Worried about mum and dad

[Rosebel]

My mum has had quite a lot of falls in recent years but has mainly been okay afterwards. She had a fall just after Christmas and another one last week. My dad has taken over looking after the house, has been that way for quite a while and he looks after mum too. When I say looks after I don't mean physical care or anything but if she falls she can't get up, she now really needs two people to get her in and out of the house, things like that.
After most recent fall mum said her ribs were painful and dad is worried it's from where he helped her up.
My sister lives close by in fact all of us siblings live within 20 miles but does he call anyone to ask for help when mum falls? No of course not. Will he agree to being signed up to an alarm system where they contact someone to help if mum fails? No. Will he accept carers coming to the hou6? No. He won't even agree to leave the house and have a drink or go to the garden centre while one of us sit with mum.
My sister goes over most days, I go once or twice a week and my brothers probably once every 10 days. It doesn't matter who's there he still won't go out on his own or with someone.
I'm worried about my mum as she is now almost housebound. I'm worried about my dad as he's exhausted and if he won't accept help fear he'll make himself sick or worse.
They do have the support of local nurses and mobility services came out recently and will be providing some aids. There is a builder coming to fit handrails outside so good in that sense but can't stop worrying.
I work nearly full time and might have to get a second job and I have 3 children but I feel guilty like I should be doing more but what can I do if he won't accept help.
A, while ago they did talk about going in to a care home but it's incredibly expensive and I have a feeling it was more to do with your savings have to stay at a certain amount which would mean us siblings paying for it and dad doesn't want that.
He's so stubborn and I think he forgets he's almost 80. Not 50.
Is there a way I can persuade him to accept our help, even if he won't accept outside help? I really worry about them both anyway but can't help being really worried about what will happen if he gets sick. I think he believes asking for help makes him a, failure. I think it might be a generation thing.

I’m afraid that the only thing your Dad can do if your mum falls is call an ambulance. It’s the only way to ensure the lift is done safely if your mum can’t get up herself. Alarm systems are more for people on their own - they call a relative or an ambulance or both. Sounds like he is lucky to have the support of caring children. Cost aside, your dad doesn’t sound like he needs to be in a home? Your mum can
still fall in a home and even there to get a safe lift ambulance help might be needed?

Perhaps you might need to explain to him that women are more prone to osteoporosis, and that if she falls, then she needs to get checked out and have an x-ray just to be on the safe side? An elderly relative of mine had a minor fall a couple of years ago and cracked several ribs.

He is probably thinking that asking for help means that he has failed. He needs to understand that not asking for help might have disastrous consequences.

Does he know how to help her up? Check for any injuries or pain. If all clear, Get her to roll over on to hands and knees, put a chair in front of her for her to put her arms on so she can move her best foot under her and straighten her legs, then stand up. Bring another chair behind her ready to sit.

I have a feeling it was more to do with your savings have to stay at a certain amount which would mean us siblings paying for it Not sure where this idea has come from. The only thing I can think of is that if you’re a self payer, the home may ask for proof that you have savings to cover 3 years fees. But you don’t have to keep your savings at that amount. The average stay in a care home is three years.

My Dad is in a nursing home and wasn’t asked for proof of savings. But he’s in a home which takes Council funded residents, so I guess they knew they’d still have their funds from the Council even if his money ran out.

The only other situation in which family can be asked to pay is if Council is paying and you choose a care home which costs more than the Council is prepared to pay.

Obviously Council payment only happens if Council agrees that a care home is required, so getting an assessment from them is sensible unless they have savings which are enough to cover 10 or 20 years in care.

Your dad needs to realise he'll make himself unwell taking all the care on himself.
Perhaps remind him this is what savings are for, comfort in their older years and if he needs to pay for care then it's money we'll
spent.

Have you had a straight conversation with your dad about the consequences of his decisions, and what he plans to do when that happens. Eg him not calling for help to lift --> HE gets hurt and can't care for mum (even more likely than he hurts her). What will he do then? If he gets ill (eg chest infection) there is nothing in place to look after your mum.

He also seems very confused about finances - does he understand how savings impact care costs? (do you?)

If he won't have the conversation then you'll just have to keep nagging and wait for the inevitable crisis. Hope you have POA in place.

You've had some really good suggestions on here already. Definitely try to get POA for both health and finance.

I would talk to him about what he wants for your DM.

We had similar with DFIL where he wanted DMIL to stay at home as long as possible and saw it as a failing if he accepted help.

No he realises that if had the hell, she could have been at home much longer.

I'd ask for a Social Care Needs Assessment and make sure you're there when it's done, otherwise they might be tempted to be a bit tight with the truth.

I'd also ask tire DM about going to the falls clinic. Transport can be arranged and it's free. My DF went for while, did the exercises at home and it helped him terrifically.

Thanks for the replies. Falls clinic are supposed to be getting in touch but I will call them again Monday as mum has had 2 more falls this week.
Unfortunately mum has very little strength and wouldn't be able to get on her hands and knees or pull herself up.
Care home costs is working about what happened with my gran but this was over 20 years ago so things have changed.
I have said to my dad that he doesn't look well and needs to accept help but he doesn't listen. We are all incredibly worried about what will happen when ("not if) he gets sick but trying to decide what to do or how to help them seems impossible because nome of us can agree a way forward.
I've got a permanent stress headache and even when I'm at work or home my mind is in overdrive worrying.
DS is awaiting speech and language and physiotherapy I just feel stretched to breaking point.

Please don't take it all on yourself. Clearly your dad is very stubborn, in denial, and not behaving rationally. But that is really , really normal for elderly people faced with their declining powers. Ignore it and hope it goes away.

Obviously it won't, but possibly you just telling him the truth isn't going to get him there faster.

I don't know if you (collectively) are brave enough to ask him about what he would want for mum if he injured himself lifting her, for exame - ie to get him to think through some scenarios in advance. (I have never managed to do this with my dm but she does sometimes talk about it hersef, which I am grateful for)

But I think there is a natural brake on how quickly someone like your dad can adapt mentally to a fast changing reality because it is so painful. You are making him think about the end of his role as an autonomous capable adult. That hurts!

Sometimes it just isn't possible to get people to get their heads round these truths fast enough, so don't wear yourself out trying, if you can manage to go a bit easier on yourself. You are not a bad person for being unable to achieve the impossible. (I am wondering if you are a bit like your dad here? No point in you both making yourselves ill!)

You can subscribe to a service with a pendant each and they will send a team to help you up if you fall. Dp's mum has it. It's a lot quicker than an ambulance and you don't have to feel guilty because you are paying (you aren't taking the ambulance away from someone else) I know that's a concern for many people

@gogohmm I haven’t come across a pendant alarm service that does anything other than call a relative or an ambulance. are you able to share the name or is it just a service local to you?

Unfortunately mum has very little strength and wouldn't be able to get on her hands and knees or pull herself up. In that case she needs more than one person looking after her. My dad is very frail, and even for moving him up the bed they use two people.

@ValerieDoonican talks sense

There's one in Perth that will go out and check on the elderly. They usually call my husband first as his parents have cameras in their house and he can see if they are upright and ok. Have had it go off as a false alarm in middle of night. Once they went in to check they were ok can't remember why.

@Musicaltheatremum it sounds like a good idea to have I’m just not sure how common non-ambulance assistance is across the UK? Presumably it would be NHS supported or authorised and not a private company connected to a specific pendant brand? I heard a lady on the radio talking about the ambulance strike and she said her mum had fallen and been assisted by ambulance something shocking like 200 times in a year. It would totally make sense to have a team of responders who could get there faster and not draw on ambulance resource like the Perth scheme. I know there will be cases where the patient may need further medical assistance or the patient needs to go to hospital, but not always. It could be a way to reduce pressure on ambulance services if people are prepared the accept the slight increase in risk that would be associated with someone who is not ambulance service attending with the right training and kit to lift. If these schemes are in some parts of the country, I do hope expansion is considered.

There are some areas that have specialist teams that do just getting people back up, but not in all areas. There may be something else in other areas instead.

I'd say to you @Rosebel to try something very difficult- to let it go. Your first responsibility is to your own children and that sounds like a very tough situation right now waiting for services and worrying about money. Your parents are following their own wishes at the end of long and successful lives. This bit at the end doesn't define the rest.

Tell your sister that you are close to breakdown, that you are going to step back and you would support her doing the same, and stop. Do what you can do - maybe more phone calls if you can, short cheerful chats, but maybe only visit once a month. Yes there will probably be a crisis but here's the thing - it will happen whether you worry or not. The local nurses know about them and that's a good thing.

@Makingupfactstosuitmyagenda
The system where I am is called MECS, here is the link, maybe check for one in your area

www.falkirk.gov.uk/services/social-care/care-at-home/mecs.aspx

@OnaBegonia hmm, sounds like a council supported version of pendant schemes: They say they will do three things ‘Contact your GP or next of kin, Send a warden to your home, Talk with you to reassure you’. none of these actions get a person off the floor or avoid an ambulance being called. I think what’s needed is a lift team with the appropriate kit and enough medical knowledge to make a decision whether the person needs to go to hospital. It might help some people or be better than nothing but it doesn’t go far enough.

I feel your pain as I am in the same position. Parents mid 80's. Dad is basically carer for mum. Mum has multiple health issues and unsteady on her feet. Dad is exhausted and not in the best of health himself, but won't admit it. They need outside help, but refuse everything.
Can't even get them to agree on POA. I have had very long conversations with them detailing what would happen if one of them falls or has an accident. They wouldn't be able to get each other up. But it falls on death ears.

I have got to the point where I have had to accept this and just support the best I can from a distance.

We went to visit on Saturday and mum had fallen when we got there. Dad was in a state as he couldn't lift her. Obviously as I was there we got her up but she is really starting to hurt herself now.
Thinking this was a good time to mention carers but might as well have talked to the wall.
I can't help but worry, they are so stubborn!

It's really hard to watch, but I think you have to accept that your DPs still have agency.

Your DF would still rather have his DW at home than in a care home, however more practical that might be.

I'm not quite at that stage yet and I guess have more options as DPs can fund own care for a number of years, but I feel the only thing you can really do is not frazzle yourself out. Do the maximum you can but not at the price of your own DCs or health.

Has your mum got a walking aid? Would that help? Aunt has the mecs service but refuses to wear the pendant, it just lies on the table. She is in her 90s and increasingly unsteady. Think you just have to wait till a something bad/hospitalisation scenario to make them see sense.

It needs to come from someone else not his children - Occupational therapist?, GP?

We've used a company called Care Call for years now - dad has Parkinson's and mum can't get him up on her own. He wears a wrist band to alert them of falls even though he is never alone. They come with an air cushion to raise the person back up again and check the patient over. Invaluable and very good value for money.

Hopefully the falls clinic will be able to give advice/walking aids to minimise the risk. What does your Mum want? Rather than your Dad? As it is not really his decision what care she gets, it's hers!

Re a care home, this will swallow savings very quickly, and it isn't guaranteed that adult social care will pick up the bill as it would be expected that least restrictive options were trialled first, such as carers in the home. This would be the first step.

I worked in an area that had a team that worked via a lifeline pendant and would help people up after a fall, they had a blown up chair they would take round that got people up. They were very busy!

As others have said, you normally have to wait for a crisis to occur for anything to change if your DaD is so against any kind of support.

The pendant is still a good idea for a couple (get them one each) because it is easier for the pendant service to call the ambulance and keep your dad informed of progress etc than for him to do it and also be keeping your mum company.

Ultimately, few elderly people with capacity make changes until there is a crisis, it’s the nature of the beast. My dad went into a home when the number of falls increased and when the neighbours said “enough” to helping (they had a pendant service but my mum always called on the neighbours as well once it was daylight and they always beat the ambulance there)

I think you really need to get social services involved. They will do a care act assessment and it might be better coming from someone else rather than family that actually he does need help.
A move to a residential home won’t be automatic and is usually the last resort after other options have been exhausted. Social services will like to try carers first for example. You could also request a carers assessment for your dad, they will be able to suggest options to make his life easier. In my area they have an organisation called carers resource which you can access without a referral from social services.

In my experience respite can usually be a god send, as it gives the main carer the opportunity to have a break and it can be the wake up call they need. That actually life doesn’t have to be this difficult.