Help me through the coming weeks with my elderly mother.

[Tolkienista]

My 95 year old mother had a fall at home on Saturday, I found her. She lives alone.....very independent, good health, no dementia, but she's fallen. She's currently in hospital being assessed.
I'm one of her three daughters. I live very close, see her around five times a week, do lots for her, spend quality time with her too & I know I'm massively jumping the gun but could they discharge her home without a care package if her mobility is likely to be a major issue? She's massively slowed down in recent months & now lacks confidence in getting around.

I've got a feeling my siblings will imply "as you're recently retired, could you stay with her at the start (including staying overnight) to help out, build up her confidence". I just don't want to go down that route, I think it would massively impact my mental as well as my physical health & would be impractical.

As I said, I'm over thinking things at the moment, I've been awake for the last two hours, its 5 am & in reality we'll all get together & realise its time for residential care.

What do I say to my siblings and their spouses to take myself out of this scenario of ending up moving in with her for (just) a few days?

Just say it's not a long term solution and they need to look at other more permanent options.
She's 95, realistically her mobility is unlikely to improve at that age.
Once you open the door of becoming the default carer it's very difficult to shut it again

I’m afraid you will have to be brutal - I work in the Care System.

You make it very clear to the hospital that you are NOT available for 24hr care and that you are only able to see her a few times a week on certain days and times. You say your other siblings are NOT available. You say she is not to be discharged from hospital until an appropriate care package is in place. Also, contact SS and reiterate this - put everything in writing via email.

If they think the family will unconditionally support, services will do NOTHING and you will find yourself in an impossible situation and there will be safeguarding concerns for your Mum.

Be hard as nails OP.

This is good advice. The focus of my hospital at every bed meeting is discharge, discharge and discharge. I know of a case pre my NHS days where social services suggested that a young man give up work to care for elderly relative!!

However, to balance this, the longer she is in hospital, the less likely she will ever get back living independently. We see this all the time.

The hospital was ready to discharge my mother back home for my elderly father to take care of her. It wasn't until my brother asked if she was able to walk that they moved her to a rehabilitation unit for a spell and further assessment. Be assertive about her needs.
If she can move about snd weight bear, you could get a care package in to help wash and dress early morning. That has made a huge difference to us. We know someone is there first thing to check, sort breakfast and manage showering. They also leave lunch ready and then we check at the end of the day making sure the house is secure. The early mornings are when the majority of help is needed. My father now accepts help from caters but resisted our pleas to maintain personal care.
At the moment, good carers are helping us keep him in his own home snd taking some of the stress away for us.
On another note, if you don't already have it, get POA in place for health.

This is good advice. I’ve just been through the system with my mum, now in a care home. It’s a long hard road get your hard hat on !

What does your Mum want to do?

If she wants to stay at home there are discharge to assess teams that can put in a short term package of care to assess her at home. Either she will be OK remaining fully independent or they can help transition her to receiving domiciliary care. They can also sort out equipment and adaptations to make her safer.

I understand its a worrying time for you, but you might be jumping the gun somewhat going straight to she needs a care home. There's lots of options before that, none of which have to involve you being primary carer against your will.

If your siblings feel it's necessary suggest they chip in to pay for a live in carer for a few weeks. Reframe every suggestion away from you doing something to If we feel this is needed how do we put it in place with professionals.

The Hospital Social Work team should get involved when she is close to fit to be discharged. Discuss it all with them, but be clear what you can/can't offer. Ultimately though, your Mum has full mental capacity so it's her choice.

Be realistic. If you see her around five times a week and do lots for her, she's not really 'very independant' is she? Regardless of age. Quite the opposite.
Time to step away and let the hospital know you are facing carer breakdown and will be doing nothing more. No shopping, cleaning etc. Be also very aware that your DM may likely refuse carers (many don't want to pay) and will tell staff her DD will look after her. They may take her at face value for a quick.discharge.
Agree with pp and be hard as nails. Think long term. This is unsustainable and unfair.

Re a live in carer, chip in nothing. This is what we scrimp and save for all our lives. Any paid care should be funded by your DM.

In our area you can only get social services to pay for residential care if the person has dementia. My mother, over 100, was discharged home when completely immobile with carers 4 times a day. I ended up being with her for hours every day, in between their visits and often in the middle of the night. We could not afford to pay for residential care and there was not a second bedroom for a live in carer, could we have afforded one.

Do you know what mine in carer's cost? They of course need time off every day and most don't get up in the night. For that you need a different carer.

Even the day time person will cost tons. Simply to living in a care home, plus money to run the house.

It's usually cheaper to live in a care home.

So not a case of "chipping in" to find a live in carer. It will cost quite a few thousand per month for wages.

Yes, @Sparklywolf , but unfortunately what some elderly people who are in urgent need of care do want, is family doing it all, which may well mean giving up their jobs and moving in.
What they often don’t want is any strangers coming in - and/or having to pay for it.
This is where, all too often, it gets very difficult.

If possible, you need to be present at any interview between your mother and a social worker as regards post-hospital care. I’m afraid it’s all too common for the patient to tell the SW that they don’t need any care, thank you - their daughter will do what’s needed. And naturally enough, SWs are only too happy to accept this.

To be fair, OP says she spends quality time with her mum. Maybe you are being over-defensive on her behalf

This is what we scrimp and save for all our lives. For you, yes. For the generation now in their 90s, who have far exceeded their at-birth life expectancy of 60, saving was more likely to be for the benefit of their children and grandchildren. That’s one reason they don’t want to pay for care - it’s at the expense of their children.

OP Stand firm. Anything you commit to is for the long term. That’s why the bulk of necessary care should come from paid carers, who have time off for holidays and can take sick instead of soldiering on no matter how bad you feel. As a result the care will be better than what you will end-up providing after 4 years with no holidays, no days off, no time to recover from illnesses.

My experience is that no-one in SS will condemn you for standing back. They know what it’s like.

My mum had a fall recently and one of my siblings took on the caring role. She said she would do it for a month as mum has a plaster cast. I think she's already realising it's more than she can cope with mum it's given mum the idea that she will be there. Mum doesn't want strangers in the house.

I don't have solutions to offer (except to say I stood my ground about why I can't do more). I wanted to offer solidarity though because it's really difficult. There are no really good options.

Op, you’ve had great advice- and no, your dm isn’t independent, you’ve been doing the “ invisible mending” to keep the show on the road.
your aim should be a daughter, not carer.
facilitate, not do. Does she have attendance allowance? Non means tested. Get that in place- advice from age uk/ carersuk to complete.
push for a falls team referral/ ot assessment for mobility aids at home. Seek physio to build confidence/ strength.
and join the vets in the cockroach cafe on here who’ve been in your shoes for support, info and cake.

I agree with all of the comments on here and am in a very similar situation. widowed DM is 93, diagnosed last summer with a terminal condition, 2 siblings who couldn’t/ wouldn’t offer any help at all and only visit her a couple of times a year anyway. We live locally and have always done the “support” work, shopping, cleaning, garden and house maintainance so that she could remain in her own home as she wanted. Came to hospital discharge and she announced that she wouldn’t need any help as daughter would be doing it. I admit that I am now retired but do have a husband, adult children and grandchildren. We’ve had to cancel 3 planned short breaks and numerous events due to her health crisises as there is no back up. I’ve spent the last 9 months sleeping on the sofa at her house, virtually abandoning my very patient DH and I’m convinced that I’ll go before her! Unless you can put down, and stick to, a very firm timescale and boundaries, please don’t do it

Thanks for all your invaluable advice, really good reading, did not have access to this until the last hour when I got home. She was discharged this morning, she's back at home, they said she was medically fit for discharge and they'd assessed her mobility too. She's come home with a walking stick. A follow up therapy team will be coming out in the next few days to do an assessment at her home.

She's absolutely fine in herself but her mobility is not great, that's the biggest concern. We've ordered a pendant alarm which will be delivered tomorrow. My sister is staying overnight tonight, I'm doing it tomorrow, but in the long term that's not going to work.

Just don't know what the future holds, it's so scary and we'll have to see what happens at the follow up therapy appointment. Will not be offering my services as an official carer, I'll post a follow up soon.

Any more advice will be very welcome.

@MereDintofPandiculation Yes that's it....... "quality time." It's never ever felt like a duty or an inconvenience, as it's benefitted me as much as her.
However, since her fall only a couple of days ago, everything has changed. Can't get my head round how quickly it's happened.
Only five days ago we went on a forty minute walk.
The future is very scary.

@Chicca1970 too late for that she's already been discharged from hospital. I guess our next port of call is with the assessment team when they come out to look at her home.
Feeling very down and deflated at the moment, this is all completely new to me, already feel we're getting it wrong.

Uu

Hang on in there, your dm sounds strong. Push for that assessment. Talk to everyone about risk of readmission to prompt action. Is there a local falls team? The6 can help with physio, equipment etc.
loads of experience on here- ask away.

You have to make sure the medics know that. Unless you state that in detail, with dates (get it written down) they will assume what they see now is her norm.

From now on outsource all you can. What you as a daughter can do is quality time, a sense of security from you being there to advocate, help with decision making. These no-one else can do. Save yourself for these

Feeling very down and deflated at the moment, this is all completely new to me, already feel we're getting it wrong. You've been a wonderful daughter so far.

Get on to social services tomorrow, make it clear that you are not there offering care and she needs care. They're overstretched, they work from crisis to crisis. They need to understand that your Mum is a crisis.

Meanwhile, get some sleep. Everything feels better in the morning.

@MereDintofPandiculation thank you for your lovely words...... we're less than a week in and so exhausted, so overwhelmed but already we're making progress, albeit slow progress. We just want the very best for the fulcrum of our family, she's worth every minute on the phone.

We're fast tracking an assessment tomorrow at a local centre. It's all so scary and the speed of her decline is devastating.