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Elderly parents

73 yo Mum just out of hospital - needs care in the home, but how do we navigate this incomprehensible system of 'care'?

10 replies

SphincterSaysWhat · 22/05/2023 11:24

Hello everyone,

I've been a lurker on this board for some time, reading the cockroach thread etc and picking up bits of info here and there, but I think I need some pointers for my specific situations.

I feel thoroughly lost in the process.

Mum was admitted via A&E a few weeks ago to a ward in the hospital. She was suffering from dehydration and was stumbling around, not making much sense. We suspected she had a UTI, and she did (e-coli). She self-catheterises as a previous infection caused her to lose muscle tone in her bladder so she can never fully release the urine. That would obviously be catastrophic, so she catheterises herself and is good at it.

After many, many blood tests, cannulas, collapsed veins etc they managed to get some IV anti b's into her along with fluids. Her sodium constantly levelling out at 131 which is low, but she has to drink so much to flush her system, she's got no choice but to take in all that water.

She has had a hip op recently. The other one replaced 4 years prior.

She is constantly, and I mean constantly stumbling. She'll see the bed/chair in her sights and almost throw herself down into it.

She uses a stick to twirl around, not to walk with. She rushes with a trolley. She rushes when linked to us.

She constantly smells of either urine or faeces (and I could cry my heart out, writing that). She taps her right hand against her chest or the bed or whatever, constantly. She's there in the head, but vacant.

She can't walk straight, for some reason. It's odd.

She has lost her appetite. She doesn't want to make food because she doesn't want to eat it.

She is chronically tired - I mean constantly plagued by this crushing fatigue. She wants to be referred to the CFS clinic, but what are they going to do? She's obsessed with it.

When she does go on walks, it's for way too long. She went on a walk with her sister (very capable, over from Ireland) yday and as usual they went too far and she messed herself (number 2).

Her house is now gross again, apparently. Even though when she was in hospital I went through it like a whirlwind and cleaned it from literally top to bottom.

The house is falling apart. She lives in one room in the winter, the house is extremely cold. She won't move. She won't visit is (I live about 4/5 sometimes 6 hours away) citing various reasons "oh, I have an eye test" (which she got the bus to, but fell on the street). "I have a scan on my bladder" which never happens as she never dips clear, there's always something wrong (although not at the moment, thanks to all the IV anti b's she's had).

I believe she should have had a team assess her house and provide her with an alarm? That hasn't happened.

As I said, I live far away and this is all falling to my poor sister who lives close by - she doesn't mind, of course, but she is a single parent and is starting a new job soon. She won't have time to sit with mum all day/night.

Every time mum's sister visits, I get a call from her and mum's best friend (I call it a doom call) where they tell me she needs to be in hospital (why?) and that she can't be left alone - but mum refuses to come to me, she won't go to residential care, she has capacity...there's no need for her to go to hospital, because (as we were told, quite fucking clearly, they treat what's wrong with that person there and then in front of them - then they pass them back to the GP for referrals to MOPS, frailty, falls etc).

She's had all the tests, save an MRI, and save for sodium is good on paper. There's nothing obvious going on like brain injury etc, so I guess I'm asking - what do we do next.

I am so upset. My poor, fire-cracker of a mother. She was an NHS nurse, an immigrant who trained in the hospital she just left. She then had a nursing home for years with her best friend. From being someone who'd come down to us on the train for a week and when I got home from work would have painted the shed/sorted the cupboards, to this shell of a woman is hard, harder even than when our dad died of oesophageal cancer 2000.

Can anyone help? What next?

OP posts:
IthinkIsawahairbrushbackthere · 22/05/2023 11:33

I have no real advice as my situation was very different but I feel for you and your sister having to support mum. It is an impossible situation for both of you. Sadly as you will probably have gathered from other posts on here often there is no real help until a crisis happens. Can you report the situation to social services as a safe guarding concern?

Soontobe60 · 22/05/2023 11:37

It’s a nightmare isn’t it!
Does your DM have any carers? I would contact the elderly social care assessment team and arrange a visit to assess her needs. The last time she was in hospital, she should have been assessed by the hospital social worker to make sure she was safe going back home. If family told the hospital that they’d be able to look after her she would have been discharged. In reality, she needs more care than can be given by yourselves.
You say she has capacity, but if she’s unsafe with all the falls, medical needs etc, but is refusing help, then that’s a sign that she actually lacks some capacity as she can’t make a decision in her best interest.
I would say that the next time she has a fall, whoever finds her must ring 999 and not deal with her themselves. When the paramedics arrive, make it clear that she lives alone and there’s no one to stay with her. They likely will take her to hospital where they will assess her needs again. You have to be very clear that family are unable to care for her. Likely they will arrange carers to visit up to 4x a day initially. She may well be sent to an assessment unit until carers can be organised. I’ll reiterate, you have to be clear that you cannot keep her safe.

SphincterSaysWhat · 22/05/2023 11:55

Thank you both @IthinkIsawahairbrushbackthere @Soontobe60 for your sympathies, kind wishes and advice.

I will defo contact the adult social care team, or rather my sister will as they want to speak with mum. Fingers crossed she will get some support - we only have a couple of weeks until sister starts her job, we'd dearly love to have something in place.

OP posts:
funnelfan · 22/05/2023 12:39

Either of you can make the initial report to the adult social care team, it doesn’t have to be your sister. The key things are that you think she is unsafe (fall risk) and she is not managing her toileting and personal hygiene needs.

The social workers have seen it all before, including worried relatives. I would say, if both you and your sister can try to be there when the social worker visits your mum. Then you can ask questions about what happens next, the system in your mums area etc. We only ever saw mums assessor once but she was very supportive in signposting us to the next stages.

LadyGardenersQuestionTime · 22/05/2023 15:50

Do you have any understanding of her finances? Do you have POA? If not can you get these?

You say "she has capacity" - capacity is situation/decision dependant. Can she predict the consequences of each of her decisions/actions?

Will she accept care at home?

What do you think she needs?

(just things to think about).

If she has no £ then Social Services will assess her and try to put in place the care they deem she needs. If she has £ (ignore the value of her home) then she will be self-funding and SS can do an assessment and make recommendations but it's up to you/her to put the care in place.

SphincterSaysWhat · 22/05/2023 16:56

Thanks both.

Yes, we have LPAs for both health and wealth (of which she has little) but she has definitely not lost capacity. The LPAs are registered, but we're not yet at the point where we have to use them over her head (I'm a lawyer, my firm dealt with the LPAs etc).

She has a little money set aside (money that husband and I gave to her last year as she was worried she didn't "have enough") and she owns her own home. I've been in touch with Age UK and they were really helpful on the phone - I think mum has just enough savings that she'll have to contribute but not loads.

Today, sister managed to get the occupational health out today to assess mum in the home and it went well. They're going to also call adult social care team (as is sister) so hopefully we'll hear from them soon and then we'll get a plan in place. Even if it's two visits a day, quickly, from a carer - that will do nicely for now. I am so lucky to have such a capable sister on-site - but we're worried about when she (DSis) goes to work how this will all play out.

DSis was very pleased with the OP today and what they went through everything with DM. Thank god she's there!

Isn't it hard? But thank you so much for your thoughts.

OP posts:
funnelfan · 22/05/2023 17:26

It is hard, and I went through a stage last year of feeling like I was flailing about trying to get to grips with what we needed to do to get mum some help. She was clearly declining and not managing (eg losing loads of weight because she couldn’t cook any more, poor personal hygiene) but denying she needed help. But not so bad she was an immediate danger to herself or others. For me the adult social care assessment and being admitted to hospital were the two key points. The hospital were great at looking at her as a whole person and not a set of symptoms, she was thoroughly assessed and we finally got a medical diagnosis to explain her issues. Between the two, I felt we got mum in “the system” and we have an idea of her prognosis. It gives us a starting point to open conversations and ask for the right kind of help.

The need to advocate for mum never goes away, but we’ve now got a Plan A. DB and I have discussed at what point we think Plan A won’t work any more, and what Plan B would look like. Just having those conversations and plans at a high level made me feel much more grounded. Of course it’s not possible to plan for every eventuality, which is why we’ve kept it general but we’re aligned on the important things. Having sibling(s) who are supportive is a huge blessing that it appears not everyone has. No one else understands the loss of the woman that you knew as your mother as much as your sibling. For me, it’s like dealing with a living ghost that looks a bit like her, and sometimes has her sense of humour. DB has taken her decline from strong independent woman very hard indeed. But we have a line in very black humour and “what dad would say” that gets us through.

SphincterSaysWhat · 23/05/2023 09:41

@funnelfan Ah, it is hard, isn't it. But you are right, I read on here about siblings who aren't on side with each other and know to thank my lucky stars. The guilt at not being there is overwhelming, but DSis is doing a stellar job and I help with money and the legal bits, where I can. Together we are a good team.

We feel like we too are "in the system" now and just waiting for the appointments to fall into place. The meeting they had at DM's yday was useful and SO QUICK (I was like "they'll never come today" but they did). DM was so tired afterwards. I usually call her on my way home from work, but will switch that to lunchtime as that's when she's best.

Aging is a privilege, but when it comes to cognitive decline in someone who was so fucking ALIVE - the shit she did as a young woman, she was a trailblazer - it's sad. So so sad, but it is what it is. Our father died when we were young, so that too was sad. I wish we'd gotten something in between for mum - not this living death.

I am grateful for your replies and this board. I feel less alone and I take succour in there being a period of flailing about which settles.

Thanks x

OP posts:
Messageina80ttl3 · 23/05/2023 17:36

Have you applied for attendance allowance for your DM
Look here
Www.gov.uk

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