Demented grandmother who won't take meds or be changed

[Newparent101]

Looking for advice on my mum's behalf, who is full time carer to her mother, who has severe dementia. Mum and her brother take it in turns to look after her, 2 weeks each before swapping (my grandparents live in spain - since brexit we can't bring them back as they wouldn't get NHS care). Grandmother's dementia is severe enough for emergency care home, but her husband's is only stage 6 dementia so he can only qualify for the 1-year wait list care home - separating them isn't an option (they've been married for 50 years and panic when the other leaves the room). So mum and her bro are stuck flying out to take care of them at their home.

She won't let mum change her adult diaper, she will often have overflow of urine into her bed so mum needs to wash the sheets in the middle of the night. She says mean stuff intermittently, which mum finds upsetting. She won't take her meds, so mum is desperately prioritising the most vital ones. She often refuses to eat - so mum leaves food out next to her and sometimes (often not) she will eat it. Can't be left alone for more than 5 minutes or she gets up to all sorts of trouble, eg eating cat food. Often mum wakes in the night to find her downstairs, so mum is often too scared to sleep and totally sleep-deprived.

Just wondering if anyone has had a similar situation / can offer some good advice or tips that I could pass on to mum, who is completely at her wits end? Thank you 😊

Sorry if I have missed it but are they British citzens?

One of the female residents at my DM’s care home thought she was running a boarding house! As she evidently had in the past. She once told me that so and so still owed her nine quid for last week!😂

Nope, they aren't British citizens / don't have a British passport and have never lived or worked in the UK, so they wouldn't qualify for NHS care right?

They are dutch and did work in Holland for a while, and my uncle is living in Holland- we looked into the possibility of moving them back to Holland and going into a care home there, but it's the same problem with waiting lists up to 1 year or my grandmother goes into emergency care immediately - but then at least maybe my uncle could drive my grandfather to visit her very often?

Thank you for the excellent advice!

You mentioned that my grandfather would be able to visit my grandmother in a care home every day, but would he need a family member to transport him to and from the care home? Or could the care home also organise for someone to bring him to visit her and drop him home again afterwards? (I'm guessing not, but in case yes, that sounds like a potential solution)

There comes a point with dementia where a person needs to be safe, more than they need to be happy. If they don't have capacity to make that decision, someone else might have to. Is there an equivalent of power of attorney operating in Spain?

Do they have financial resources? If your grandma went into a care home, could you sell the house to fund your grandpa staying with her too?

For night time wandering an alarm alert via a doorway alarm or pressure pad may help you feel you can go to sleep even if you are disturbed.

What is priority?
Keeling your mum healthy?
Very important here.
Sad as it isyour grandmother needs way more care than your mum or uncle can reasonably give without crashing
Look at homes in spain.figure the costs.
Getting her or them on planes to uk is probably now not feasible or realistic given dementia and continence issues etc (do they even take her out locally? Or not any more? )
And find out costs but as they have assets they would pay and a dementia facility depending where in uk is 1500 plus per week. What are costs in spain?
My relative paid £2200 in uk per week but that was essential as dementia progressed. Staff ably handled her shouts when changed etc and it took two staff each time

Is the one year waiting list for a place or for a funded place? I'm guessing you have been in touch with the equivalent of Adult Social Care in Spain about what they can offer. I think it is interesting when people run down what we have here to hear experiences of what is on offer in European Countries. Do they not offer the option of someone coming into care? What would happen if your mother/uncle just stopped coming?

Grandparents have very little pension/savings - they do own an apartment, so I suppose we could try to sell that ASAP and use the money to pay for a private care home?

Unfortunately my uncle is living in that apartment, he is too unwell to work and lives on state benefits, and as a single man will be very low priority for state funded housing so will probably be homeless for a while.

Its all a bit of a mess but you're so right, we do need to prioritise keeping them safe over happiness, thank you!

Are your grand parents connected with the Spanish healthcare system? Is their dr aware of the situation and have there been any care assessments? Have your mum / uncle contacted social services on their behalf?

you say that your uncle is living in the Netherlands but also in their Spanish apartment?

Clearly what’s happening is not sustainable, and social services have to get involved. Are they? Is your mum’s Spanish good enough to do this?

I wouldn’t necessarily prioritise ‘safety’ over happiness for anyone, but I definitely would prioritise the wellbeing of the family as a whole including your mum and uncle. This is in no way sustainable. Therefore I think your grandparents are going to have to go into care. Unfortunately they may also have to be separated. That would happen at some point, and most of us assume it will be death that separates us, but it won’t always be that way.

I am assuming here that there is something available in terms of social care in some form - obviously the most urgent need is for your mother to find out what that is. But does she even have time to do that while caring?

You are getting hung up on details that can be sorted out after your grandmother is settled and secure. What your grandmother needs right now must be the priority. She is at significant risk from a catastrophic fall or from infections - even sepsis - as things stand.

Your grandfather might be able to take public transport or a taxi to and from the care home. Or, since he is also beginning to experience alzheimers/ dementia, he might not accurately recall whether he visited one day a week or seven days in a week.

Thank you so much everyone! Have relayed all your advice on to mum. They've put both grandparents on the waiting list now for an emergency care home, and have an assessment booked in for next week. Really appreciate it, you guys are the best!