How do you know when a parent needs care?

[SeaBoat]

My mother is nearly 70. Over the past 12 months I noticed some things with her and last winter I began to think if she's going senile. The stuff I observed so far is all relatively mild and subtle and hardly noticeable. Then it progressed this year in April and I noticed she had items of my underwear. We are completely different sizes and she had them as if they were hers and they were in her laundry. Our laundry is always separate and she never washes my clothes. There has been episodes of anger of her that never made sense.

So far I don't have a diagnosis for her. I mentioned my concerns to our GP.

Then this morning she mentioned her eyesight is gone blurry in one eye. She was diagnosed with cateracts a few years ago and she got the cateract procedure done in the hospital.

So my question is how do I know when she needs care or even part time care. She doesn't have a partner and all she has is me. The rest of my siblings are abroad.

All of this is happening so quickly for me. The role reversal is tremendous for me. I doubt a lot what my mother says and sometimes do and I go about double checking everything right on down to the dishes. I discovered that she wasn't using dishwasher tablets and another time when she put a washing powder pod in the dishwasher.

So it's all very mild and subtle and hardly noticeable but I think there is something happening with her.

I am due to have a holiday abroad in October and now I am not looking forward to it. It should be a good time. The first holiday in years. But my partner booked it a few months ago and all of this is happening so quickly. I don't feel comfortable leaving my mother alone for a week. I feel like my partner won't be able to understand. His aging parents are still together and they have each other. I feel selfish for going away for a week.

My mom is still independent in a lot of ways too but there's still some stuff happening here and there.

There is a route through adult social services which assesses for community based care including whether a person is safe to stay alone.

There will be a waiting list though and I doubt this would be done in time for your holiday.

If you think she ay be unsafe:
Could your mum stay with relatives ?
Could friends or relatives stay with her?

Once she has been through the memory assessment via the GP the diagnosis (if she has a diagnosable memory loss) will lead to access to other agencies to help too both formal and voluntary. (eg Admiral murses).

I'm sorry, this must be very trying and worrying for you

I guess the first level is safety: is she safe to be left alone? Can she safely toilet, wash, cook / eat, drink, take her medication? Is she safely mobile in her home?

it also depends what you mean by care - it can be anything from a visitor once a week, to daily visits, to actual personal care being done, to nursing care in a residential setting?

is she willing to start the assessment process?

First thing you need to try get done is getting the legal end sorted re a power of attorney.
You should check if her GP is willing to sign off a mental capacity / competence letter which the solicitor will request.
If she is willing to go and appoint you or other family. Having that will make any future decisions if she looses capaciry, easier.
Then it is down to assessing can she manage day to day living.
Short term as you are going on holidays and if you can afford it you could hire a carer to pop in for 1/2 hours and give her dinner and company.

Your mother is not particularly old at nearly 70.
1st port of call should be back to the GP to get her symptoms investigated. There could be various treatable medical conditions causing those issues.

Then if they tell you things cannot be improved any further that's when you can look into care. Arrange an assessment through social services.
But you really need to find out what's actually wrong with her.

And agree with getting Powers of Attorney organised sooner rather than later

I remember you posting about this before, sorry it all sounds so stressful. Like Chocchops says, there are a lot of different kinds of assistance available, sometimes people think asking for help for themselves or their parent is a fast track to being "put into a home" but it really isn't like that, the system really is designed for people to stay in their own homes if at all possible, sometimes longer than is really in their best interests IMO.

Relevant factors you haven't mentioned are how your mother feels about having some care/assistance and what her financial situation is, does she have spare income or assets other than the house you both live in which presumably she owns at least part of, and a pension?

If a person still has capacity to make their own decisions which it sounds like your mother does, no-one, not you, not her GP, not social services can insist on her having any care she doesn't want, even if it's manifestly 'needed' and in her best interests, so really it isn't necessarily up to you to decide at this stage. I think it would be useful for you to start gently having some conversations with her about this, you don't have to say that you are worried about her memory if that will upset her, you can just talk about the natural process of getting older and needing more help and so on. I find it can be useful to 'thin end of the wedge' it, going from total independence or only family help to full on personal care is far too much for many people, so starting with perhaps discussing something low impact like having a cleaner or gardener in to help with the house or online shopping delivered instead of her having to go to the shops, then perhaps moving to meals on wheels or another meal delivery service instead of her cooking when you aren't there (which can be quite hazardous for frail people or those with early stage dementia). If she gets on well with the cleaning person and you find the right person this can maybe transition to them being more of an all round 'helper' (the word 'carer' can be offputting) who can help with things like reminding her about medication, taking her on errands, helping her do her hair, that sort of thing. And if she does progress to needing more personal care, at least she's used to having a non family member in the house etc. The caveat to all of that is this it has to be paid for, there is no real state assistance for any of it so if your finances are tight it may be more of a struggle. Social services will provide care at home for those that really need it but this will be an hour or two a day max and you/your Mum don't get much choice in who comes, and if your mum won't accept the help or let them in then that's it, so it is really important to get her on board.

I think a visit to your GP would be a good first step (get them to look at her eyes if nothing else), you could quietly tip them off in advance that you are worried about your mum's memory and get them to do memory tests at the appointment, can be done sensitively as a standard check up for someone of her age if GP is able. Maybe a SS assessment too if your Mum is willing. For your holiday, are you able to get one of your siblings or another relative to come over and stay with her for at least some of the time (or can she go to them?), sounds like your Mum might struggle if left alone all week, it would be helpful too for someone who isn't with her all the time to look at the situation with fresh eyes and see how hard it has been for you with your own eyes (quite easy to get complacent or be in denial from a distance). If not is there someone local (a neighbour?) who would pop in a few times while you're away to 'keep her company' and just reassure you everything is OK?