Help with what we say when DM has an assessment!

[drspouse]

Mum is 84, I don't get on that well with her (she massively favours DD over DS, and is incredibly rude to me) but she definitely needs some help.
She's been in hospital recently with an infection, but then a couple of weeks after coming out she got shingles and then had a fall.
House is a death trap (lots of rugs, and wires everywhere!) so I'm not surprised. My dad (who is older but in better health, they are divorced) lives nearby but he still travels a lot and she asked to stay at his, he says she's not eating, then he had to go away, she's gone to a friend's for a couple of nights and then my DB is going for a week.
I have a DS with a disability so am much more able to talk the social care talk, with neither DB nor DF knowing what OT is etc. So I rang adult social care and they suggested I ring the District Nurses.
They've said they might be able to do personal care as a short term thing, I'm struggling to work out if mum actually needs this.
I know she needs some kind of assessment even if we have to put things in place privately. I'm not sure how much she actually needs and I think though her local friend (equally elderly), my DF (but very intermittently) and my DB can cover a week or two it's hard to work out what to ask for if this is just an acute need and the long term needs are different.
Any advice on what to say to the District Nurses now and/or ASC when they assess? I don't want them saying my DF/her friend/my DB and I who live several hundred miles away, are her care package!

Unfortunately although you may have input, ultimately it's going to be down to what your mother says. Yes, it will likely end disastrously or she'll have another fall but that's the way it will be until.she accepts an assessment.
Do you have LPA?

Do not minimise the problems, describe thevworst, most difficult times
Do not overstate what you can do.
These are hard as we tend to go through opposite way, think about this in advance.

Thanks, astonishingly she has agreed to the assessment which will happen tomorrow. She even said thank you for arranging it!

I think she will say she's ok for care at the moment (and the immediate assessment is for 3 days emergency care only anyway) but I warned the nursing team that she doesn't think she needs to eat ("I'm not doing anything so I don't need any calories" - she has a very long history of disordered thinking around food) but they will also assess her house and even if nothing is done now they will refer her for an adult social care/OT assessment.
If they don't think she needs care in the next few days (I'm not sure if she'll be more comfortable at home with carers or staying at her friend's) then I'll see if DB thinks she needs a carer coming in a couple of times a day after he goes, they've given us a list of agencies.
She probably would refuse to pay but I think we can pay anyway (since we would be inheriting her house so it makes little difference! and we have LPA).

Well done on getting the LPA.
My mum has someone private, just an hour a day but at least they make sure she has 1 proper meal at least or she'd just eat biscuits and it's social engagement for her.

You can only implement LPA if your mother lacks capacity to make her own decisions. Does She have a diagnosis of any cognitive deficit?

Incorrect. The finance LPA can be invoked prior to a person losing capacity if they want you to.

@Squirrelchops1 I think that might be helpful though she does have friends she sees, if she can't get out she's less likely to see them. Plus she would expect to "host" if they came round.

That's not true - as previous poster says the finance one can be used straight away with the donors agreement (I do all my mum's banking for her - she has capacity but is visually impaired and housebound) and I have the health one logged with her GP so that they will speak to me about prescriptions etc.

I'm not actually sure if we have both (brother and I both have them, and at least I have them for my DF), but we got them quite some time ago for DM and I seem to only have one piece of paperwork, though that doesn't necessarily mean we don't both have both types. However, I seem to remember the system changed a few years ago, so I'm still not sure what it would cover.

There should be a discharge care package offered for up to six weeks support. That could be carers visiting to dress/undress, heat food, prompt meds, equipment such as grab rails, trolley and seat for kitchen, chair raisers. If you are lucky home physio visits. An OT can visit before discharge and make recommendations about decluttering and adaptations. Can she manage stairs for example? If she is unable or unwilling to have a safe home environment she may need a place in a rehab unit first. Commit to the least amount of caring yourself, make it clear you have a disabled child and cannot be available.

You don't want to pay, you need her to pay.

Otherwise her assets won't depreciate and she will never end up with state support and/or you'll pay more inheritance tax than needed.

If she says she can't afford it (she already said this about a care home) then we may have to. Though the tax implications may persuade her. She also needs a cleaner but again "can't afford it" (she can).
She has a mental image that she is very poor and we and DF are very rich (they got divorced 40 years ago though are still on fairly good terms), and he is better off, it is true, but she does not have the bailiffs knocking at the door and would be much better off spending money on her own care than saving it, except she always thinks everyone else should pay but not her (e.g. if we go out to dinner, my DF always pays, but she never pays not even for herself, she won't take taxis, won't shop at Waitrose, etc. etc.).

@LIZS I'm sure there should have been but she probably told the hospital she could manage fine on her own and nothing was put in place. She was discharged from hospital a few weeks ago after the first infection, then she got shingles and wasn't hospitalised, and since then has come the fall, poor appetite, and (she says) as a result of antibiotics, stomach problems.

Ah I was thinking she was back in hospital after the fall. Sometimes it is referred to as Reablement and a gp can refer to ASC if hospital have discharged and she is not coping.

Ok so the latest is she is back in hospital - nurse came round to do the assessment and decided her infection has become ulcerated. So here's hoping she will actually get some care on discharge.

Good news today - DB says DM has been asking to set up her Wifi, and the OT has dropped off some aids after seeing her yesterday plus is arranging for her to have an extra handrail fitted.
Now just to persuade her to have a carer come...

Maybe not applicable in your case, but in the case of dementia I’ve often seen it advised to sit slightly behind the person, so that when they’re asked e.g. whether they still do their own shopping/cooking/cleaning, and they say ‘Oh yes of course!’ - you can emphatically shake your head out of their line of vision.

In my DM’s case (and I dare say in many others) it wouldn’t have been lying as such - in her head she could still do everything, even when she could no longer even make herself a cup of tea.

This is correct. Unless the LPA for Finance was set up only to be invoked when they lose capacity and its fairly rare for that to be done.

Do you have visibility of Mum's finances. I had a sharp intake of breath when I saw my late DF! He didnt live in the way you would presume at all.

Please dont pay yourself. Her money needs to be used. Be very very careful that she doesnt out of your hearing say that her children will do everything.

I have said this before but a good friend had a Mum who was a complete nightmare (yours doesnt sound at all like this btw!). Unbeknown to the daughter she told SS and medical professionals that her daughter was doing everything and there was no need for carers, aids etc. She outright lied when all sorts of help was offered. It was only when daughter was on her knees that she found what her Mum had done.