Refusing a Care Assessment - any advice?

[BlueLegume]

Hi lovely people. I will try and keep this brief. Mother has been referred to Adult Social Care. She is self neglecting - not showering, not dressing, not eating food provided, not taking medication. Adult Social services contacted her earlier this month but she has refused to let them do a care assessment and refused them permission to contact her GP surgery. The ASW was excellent in terms of saying she will do an unannounced visit BUT what then happens if mother refuses access to them. Any experience or advice on this stage of things would be appreciated.

@Lastknownaddress yeah totally get it. Kind of have my stuff in hand as you say. Just the expectations of a very superior SIL - and our brother who seems to also have expectations but never voices them until I/we sis ‘fail’ is exhausting. Savage is a brilliant word. ☺️

I remember finding out my "D"M had been badmouthing me to other family members despite all the travel I'd put in, I wish I'd said something at the time but didn't and it just really festered away at me.

I would have a think about whether it's worth telling your brother that things he has said are getting back to you. And also whether it's worth saying that you're going to do nothing whatsoever until you they both start meeting some conditions (reasonable expectations, self care, whatever). And then just sack the pair of them off until their attitude gets better.

Expecting you to give up your life and move in is a ludicrous expectation and you need to make it very clear that it's not ever happening, and they need to get the idea out of their heads.

Also, she only owns all the cards if you let her. At the end of the day if you don't see her you can have a nicer life without her. She on the other hand loses a lot of support.

Thanks @JohnPrescottsPyjamas she definitely has always lacked empathy but sadly I think her personality ‘thrives’ on negativity. @HoraceGoesBonkers I am comfortable knowing I cannot do anything right for her so if people see fit to criticise then I will just have to suck it up. We are now at a stage where all her half truths to family, neighbours and friends are getting found out. Her response is always ‘oh I didn’t mean to give them that impression’. But she did because in the moment she portrayed herself as a victim and garnered sympathy and attention. A recent one was a neighbour who explained our mother had said 18 months ago ‘Blue isn’t speaking to me because I put (Blues Dads name) in a home and Blue wanted me to look after him at home.’ This is the absolute opposite of what happened I had to fight tooth and nail for my mother and brother to see he needed residential care. I even offered to pay the fees…we luckily got CHC so that never happened but you get that I wanted him in the home so he could be properly cared for. I have tried to contact ASS today again as I am so fed up and whilst walking away seems easy on paper it is so hard to do in real life.

Thought I would update you lovely people. Adult Social services have been in touch to tell us that our mother cannot be forced to have a care / needs assessment. The social worker was incredibly helpful and answered my questions when I asked how my mother reacted. It was no surprise to hear that my mother had told the SW that she would not accepts carers as and I quote ‘I did not put any of my 3 children in care when they were babies or children and I gave up my job to be a housewife to look after them myself’. The SW told me that mum clearly expects this ‘transactional behaviour’ to be repaid now she requires care. SW was clear there is absolutely no expectation from them for us to do this but we do have choices and one of those choices can be to back away and let the crisis happen.

My mother’s response speaks volumes about her. She clearly feels she is ‘owed’ this care from family because of ‘sacrifices’ we did not ask her to make when we were babies. The reality is that in the 1960s she just did what most parents did and IF she did it because she was ‘banking’ on us ‘looking after her’ in old age she should have made it clear to us and not spend her life telling us and anyone who would listen that ‘I will never ever be a burden to Blue, Blues sis and Blue baby brother’.

@BlueLegume That’s really helpful and clearly very cognisant advice from the SW. They’ve obviously come across this similar behaviour before, which hopefully is of some reassurance to you?

Fascinated by this reference to ‘transactional behaviour’ as I recognise it so well. I always referred to it as my mother’s ‘payback’ routine. Everything always had a metaphorical price. If she did me a perceived favour - even one not asked for - she would almost set up a tab and call in my emotional debts. She would endlessly refer to the ‘sacrifices’ she made for me as a child, how she gave up a career, her social life, overseas holidays etc etc to ensure she was always there for me. Ironically, she wasn’t interested in a career, had very transient friendships and never wanted to go overseas as she didn’t like anything foreign anyway. My father brought wealth into the marriage so she never wanted for anything and always had the financial clout to do everything she always wanted, so she never actually forfeited or had to compromise on anything.

i must be a very similar age group to you as I was brought up in the same era and so much resonates the same way.

“I never want to be a burden to you” was a regular mantra too, despite her being incredibly needy, pretending she couldn’t cope and then, once she’d got my attention, demanding everything was done her way or we’d have the temper tantrum and sulks. Followed then by the reminders about how much she’d done for me when I was a child. Once I became a mother myself, I realised that being parent does involve giving up certain things and compromising on others, but that’s entirely the life choice I’ve made and I don’t hold my children responsible for those choices and I certainly didn’t have them for insurance and to recruit as free carers for my old age.

This transactional relationship stuff is very familiar. Not only with [female] children but there's a weird transactional thing going on with friends where she can't accept an invitation to do something as she then has to invite them back and she can't be doing with that, so she doesn't accept the invitation. Or she decided the invitation would "put them out" even though they're the ones doing the inviting so she declines out of pity for them. It's a completely warped view of relationships.

I definitely don't keep tabs on relationships with friends and whose turn it is for whatever!

@JohnPrescottsPyjamas @EmotionalBlackmail if it wasn't so horrible to live with it would be incredibly fascinating. As to the over complicating of invitations she has also always been really odd around them…’oh but you are busy’ ‘it’s too much work for you’ the list is endless BUT then she massively outstays her welcome - think me inviting them - I am going back to the early 2000s so well before ‘old age’ kicked in…Sunday lunch. Mum and Dad I will be serving the roast dinner around 2pm. If you come for say 1.30 that will be great. The children have school tomorrow so it would be helpful if we wound the afternoon up around 5 ish so we can get school ready and have an early night.

The various incidents off the back of this type of exchange include:
Being late by an hour at least.
Arriving an hour early but expecting to be entertained.
Saying ‘if you are laying down rules and times we’ll not bother as it’s clearly inconvenient having us.
Coming in their car but arranging a taxi home ‘so we can enjoy some wine with our meal’ and said taxi being ordered far later than is convenient when you have young children and refusing to budge when you say you will sort a taxi for them because they will only use the taxi firm local to them
The last one also then came with the next day message of ‘oh Blue can you come and pick Dad up so he can get our car from your house?’……an hour away on a good day.

So yet more examples of transactional behaviour well before ‘old age’ kicked in.

What I will say is how impressed I have been with the attitudes of the social workers. Zero expectations of us in fact very much advising to ‘let the ball drop’ and then they can intervene - within reason obviously. Yet another conversation with our mother today where my sister asked about the carers our brother keeps telling mum he will organise if she doesn’t start trying…apparently he hasn’t organised anything yet but he is planning on talking to mum about it next week. Rather like his parents head in the sand and keep putting things off until one of the bad daughters eventually sorts it.

Yep, mine did similar about timekeeping but only ever being early, and any sort of attempt to put down boundaries (please don't turn up early/please don't book a hotel in the town we live in without checking dates) resulted in a huff and/or tears.

I think she's made her position really clear so if you haven't already, tell her there is no way you're moving in and leave her to stew for a bit, and make this clear to your brother.

I think any attempt to help her now, at least until it's sunk in, will be interpreted as you leaving the door open to becoming a live in carer.

My mum had quite a few goes at hinting about me caring for my Dad, the one time she outright told me I had to do it I phoned her back the next day and said I couldn't, she then pretended she hadn't asked me! Then she started again a bit later.

This could be a defining moment for you all @BlueLegume
Continue to be the "bad daughter" and don't step in this time. Let the cards fall where they will. I'm going through something vaguely similar with my own father at the moment and I've now reached this point.

I think some folks need to hit rock bottom and as adults they are entitled to fall to their rock bottom if they wish. We, as the children, don't need to be the safety nets if we are going to harm ourselves in the process.

That’s very wise advice. It’s not easy, and because we’re all so programmed and expected to be respectful and kind to a parent, it goes against the grain, but it’s true, she’s an adult that’s been assessed as having full capacity and therefore able to make her own choices.

I never realised at the time, and this thread has opened my eyes to the fact that the time keeping nonsense my mother also indulged in, was a way of pushing boundaries. I always knew she would arrive at least an hour earlier than we had agreed, even if I had explained that there was a reason for a specific time. If she was staying in my house, she would get up ridiculously early and then proceed to make a lot of noise, turning up the TV or radio and crashing around until it was impossible to ignore her - this could be 5am at the weekend! She would then make comments about “laziness” and “people who are bone idle”

@JohnPrescottsPyjamas it is so interesting putting the lifetime of jigsaw pieces together. Sadly though no one really listens to me when I say - she has always been contrary, controlling and never valued my opinions. It is all wrapped up in ‘cognitive decline’ possible ‘dementia’. All really horrible for people with it but I have lived almost 60 years of manipulative behaviours.

Always just a bit off key but to make herself seem superior.

Yep. Your experiences with your mother sound so uncannily familiar - except mine definitely did eventually have dementia, which was not recognised by anyone for quite a while because her irrational behaviour, deliberate obfuscation and contrariness were just so ‘normal’ and we were so used to it, no red flags were raised.

What is strange how some of these jigsaw pieces and forgotten incidents suddenly come back to you too. Whilst typing my reply earlier, I remembered a very odd incident some 20 years ago when I’d offered to drive her to a ladies club social do that we were both invited to. I’d agreed to pick up a friend of hers on the way, but at the last moment, my husband volunteered to drop us so I could have a drink too. When I told her this was now the arrangement, she had an absolute and illogical meltdown. She literally screamed at me and told me it was so embarrassing as she had told the other woman I was driving. It made absolutely no sense whatsoever as it made no difference to her. She did a similar thing, embarrassingly at a funeral. In order to reduce the number of cars, we arranged to share with another couple and she was included, but she threw a hissy fit because it wasn’t the way she wanted it.

Wow so much of this resonates and in a week when I’ve had a lot of vitriol thrown at me (practical, geographically closest bad daughter). I am guilty as charged for putting him in the nursing home - but following medical advice and because we were all losing our minds.

DF is ‘sick of assessments’ and swears he is better and doesn’t need nursing care even as he presses the call button… I think the assessments are everyone trying to figure out what to diagnose him with and ‘bloody difficult’ isn’t a medical term.

DF definitely thinks his children should be doing all his care and sacrificing our lives for his (although he doesn’t need any care because he is better - but he does need us to step up).

I think there’s a bit of an obsession with ‘leaving a legacy’ that children / grandchildren should all ‘be grateful for’ when in reality the ‘legacy’ is needed now to provide 24 hour care. It all smells of wanting to keep up appearances even after death.

@JohnPrescottsPyjamas I smiled at that. It's like they have at some point in time gotten together to plot ways to wind people up!

We stopped staying at my mums (the pandemic was an excuse) because she'd get up super early and crash about the house, do the dishes with a lot of banging of cutlery, slam the doors etc. My kids were quite young and the last thing I wanted was for them to get up early.

She'd also text us really early when Dad was ill, when of course everyone was keeping their phones on and being on edge.

The early morning thing, and turning up early for things (even when I explained I would not be available) seemed to be a sign of moral superiority. Rather than just bad manners.

@JohnPrescottsPyjamas really interesting to hear about the dementia diagnosis and the link to her normal/usual behaviour. I sense our brother is pushing for a dementia diagnosis and would not be surprised if he has already ‘diagnosed’ this himself because he refers to her as being ‘ill’ constantly. As in previous threads and messages I have taken her to the GP and to a specialist but they were not alarmed at her and did not raise any issues other than her being a bit down in the dumps and not being prepared to try and help herself. She refuses to engage in any kind of activity, she won’t read a book - in short anything put in front of her to help things she is utterly defiant in saying ‘that doesn’t work for me’. She has a superiority complex and always has. She could never buy high street clothes ‘they just don’t work for me’ - she is a normal sized person she just never wanted to be seen wearing the same thing as someone else. Always long days out to far flung towns with boutique ladies shops where she was treated like royalty. I took her a couple of years ago to her town centre department store. It was quite an insight. Grabbed some things for her to try on - she refused to go in the changing rooms - individual cubicles with lockable doors. Out loud she said ‘Blue you don’t expect me to try things on with the riff raff’. Everyone heard.

Everything is over complicated. these people end up with daughters like us, capable, imaginative and problem solvers because we have never known anything else.

Yesterday another phone call - oh I dialled you by mistake. no you did not - you dialled me because you want to keep me on my toes and you know I will call back. Much as a diagnosis might appease my brother I agree with @FiniteSagacity and the ‘bloody difficult’ comment. I have had almost 60 years of this woman and her demands - no one was looking for a diagnosis when she made my life a misery as a kid and teenager. If only.

@BlueLegume That is so true and genuinely sad - “no one was looking for a diagnosis when she made my life a misery as a kid and teenager“

With hindsight, clearly these women had some kind of either undiagnosed MH issue or personality disorder, which we as children bore the brunt of, and ongoing throughout our lives. Because their behaviour is all we experienced as children, we tend to assume it is ‘normal’ parent conduct. Looking back, I realise I spent all my childhood in a state of heightened awareness, anticipation of trouble and genuine fear of consequences and repercussions, which is so mentally destructive to us as well.

She was never diagnosed, as she would never have acknowledged or recognised she had a problem, but she so fitted and ticked all the boxes of NPD. It was some sort of comfort to me to see that her issues were not my fault too, as whenever she lost her temper or was irrational, she always accused me of driving her to it and somehow it was me (a child!) that was responsible for all her bad behaviour. The was absolutely no self accountability whatsoever on her part. Everything was always someone else’s fault.

I'm an eternal people pleaser and am always worried I’ve said or done the wrong thing, so get completely the sense of obligation you feel with regard to your mother’s care - despite her manipulations and rejections of help. I wish I’d been brave enough when she was alive to just walk away. I was very cool and measured with her in her later years because by then I had learnt not to engage with her provocations, which frustrated her because she loved a drama to feed off and I wouldn’t give it to her. But like yourself, it took nearly 60 years before I finally wrestled control off her, and even then she was still breathing down my neck and managing to affect my mental wellbeing.

As I’ve posted before, I wish I had a solution or practical suggestion to help you, but all I can offer is solidarity and a recognition that, because of frightening similar mothers, you are not alone. Xxx

@JohnPrescottsPyjamas thank you. The fact someone else such as yourself has taken the time to read my posts really is helpful. I feel I have done all the reading and self help around the situation so have the ‘toolkit’ so to speak BUT every now and again I feel like I am in one of those toy machines in a fairground and the mechanical arm comes down and ‘picks me up’….that arm is full of fear and obligation so all my hard work of self awareness is eradicated in the moment.

In reality even getting her a diagnosis and whatever treatment/medication to go with it we could only ever hope she would go back to the slightly less difficult version of now. I truly believe our brother knows this but cannot face the actual reality. I mentioned on a thread last year that he had text me a couple of years ago about the state of the storage shed at our parents. They hoard cleaning products, medication, toiletries etc just any stuff really - he was outraged at the state of it. When I explained my kids used to ask to play in ‘grannies shop’ - said kids are now nearly 30 - he was aghast. It is at times quite laughable that an almost 50 year old man is only now waking up to the reality of his parents lifestyle and behaviour-what is not laughable is him having expectations of what he think his sisters should be doing for our mother. What is not laughable is him and his wife bad mouthing us to anyone who will listen when these people have not walked in our shoes for decades.

Thank you so much - this little safe space is life saving at the moment.

So our brother and his wife have now actually said out loud what my sis and I have suspected for some time. That ‘their’ time is more valuable than our time because we are retired. Yet another implication that we should be doing more as they have ‘full on careers’. Am I surprised-no. Everything with them seems to be measured in currency. When I pointed out that how I spend my actual money is my business - and how they spend their money is their business and not something I would wade in on they seemed to miss the point that the same applies to our time and their time. What we do with our time is up to the individual and should not be dictated by others. Bit of a ramble there but clearly they have an opinion. The irony of all this is we have never asked our brother to ‘do’ anything in particular. He takes on tasks that just make the whole situation with our mother worse.

I’m annoyed just now but am interested if his response to me about time being a currency is me in the wrong. His words were ‘what a stupid word salad Blue, typical you’.

Well done for not punching him in the face @BlueLegume.

edited to add: you are NOT in the wrong!

Thanks @FiniteSagacity -I am not after validation I am genuinely interested if my analogy was ‘stupid’.

TBH SIL has asked in the past of both my sis and me….’what exactly do you do all day?’

She knows nothing about our lives which is possibly why but even so it was said in quite a passive aggressive manner. She is very much married to her job. Her words.

Your analogy is both accurate and valid. DB and SIL do not value or respect you and your sister.

Your journey so mirrors mine that we could be sisters. My mum died a year ago after refusing to engage with anybody. She had been the same all her life.

@StopGo sp sorry. It’s horrible. I really don’t understand that it’s ok for our brother and his wife to tell people sis and Blue “don’t care”. We do if we didn’t we’d have walked away. Thanks - you do question yourself.

Self neglect is coveted under section 42 of the care act as a category of safeguarding. The social worker has a duty of care and can't say they can't do anything because she has capacity. Under section 11 of the care act the local authority has a duty to carry out an assessment if someone lacks capacity or they are safeguarding concerns. I haven't read all the posts but sometimes people can talk the talk but not walk the walk which could be an executive functioning issue. Don't be fobbed off there is a duty of care sp quote the above legislation x