formal Alzheimer's diagnosis yet. Is this unusual? She can't really be left in the house unattended.

There can be reluctance to formally diagnose Dementia but it sounds as though it's a foregone conclusion so getting a diagnosis isn't going to make a lot of difference. It might open some doors to support and regular reviews but it's a bit of a postcode lottery.

I would definitely encourage you to get health/wellbeing POA for MIL, jointly with FIL if that makes it more acceptable. It's a really really tough time for all of you.

Something some people find hugely valuable is to attend a course targeted at carers of those with dementia. Sometimes these are run by local dementia services, sometimes they are offered privately, but they are excellent at the nitty gritty of what to expect and how to manage it as it comes along.

Thank you @Purplewithred

I'm trying to encourage DH to have the PoA conversation with fil as it will make life much easier to do this now, rather than further down the line when she's completely lost capacity.

I'm not sure if she's at that stage yet. Sometimes she more lucid but other times you can see that she's just gone into her own world and she's struggling to follow the thread of a conversation. Frequently sundowning. Thinking my DH is a little boy when she's getting up in the night that type of thing. Or that my daughter is still a toddler. I worry as she's only left the house about 5 times this year. Fil doesn't take her out for a walk or anything like that.

How do you go about getting a doctor make that judgement?

Sorry for all the questions - it's so new and hard to have these discussions when we can't all sit round face to face because of covid. The main challenge is that dh's family would do ANYTHING to avoid talking about anything contentious/difficult and I feel that I'm having to be the driver in this.

A carers course sounds like a really good idea - I've looked into it before covid, but actually it would be good for both fil and DH to do together.

Your DH can apply for POA without FIL so no need to wait for him to face the sad and painful reality. It may be too late if you do.

As long as she is able to have a conversation with your DH about her memory not being so good and therefore wanting to protect her rights and speak on her behalf if she can't one day etc (ie she has capacity to make the decision) she can sign the LPOA form.

It is also likely the GP records it will say dementia even if the CMHT haven't formally written this to the family. This is the case with many of our undiagnosed patients especially if we are prescribing meds for AD.

Thanks @Jobsharenightmare I totally agree - the problem is that no one in his family is having the conversation. Fil won't let anyone talk about it to mil and obviously the only way we can talk 'face to face' at the moment is through video calling and she doesn't know how to do that by herself and would have to use fil's phone. She doesn't know how to use the phone anymore and wouldn't be able to concentrate enough to have that conversation over the phone and then would get distressed after the phone call and fil would get frustrated at this.

Bil and sil no longer speak with us and sil no longer speaks to pil. It's all a dysfunctional mess.

Because their family history is of avoiding issues I'm having to coach DH in what he needs to do but bloody covid seems to be stalling this.

How far away do they live? I would say this warrants a face to face meeting, if that’s the kind of thing that’s possible to do with them.

A face to face meeting in masks maintaining distance is warranted I think.

It is so hard when the family is avoidant in general.

Best of luck OP.

Yes, I think you're all right. I'll start priming DH for a face to face meeting. We could schedule it for after the next appointment and by then maybe restrictions may have lifted slightly.

Thank you - I'm sure I'll be back on this board again 😬😁