Crisis pending😩

[StarDolphins]

Mum age 78. History of strokes/heart attacks. She’s a hoarder & lives alone with carers going x3 per day.

She is deemed to have full capacity but has some MH issues which she hides.

She discharged herself after her stroke saying physio doesn’t work & didn’t engage. Refused it once home. Refused carers but eventually agreed. She broke her hip & discharged herself again.

She has bad knees & now muscle wastage as she only goes from side to commode 2 steps away.

She doesn’t shower or wash. I go once a week & she will let me wipe clean her & change her incontinence pants.

She fell a week ago. Ambulance was called, seemed nothing has broken but they wanted to take her to hospital for a scan. She refused.

Carer is texting every day saying she now is not even moving off the day bed as her knee pains her & is soaked at every visit.

What a total mess. She has been difficult all my life. I just don’t know what to do😩anyone got any advice at all?

Your mum needs an assessment for a care home placement. Unfortunately if she has capacity she can refuse this. Can you speak to her GP. GP may be able to offer advice.

Thank you. Will speak to GP. They know her history of refusal & I’m sure she’ll refuse care home too.

What a mess.

From my recent experience - try and encourage your mum to get mobile asap. Every day she doesn't move she loses more and more mobility and will end up bed bound, and she's young for that to happen. My father had a fall, spent 5 months in hospital as he kept getting repeated infections, hospital staff don't have the time or resources to walk them round the ward and after 5 months of being in bed he now can't walk at all and is unlikely to ever again.

Sadly if she 'has capacity' then she has capacity to live like this and is choosing to do so. You can't choose differently for her, so dont wate your energy beating yourself up because you can't. I think you'd be a lot better fully accepting her 'agency' and her decisions, and working with them not against them. The carers clearly feel you would want to know - and I think it's right that they inform you. But hopefully they and you can accept that she won't be told,.and responsibility (and any blame) therefore sits squarely with your Mum.

Do as much as you can bear (like the weekly wipe) to keep her more clean and more comfortable than she would be without, but don't fight her. You will exhaust yourself, but the outcome will probably be much the same.

My Cousin had an elderly Aunt who was extremely "difficult" until one day my Cousin's husband said "we're not going over this weekend"... they were cleaning the house, doing all those things that made it look as though Aunt was managing. Well thank God they didn't go over that weekend. The shit literally hit the fan, the facade came down and Aunt went into a lovely home where she was looked after.

If she is not really getting out of bed then in some ways her care is easier and she is safer. She needs regular pad changes with assistance from carer and meals provided. Has she got a hospital bed? You can get really high absorbency pads from Age UK continence shop which will help her not be soaking in the morning and you can get a washable incontinence sheet to go underneath her bottom area. Maybe ask for an urgent community occupational therapy assessment to check how her care needs can be met.

How often are carers going in and is she funding them herself?

You have done all you can, this is her choice, you can only react to what happens next.