Any tips for how to get parents to take the first baby steps into getting support?

[girlfromthesouthcountry]

I think we have arrived at this point, but I'm getting nowhere. My DP are late 70s/early 80s and live fully independently. DM has been declining for about five years, and is now in quite a bad way. Without going into massive detail, her cognition and memory are very poor (she's diagnosed with MCI, but I'm quite sure she has dementia, and if anything progressing from early to mid stage). She's depressed and anxious, and has cut off almost all social contact except immediate family. She has a whole host of health issues that mean she feels unwell all the time, and this is the whole focus of her life.

DF is still in theory fully capable (does all the financial admin, IT literate, physically very active etc) , but there are signs that this is starting to slip. He's increasingly uncertain about mum's medical appointments and medication, and just generally seems a bit less 'on it' than before. I think there might be an element of carer fatigue, along with him just getting older.

DSis and I (neither of whom are in a position to provide regular, hands-on help due to distance and work) are increasingly concerned. DM is getting worse and worse, and is definitely a fall risk. They lurch from one medical appointment to another, none of which ever seem to resolve anything. The house is grubby. I'm not convinced that DM is taking her meds properly. Although DF can still go out and about for a few hours atm, I can see a point arriving quite soon where that's no longer possible.

I've tried to suggest that they start getting in some support, but I'm getting nowhere. They both just focus on the next appointment, hoping that this is the moment that someone will press the magic button and make mum better (at least physically), but it's increasingly clear that that's not going to happen. I've suggested Attendance Allowance, house safety adaptations, a cleaner, a fall alarm, getting mum out to a social club etc. All met with a stone wall. They're not in any way hostile or difficult - they're lovely, and very grateful to us for caring about them - but they're in denial about the reality of the situation, and I think they see any kind of help as an acknowledgement that this is now old age, and it's grim. DF loves a bit of black humour, and he's quite happy to joke about death - but he's much less good at talking about frailty and care. I suspect they would see any attempt to get a care needs assessment, for example, as an interfering lot of nonsense.

I know the advice on here is often just to let the crisis happen, but I'm trying to see if there's any way of avoiding that, and improving this situation. We have PoA, so we're set up to deal with a crisis - but I want to avoid the crisis happening in the first place if I can.

Does anyone have any tips on how to get parents to take that initial first step of accepting they need external help?

I have two siblings and the three of us did gang up on my mother so that a carer came in.

It was 'sold' to her very much as just someone who would offer a bit of companionship/maybe keep an eye on things, as she resolutely maintained she - or my brother and his wife - could do everything.

I think this is not an uncommon thing and some care agencies will go along with the 'just companionship' idea. The point is that the relationship with the carers has to develop so that parents will allow themselves to be assisted by people they trust. At first the carer might just be making a cup of coffee and/or saying 'Why don't I do these dishes while I wait for the kettle to boil.' So it helps to find a care provider that won't just deliver a succession of strangers.

Do they have any friends or relatives of similar age who’ve got in carers and it’s all going well who you could use as an example? Eg now Fred has this wonderful cleaner/companion he’s been able to get back to that club he enjoyed?

I spent a year trying to get mine to have a keysafe. refused to consider it. It was only when a friend had a stroke and narrowly avoided having to have their door broken down by paramedics that they suddenly got one installed (so they could have a sense of superiority over the friend, who became, “wasn’t Sally silly not to have a keysafe installed”?!)

I had good success getting my parents to accept a gardener by asking them to employ a friend’s son casually to do some heavy work when he was between jobs to help him out. This opened the door to a bit more help and I’m hoping to a regular gardener from next year.

Girlfrimthesouthcountry

My mil has the type of Parkinsons that does not cause tremors. It’s about the only symptom she doesn’t have.

@girlfromthesouthcountry just to say that a couple of things associated with fainting in the elderly are “postural hypotension” generally related to tablets for high blood pressure and happens when standing up. The other that gets more common with age is narrowing at one of the valves in the heart “aortic stenosis” it might be with asking that the GP listens to his heart at the next appointment.

Thanks both. We know that mum has postural hypotension (evidenced by BP readings), but nobody seems to have pursued this when they've mentioned it. Don't know about dad. The Parkinsons possibility definitely warrants a conversation with the doctor.

My efforts to encourage help at home are continuing to fall on totally deaf ears. Their levels of confusion are definitely getting worse. Mum doesn't really understand what any of her appointments are for now, and has refused the GP's recommendation of a colonoscopy as she doesn't want to go through the process. Dad and I have fairly sensible conversations about the things re mum that he ought to talk to the GP about, and then he comes out of the appointment either not having asked or not remembered the answer (in spite of me encouraging him to take a notebook). They've just had another apparently pointless GP appointment when he came out just saying the doctor had been 'a bit vague'. Mum's got a specialist appt this week and has zero understanding about it, and is petrified (even though it will be totally non-invasive).

The only thing I can think of to do next is to ask to go to the next GP appointment with them, and see if I can start a relationship with the GP and maybe even get added as an authority onto mum's record. That means a day off work though, and I do worry about the slippery slope. I'm considering applying for a much more full-on job at the moment, which I really want to do, and the only thing giving me pause is the fact that I'd become even less available for mum and dad. Just as the kids finally need me a bit less... It's hard.

Can you phone up their GPs and ask what the process is to get added on so you can speak to your DPs GP?

For me it was getting them to sign a form each and then emailing to the doctors. I have managed to do this for both now - I may have done some slight subterfuge to get DF (forgetful and ornery as heck) to sign his.

If you have that then you can ask the doctor what was discussed at the appointments.

I don’t know what the right answer is though. I did go to DMs neurology appointment and was glad I did because I could explain a lot of her symptoms with more clarity than she could , and she clearly appreciated me being there. But you’re right it’s a very slippery slope and she now expects me to attend both DF and her appointments, regardless of when they are. My circumstances are different though as they are an hour away and I am currently job hunting and looking for part time work, so I have a bit of time to do it.

Maybe consider asking the GP if you can join appointments virtually? Even just on speakerphone, even better via Attend Anywhere or whichever video call platform the doctors are using.

My own view is that the time spent going to the appointments really is worth doing by you - pretty much everything else should be outsourced. Unfortunately this is probably the opposite of what most of our seniors want. But in the real world, having information lets you make better decisions about the other support. Including decisions about not having further appointments about certain things.

Watching with interest and sympathising. my Mum is over 80, lives alone, I live in Europe, visit every 2 months (not easy to do more as I have kids and full time job). I tend to spend my whole time when I'm there cleaning and sorting. Trying to find a local cleaner. It's worrying with the cognitive decline I've noticed. I'm not sure at what point it gets bad enough that she needs keeping an eye on. Right now I think she's ok, and does have a lot of social activities, gets out for a walk every day etc.

Thanks for some very wise advice. I think I'll try to go to one GP appointment as a one-off to make personal contact, and then see if I can look into an online option for future appointments. And I'll call to ask if they've got a process for being added onto their records. Thanks! Of course, this all depends on my DP agreeing to it, which is by no means certain.

Don’t hesitate to wheel out a bit of emotional blackmail. ‘Oh goodness. I’m constantly worried about you. I just need to know what the doctors are really saying. I didn’t sleep last night worrying about all this.’ Dysfunctional but effective at times.