How to get gran into a home against her will

[Faciadipasta]

My gran is 96. She has always said she'd rather be dead than in a home but I think she does really need to be in one.
She lives alone, she is almost blind from macula degeneration, she is almost deaf and she is showing pretty bad cognitive decline. The last 2 days she has rung me in the middle of the day, crying, saying she's so lonely. She repeats herself constantly. Today she rang me saying she had fallen over, thought she had been unconscious but couldn't hear my to answer my questions on how she is. (This is not only worrying big it also is disruptive. I'm working. I miss meetings)
She can't hear the doorbell or the phone, although my dad has keys she usually seems to.leave her keys in the lock.inside so we can't unlock the door anyway.
I called my MIL to ask her to go round with keys to check on her. She did manage to get in (this time) and said she didn't seem injured but just kept repeating the same thing about calling the hairdressers??
Her house is pretty dirty too because she refuses cleaners and cant see the dirt.
The thing is she goes absolutely crazy if we say she needs ANY help. Literally screaming at everyone.
Even specsavers have said they won't see her anymore unless she has a chaperone because she is abusive.
WTH can we do?
My dad goes round a couple of times a week but we can't just turn up because we can't get in.
I go round a bit but really only if we can go out in her garden because I have young kids and her house is NOT a suitable.place for them to be.
Any advice would be really gratefully received. She is causing so much stress for everyone.
Thanks

I understand the dilemma, I really do. The trouble is, there is no satisfactory answer, unless the person has insight into their situation. Of course from an objective pov, she’d be much better off being looked after, kept an eye on, but from her pov that means losing the freedom and independence she’s had all her adult life. Sometimes that’s more precious to people than being kept in a safe little box. I know it doesn’t help you, but all that these stubborn, selfish old people are doing, really, is desperately hanging on to whatever agency they still have left over their lives.

I don’t know what the answer is other than muddling through and hoping for the best. Is there any person that she would allow in to the house such as someone to prepare lunch/dinner, a cleaner or companion? (Sorry if you’ve already covered this). A friend’s very stubborn father who wouldn’t entertain the idea of a carer did eventually allow someone in to clean a couple of times a week. This person also worked as a private carer, and was later on able to act as such, when his needs got greater, having already established a good relationship with him. I hope you find a way forward. It’s so difficult for all concerned.

It is in this case. Either GM has cognitive impairment or she does not. That is diagnosable by a doctor. Only a doctor can make this decision.

As to other issues, as I said before people can have capacity to make some decisions but not others - so yes a nurse or a carer or a dentist could determine capacity for x or y treatment or activity, but none can decide whether GM has dementia.

you are conflating a diagnosis of cognitive impairment with a decision about capacity. As an Occupational Therapist, I used to make diagnoses of cognitive impairment and what it could mean in terms of function. You are also completely ignoring the duty of a decision maker to take into account previouslt expressed choices and decisions.

Oh and PS I also used to make assessments that could diagnose dementia and again express clinical opinion about what this would mean in terms of cognitive function.

If she has money she may be more likely to be persuaded to have a ' housekeeper' live with her who can help with whatever she needs whenever she needs it.. you need to be really honest with her about how it is affecting you all with the worry.

Lusyge , was that necessary.Trying to do you best for an elderly relative who won’t be helped is exhausting and draining . . Because the relatives are powerless to help, the sense of despair Is deep and continuous.

There is never a minute when your mind is not taken up with them. The elderly parents thread on here is heartbreaking. Maybe you should read it, before berating the poster.

lusyje you show no compassion to the OP and the incredibly tough emotional burden she is under. She has acknowledged that the way she feels sounds bad but that is the reality for so many people caring for elderly relatives with serious issues. This board is supposed to be a place for support, not for snotty comments and judgement. Maybe you should leave the OP alone.

This just shows how we should all take out POA. Yes, now, before you are old, and while you definitely have capacity. Illnesses and accidents can render anyone so ill that others need to make decisions for them, at any age. Having a POA ready to activate will alleviate the burden for those who have to make them.

But as others have said, even with an active POA, the duty on the attorneys is to make the decisions the person would have made if they were well.

Not I’m not. A capacity assessment is totally separate to assessment for cognitive impairment and I have never said they were the same thing.

Someone with mild cognitive decline may still have capacity to make some or all decisions.

A diagnosis of cognitive impairment goes hand in hand with evaluation of the cause- stroke, head injury, Alzheimer’s etc. With Alzheimer’s for example (and 60% of diagnosed dementia is Alzheimer’s, although it may be mixed with another type) the consultant will determine the stage/progression of the disease based on clinical, radiological features and neuropsychological assessment (your role obviously).

Given the data on GM’s state:

—“Pretty bad cognitive decline” (OP’s words).
— Unsure if she had been unconscious.
— Replies to questions about health, with comments on hairdresser.
— Aggressive, abusive and challenging behaviours.
— Paranoia - Thinks the chiropodist is trying to track her and kill her, carers might steal.
— Keeps locking the door so no-one can get in.

It’s possible she’s mid stage dementia, for example, in which case the issues of home safety, self care and staying engaged in personally meaningful tasks become paramount.

That being the case the family may be able to get her capacity assessed to make decisions about her living circumstances.

This is why as I will be dead within weeks if I am forced into a home. I have a legally enforceable Advance Directive which states that all life prolonging treatments are to be withdrawn and no infections etc are to be treated if I lose capacity to make my own decisions.

It takes the pressure off my POAs. They are unable to over-ride it whether they want to or not. The decision is entirely mine. I've seen too many old people in too many poor nursing homes to ever want to be in one myself. If I die alone after a fall then so be it.

I'm heartbroken to report that just what I was worried about has actually happened. My dad went round on Sunday to find my nan lying on the floor. We called an ambulance and she was taken to hospital where she died about 12 hours later. The doctors think she had been on the floor unable to get up for a long time. Someone had last spoken to her on the Friday so she could potentially have been there for over 24 hours. This thought alone is actually killing me. For anyone who has a relative in a similar situation, my advice would be it really is worth forcing the issue.

I am so sorry for your loss it is heart breaking x

I'm so very sorry @Faciadipasta

My heart goes out to you and your family

My huge condolences to you. You did your best and you cared and I'm sure she knew that.

So sorry @Faciadipasta 💐

My condolences to you and your family.

It may not be a comfort to you, but it seemed your Dgran was very clear on what she wanted despite her diminished capacity- which was to remain at home, and that's what she did.

This absolutely. I am very sorry for how you are feeling about this. It happened in my family too. The thing is that she got what she wanted.

I am sorry for your loss OP and that you are feeling so devastated. It must be very upsetting for you thinking about this .

Sadly I also understand where @rookiemere is coming from . We had exactly the same thing occur with my FIL and although my DH struggled especially, older family members (those of FIL's generation ) were in agreement that this was what he wanted and he would have hated being in a care home. (Not that I have anything against care homes - the one my mum is in is fab, but given my FIL's personality he would have hated it)

I am so sorry for your loss

I'm sorry you lost your gran like that. I fully understand why you are so upset but I hope that if you reread this thread in a couple of months time you will realise that you have nothing to feel guilty about and it will reassure you that you did everything you could.

She may have been hard work in her last years and caused you so much anxiety but it is clear how very much you loved her.