Massively overwhelmed - mums hip op

[BhxEzs]

Quick back story. My mum is due to have her hip replaced next month. She is a carer for my step dad who has progressed parkinsons. (Diagnosed 9 years ago). Both in their 60’s.

Step Dad in total denial about his Parkinson’s symptoms. He has several falls a week, his dyskinesia (involuntary movements) is very bad at the moment - my mum often gets hit and kicked in the night by him but won’t tell him. He has toileting issues and occasional incontinence.
He is not able to safely and consistently do things such a prepare food/drinks, keep house in a reasonable state and of course due to balance no way can he asist mum with getting anywhere post op. Mum shelters him from a lot of his symptoms and wants to encourage him to keep positive and as independent as possible. Step dad says he’s determined to get back to the physical state he was in 2 years ago - head in the sand with a refusal to understand Parkinson’s.

I see my mum being dragged down mentally and emotionally the way a carer often is. Things often get smashed or broken in the house as step dad refuses to not do things like carry plates of hot food (falls and smashes them), accidentally swipes glasses off the table with an involuntary movement etc. She is his emotional crutch as he struggles with anxiety as he is terrified of looking ‘disabled’. He doesn’t like using mobility aids - although he desperately needs to.

I am one of 6 children but everyone else lives abroad (I.e the other side of the world). I live 25 mins away so of course I will be the post op help.
I have said I will move in for 2 weeks to assist with everything including overnight. I’ve said - in the nicest of ways - they should consider sleeping in separate beds for a while, told step dad mum categorically won’t be able to help him up if he falls and that I will be able to assist with sorting meals etc as sometimes he has issues with carrying plates etc. He has taken huge offence at this. He says he’s perfectly capable of looking after my mum. Everyone around can see he isn’t. Mum is underestimating how much help she’ll need and doesn’t want me putting myself out. She always quietly gets on and gets things done and she thinks she can do the same with this.

I am literally feeling sick about the situation. I hate confrontation and what started as a calm chat with my step dad turned into him losing his rag and being very unfair to me. (Calling me pathetic etc). I know this is him struggling to cope with acceptance of his disease but I’m not prepared to be a whipping post in that respect.

He seems to think I’m meddling but I would love for us to be in a situation where I don’t need to be involved. I have had rheumatoid arthritis for over 20 years and have limited use of my right hand, struggle with fatigue, pain and all the other rubbish that comes along with it. I’ve had nightmares every night for the past week probably due to stress and today I’ve given up and just come back to bed for the day.

I also have a lovely 7 year old son who will be on school holidays so it’s going to be so difficult managing it. No support from my husband (that’s another story), as he will be away visiting his family (abroad) - a trip I should be on but will be postponing due to my mums hip op.

I guess I partially needed a vent but would also like to ask what sort of care will my mum need at home post op?

I now feeling like I’m treading on egg shells as my step dad has made this massive fucking elephant in the room.

I’m just so angry that my mum can’t even have a hip op without it all becoming about my step dad!!!

That's a horribly difficult situation to navigate. I strongly recommend getting outside parties involved if you can, to take some of the emotion out of the conversation - adult social services, the hospital discharge team (especially the OT), whoever you can bring in to give an objective, professional view. And sit in on meetings if you can to counteract your mum's minimisation.

It sounds as if the ideal would be getting your stepdad into respite care while your mum recovers. Unfortunately that would need them to both cooperate. The next best option would be to see if you can get residential intermediate care for your mum after the op rather than her being discharged directly back home. Unlikely, but worth a try.

Thanks for replying.
You’re absolutely right - I’ve said all along the best thing for my mum would be for my step dad to go into respite care at least for a couple of weeks, but he absolutely will not agree to it. He actually ended up in respite at the start of the year after 3 failed hospital discharges following on from a bout of pneumonia after letting himself out in the middle of the night (confusion due to UTI) and collapsing in a field when it was -2.
He really enjoyed the respite (which only happened as I insisted the third time he was discharged that he couldn’t come home as my mum was a dead soul by this point). He now sees himself as ‘much better’ and wouldn’t consider staying there again.

I’ve asked to sit in on any appointments and also insisted my mum formally make her gp aware that she’s an unpaid carer.

I’ve actually suggested to my mum that she consider discharging direct from hospital into respite for the first week. I don’t think she’ll do it but I’ve planted a seed. Only problem with that is what happens if step dad has a fall etc. I don’t think he’s safe to be left for so long. But at least my mum would be safe. It’s exhausting!

Also with regards to getting outside services involved - they’re both incredibly good at putting on a great show as if they’re coping with life and will contact the necessary service providers if they need help (but they wouldn’t!).

After a new hip they'll get her mobile as quickly as possible to prevent clots, sores and muscle wastage. She'll be seen by the OT before release and they will ask her about her home situation and provide aids as much as they can. These will not need to be returned (oddly) so can be helpful (possibly) for your SDad.
Things like walking frame, perch stool for the bathroom, frame to push up off the loo etc. when FIL broke his femur the only extra thing we bought was a sock putter-on gadget.

I completely understand why you are feeling overwhelmed, but this access to OT help focussed on her needs may actually be a benefit to both of them.

Make sure that you talk through with her what kinds of things she thinks might be useful for her as she recovers. Getting a proper OT assessment for her might just be the thing that helps their overall situation for both of them.

So sorry about this situation. Sad and frustrating. I know you really want to help, but I would gently suggest that you become clear in your own mind about what support you are willing and able to offer.
It would appear that your mum and step dad have mental capacity. In this case, they are entitled to make their own choices, even if you 'deem them to be unwise'. Now this can feel like a cop-out, and if you leave them to make unwise choices and something bad happens, you risk feeling very guilty.
But, allowing people to make their own choices is what is considered the best thing for all of us, even if we don't agree when it comes to our own parents. So by all means make some suggestions to mum, and make yourself available in that two week period, but if they are adamant that they can cope, you may need to wait and let the wheels come off, as they probably (definitely?) will.

Before mum goes home after her op, she should be seen by the discharge team, and if it's possible you could have a word in their ear and mutter the magic words 'unsafe discharge'. If you can, let them know what the situation is at home.
While I have sympathy for your mum and her husband, I am more concerned that this situation is totally unfair on you. Are you able to pick him up if he falls? If it's not simply a question of finding him a bit of solid furniture to haul himself up with, you should not be doing it. Mum is unlikely to be able to get out of bed or into the toilet unaided for a while.
Hopefully they will realise that for themselves before she has the op, but if necessary they need to live the consequences of their choices, with you on hand to ensure they get professional help when they need it.

You have your own health and your young son to consider. I wish you all the best 💐

I've had hip ops and kicked DH out of the bed every time! Partly for my benefit - I want to be able to spread out fully and have pillows and things everywhere and anywhere and have zero risk of being knocked, but also for his, I slept badly for a few weeks, got up in the night, read etc. so it was in everyone's interest.

The most important thing post op is to prioritise exercises and rest. A daily cycle needs to be wake, eat, wash, exercise, rest, eat, exercise, rest etc. don't worry about achieving anything else or about napping in the day, just make sure the exercises are done - it's the best way to get the best results.

Someone else taking on anything else that needs doing in the house is perfect.

All the best.

Sorry to hear about your situation.

My mum has had both hips replaced in her 60s. Both times she was up and about within a day and back doing jobs with the horses (gently and not handling them, but mucking out etc.) by the next day. She has bad arthritis everywhere including spine but is generally very active, 15-20,000 steps a day etc.

She found a shoulder replacement much more debilitating and painful.

Fingers crossed that your mum will find recovery similarly straightforward!

Try to get your mum into nursing home post op for a few weeks and let the 'capable' step dad cope by himself as he says he can. If he won't accept he needs help then just try to shield your mum.

In my experience @Brbreeze's mum's recovery is the exception rather than the rule. But still, also on reading the other replies, it's all very well suggesting this and that, but if they want to ignore it and do their own thing, they'll have to face their own consequences. They will figure it out one way or another. You obviously care deeply @BhxEzs and that is why you are so stressed that you have taken to your bed. I can totally understand that response! And the nightmares 😔

As I said before, just be on hand, and don't do more than you are physically capable of. And none of this is of your making, so stand firm in not letting step dad treat you badly.

I'm very cross on your behalf!

Does your mum have another appointment regarding her op soon? If so, go along with her, ask the surgeon about post op rehabilitation/expectations, help your mum will need, explain about your stepdads condition and what that entails for your mum … I imagine the surgeon/admin will get the ball rolling with how to proceed.

Slightly off topic, but there is a cognitive element to Parkinson's disease, too.

People's executive function diminishes and they become very concrete in their thinking. Ability to predict the consequences of actions, emotional lability, seeing things from another's point of view, memory issues and ability therefore to learn from mistakes/exoerience, patience, etc, all start to be affected.

Not excusing behaviour, but worth remembering when you're trying to negotiate or explain the position!

@50plusproblems she’s got a pre op appointment in 2 weeks but is that just doing blood pressure etc? I’m not sure if there’ll be any one to properly chat to then?

I’ve had some counselling over the first few months of the year as I’ve really struggled. (My real dad has vascular dementia/hydrocephalus just to add to the joy of it all) and I do feel I’ve got a better sense of boundaries now. I also feel I can see where things are actually other people issues rather than something that’s down to me. So that all helps.

@CreakyDormouse you’re spot on with that. They do have capacity and only in their 60’s. I just hate the thought of my mum struggling and I feel responsible for making sure she’s not ‘lost’ to being a carer if that makes sense? (Totally contradicting my previous para about boundaries and guilt 🙈).

My plan is to step back over the next few weeks from any physical or emotional support I’ve been giving my step dad. He seems intent on proving himself. I’d love to see him embracing life with all the mobility aids etc on offer and actually being able to do more than he can now. But he’s intent on keeping this charade up. Maybe it’ll give them a bit of a reality check.

I definitely couldn’t pick my step dad up as he’s 6’4”. Problem is he’s never bothered to follow through with any physio so doesn’t have the upper body strength to lift himself up.

@AndSoFinally that is so evident now too. He’s just not able to risk assess at all putting both him and my mum in danger.
I just don’t know how to talk to him about it as he’s unprepared to discuss it.

Pre op should also cover how you will manage at home, checking bed, loo and armchair height, stairs, help, bathing facilities etc. Or if it doesn't, should refer you to OH to get it covered.

Edit: to remove autocorrect of 'loo' 🤣

Having just had dh come home disabled, and knowing a grandparent with parkinsonism, and hip and knee replacement, can I suggest you get improvement s done with both in mind. I worry about the parkinsonism as my grandad became v aggressive and possibly abusive with it. His personality changed a lot. Your mum needs a rest, can she move in with you instead, or go to respite? You could do with home help in for both, really. Good luck.

i am so sorry that things are so tough.

My mum had a hip replacement 5 weeks ago ( mid 70s but otherwise good health) .
all went smoothly. She can home from hospital on day 3 , able to walk with crutches, climb the stairs independently, get herself to the loo with seat raise , get in and out of bed independently. She did do all this very slowly for 2 weeks and needed someone to be around. I put a pillow under her knees , tucked her in, fetched cups or teas and meals etc. She was uncomfortable in bed .
She was shattered and able only to do the absolute minimum with several naps during the day. She is still pretty pale and tired 5 weeks post op. She will be able to drive from 6 weeks .
Essentially your mum will need someone to be around and pamper her a little. She will need a bed to herself ( and will be very sore) and will not be able to care for your father.

Your mum needs to speak up and tell him she's struggling. I'd be bringing your mum home to your house and leave him be, maybe then he'll realise how much she does for him.
Time for some tough love.

Thank you everyone. The points and advice everyone’s giving is really useful in terms of helping give me some clarity.

My mum and my husband have a strained relationship so I’m not sure whether she’d stay with me but I will suggest it.

In terms of improvements, their current house is out in the sticks and totally unsuitable. They’re in the process of purchasing a house near me which I will be overseeing the renovation of to make it suitable for my step dad now but also future proofed for my mum, should she end up there on her own one day. Unfortunately the hip op can’t wait another 12 months as she’s left it to crisis point as she never felt she had the time to get it done as my step dad and her mum (with Alzheimer’s but in a care home) require so much of her time.

You tell her she needs to stay at yours, how else will you look after your 7 year old if your DH is away ?

I would also suggest to talk to her alone and state that you cannot look after stepfather as well, in no capacity. If they don't arrange something and he falls when he is on his own, the only course of action you will be taking is phoning an ambulance as neither you nor she are in a position to lift him.

Actually have this chat regardless of where you and your DM end up staying.

@BhxEzs I would definitely chat to the pre op nurse, she will definitely feed back to the surgeon, and whoever else needs to sort it.

@rookiemere my son would come and stay at my mums too. Which of course would be rubbish for him. I’d just try to do my best between taking him out for a couple of hours/friends for play dates and a bit of holiday club. It’s rubbish that it’s happening in the summer hols but I’m glad she’s finally getting it done. My husband works 6 days a week normally anyway so I’m used to not having him around.

I spoke to my mum on Sunday and voiced my concerns. I also said I felt that I was forced into being ‘bad cop’ by actually acknowledging my step dad’s limitations - addressing the elephant in the room. Also in the past when I’ve taken mum out places for a break or once for a weekend away as she desperately needed it, step dad then feels left out. I’ve asked her if she would be more open with him about how much it’s affecting her but I don’t think she will as she’s terrified he’ll fall into a depression. (I’m terrified the same will happen to her!).

@BhxEzs be kind to yourself and your DS as well.
You have a chronic health condition and are more or less looking after your DS by yourself.

If it's easier for you and your DS to have your DM at your house instead then that's what you offer. It sounds like your DH isn't around enough for it to be much of a problem that he and your DM don't get on.

You cannot and should not be looking after three people - your DM, your DS and your DSF, particularly with your own health conditions.

I know you said your siblings are not in the same country, but this seems like a perfect opportunity for one or two of them to step in and travel over for two weeks to support your DMs recovery.

If you do insist on doing it at your DMs house, you do not lift your DSF, or even attempt to do it. Any issues call an ambulance. It's very sad what's happening to him, but you have to compartmentalise as your DM seems unwilling to do.

It sounds like a very difficult situation. Does your step dad have any children of his own who can help him? It all seems to have landed on you.

I stayed with my DM for 2 weeks after she had a knee op. I had to put a chart on the wall to remember to administer medication on time, ice packs, help with exercises, food - I just never seemed to have a breather. She was in her 80s though.

@Iloveacurry he does but they live on the other side of the world. As they don’t see him often they don’t have a full grasp of how intense it is. I have tried to keep them updated but often my ‘updates’ are read and not responded to. I guess they feel relatively helpless. I don’t think they can afford to travel back again as they all came in spring for a family wedding.

Thank you @rookiemere. Actually thinking about it and my husband will be away visiting his family so it makes it more of a possibility.
When I tried to talk to my step dad I did end up saying I wouldn’t be assisting my him any more as perhaps I’d overstepped the mark with the help I’ve offered in the past. He said I was being pathetic but truthfully I just don’t have the energy to constantly be on eggshells and carry on pretending everything is fine.

I think all the comments have helped balance things in my head so thank you.