My mother –I want to take this further

[greengrowtherashes]

I've posted about my mother before under another name. To try and briefly summarise, she has had depression and anxiety all my life and probably well before (so 50 years+) and has a wretched life of seeing noone and doing nothing, from one month to the next.

She will only communicate by text with me and her sisters. She manages to come and see me and her GC on average twice a year, despite living only 4 or 5 miles from us. She loves children, is fantastic with them and would dearly love to see them more, but can't. We can't go to her house. I've not been inside it for nearly 4 years now, and she didn't allow me in her last place for the last 11 years before she moved.

I am getting increasingly concerned about what this all means, going forward. She is getting older and I worry about her not letting anyone into the house, if she took ill or had a fall or something. She's 70 but seems a lot older. The last two times she's visited she has also smelled terribly of urine and I'm fairly sure she still hasn't got a replacement washing machine – hers broke probably a year or 18 months ago and I'm guessing she's just too terrified to allow someone in her house to install a new one. She wouldn't even consider letting me help her with this.

I feel I need to tell her GP and/or psychologist (I think she has one at the moment, but she's had so many different treatments and doctors over the years that I'm not sure, and she will barely talk about any of her medical stuff).

Has anyone done this with a relative, and how do you go about it? I'm obviously not looking for any details or information FROM her practitioners, I know it's all confidential –I just want to express my concerns and have things noted down. I feel her 'normal' is so far from normal that she probably plays down a lot of things when she's talking to them herself.

Any advice?

It sounds she might need to move into a home for the elderly, and get help with most things? I don't know the procedure for being admitted to one in the UK, though, but there are probably others on this web board who does know, so I'm bumping your thread up to the "active" section, now...

Thanks for your reply, User. I can't believe she would ever countenance moving into a home. She can't be around people and is the most intensely private person I've ever known. For her to go and live with strangers would be unbearable to her.

user in the uk you would have to have been unable to cope at home with carers looking after you before you would be considered for a care home.

green it sounds like a very difficult situation as it does sound like shes struggling to cope, but wouldn't accept any help. If she still has mental capacity then this is her choice, even if it seems like a bad choice to others. You could mention your concerns to her GP, it does sound like she would benefit from a social worker being involved, but she would need to agree to this. She/you can self refer to social services through her local "Gateway to Care"

Do you think that she is a hoarder or has mess/dirt got out of control?

What in particular prevents her letting anyone in the house?

It does sound like she needs help.

Yes, I'm sure she is a hoarder and this is a large part of the problem. But I also think she guards her privacy so fiercely that her attitude is almost "It's MY space, I don't have to do anything I don't want to, don't have to let anybody in if I don't want to, everything is on my terms only!" I'm wondering if it's maybe a small way of keeping control when the rest of her life is so out of control as in, she can't bring herself to do almost anything: see people, travel, take classes or whatever. I don't know if my analysis is correct though, and think she would deny it.

Should I speak to her GP? I don't actually know who it is and might have to phone around a few possible practices. Would they confirm she was a patient if I gave her DOB, and would her doctor agree to talk to me, do you think? I've never done anything like this before and just not sure what is/isn't possible.

I wrote to my parents' GP years ago as they weren't coping after my father had a stroke. GP called me and said he had too many patients who wanted help to be able to try to force help on those who didn't! I persuaded my parents to change GP to a practice which was also nearer and set up a meeting with me, my mother and the new GP and things did improve a little. Your issue is more complex with MH issues but I agree your first contact should be GP.

Thanks, chatnanny. Of course, I should really put something in writing too, to make it more official. That was a pretty unhelpful attitude from your DPs' GP!

Once the DC are back at school later this week I'll start phoning the surgeries I think she might be registered with, and hopefully take things from there.

I'm guessing they won't even tell you if she's registered with them as that would breach confidentiality.

I've been through this with my own mother and hoarding is a very, very difficult problem to deal with, for all the reasons you've said. The combination of shame and being a private, independent person, and not wanting to change makes it almost impossible to get them to even see there is a problem, never mind tackle it. If she's anything like my mother she will probably prefer to die in her own house than go into a home.

Are you able to talk to her at all about any of this? Could you frame it in terms of fire hazard, or danger from a fall? The best practice now is generally thought to be just managing the hoard to minimise danger rather than a total clear out.

Also, can you drive past the house and just take a look to see if there are any signs from the outside of hoarding or disrepair? That might help in terms of getting outside help. I'm assuming she owns her own home, in which case it is (again, bitter experience) almost impossible to get anyone to care.

One more question - do you think she is capable of looking after herself, and also do you think she is able to make judgements about how she lives (does she have capacity, in the jargon)? It might be worth trying to get her referred as a vulnerable adult and talking to social services, but if they deem her to have capacity, everyone's hands are pretty much tied.

Do PM me if you want, it's a horrible situation.

I remember your last post OP. I suffer from depression and in my 70s and w live with my long term partner who is very supportive. My depression fluctuates and can be severe and on bad days/weeks I will not see my sons, dils, grandchildren, sister or friends. I am almost phobic of anyone seeing me when I am not myself - closed down with depression, whereas I'm an extrovert by nature.

I honestly don't see what anyone can do about your mum - she is 70 (which isn't old these days) and ok she smells of wee but that doesn't mean she needs help. Neither can anyone prevent her from hoarding. Obviously if anyone could, it would be you as her daughter but she's not having that. Don't know what a GP or anyone else could do to be honest.

How does she manage to shop as presumably she is eating ok. What would happen if you knocked on her door as she lives nearby.

Thanks for the replies. I think there probably is not much I can do.

We can't really talk about it, chopchopchop –hard to have a conversation by text and as soon as I start expressing concern about any aspect of her situation she kind of clams up (via text!) and shuts the conversation down. She will say things like "I'm starting new medicine this week" but if I try and enquire a bit further she say she is embarrassed to discuss trivial medical details, or something.

She doesn't own her own home, no –she has a council flat. Does that make a difference in some way? I'm out of my depth here with what to expect when she's older. And have no siblings to share with either! That would be a relief, I must admit.

Catrina I think she takes a taxi (which she can ill afford) to and from the supermarket once in a while and stocks up. She is overweight, in fact –more so each time I see her. And if I knocked on her door, she wouldn't allow me in –I think the most she might do is come to the door and speak through a crack, or through the letterbox. I did turn up once when she didn't reply to my texts for 2 or 3 days and I was getting really worried, but I think she had switched off the security entry buzzer so she couldn't hear the bell inside her flat. I had to drive away, and she finally texted me in reply when I was driving ... but I'm pretty sure she knew I was outside.

Chopchopchop I might PM you later – thanks. Just in the middle of half-term kids' entertainment here!

Could have dementia. Ring social services.

I don't think she does, Jeanne. In some ways it might be easier to get some kind of help if she did (not that I would ever wish that on her, of course). Is there something in particular that I've said, that makes you think that?

Yes it does make a difference if she has a council flat. Hoarding is a big issue for social housing providers these days; they may be worried about the effect on neighbours and/or the structure, but they may also be able to provide some help.

I'm off for the weekend, but do PM me next week if you want.

The behaviour reminds me of OCD. Maybe agoraphobia. But the factfact she is allowing her personal hygiene to deteriorate and increase in fearful behaviour might indicate paranoia. But sometimes if an elderley person has a physical illness. Uti or chest infection this can mimic a psychotic illness. But equally dementia can also present itself in this way. The only thing to do. Ring her GP and get them to do a home visit. They should know about your mum's medical history and will figure it out. If you r not happy with this. Then ring adult social services and ask for an assessment of your mum's needs. They have a duty of care to do this.
Your mum may be aware she is neglecting herself but can't look after herself and is afraid to ask for help. In case she is taken over by services or is very independent. Etc

Finally under the mental capacity act your mum can be assessed by social services to see if she is capable of looking after herself.

So you ring the gparty and speak to ghetto doctor. Not the receptionist. Saying you are extremely concerned about your mum. The high risk of neglect. Your can also ask them not to tell her it was you who rang. If you want. You then speak to GP saying what you have said in this thread

Yes OP - mental health nurse here - please have a telephone appt with your mums doctor .

The problem still remains centred on capacity- if she has capacity and refuses assessment from GP/social services then unfortunately they cannot make her take on offers of support or be seen. Do you think that she has the capacity to understand the risks that you feel are there?

If she is in a council flat then the council has a duty to ensure that other tenants aren't at risk from her hoarding behaviour (eg fire risk).

There are some good online resources to support people with a hoarding behaviour and their families. Take a look at Clouds Edge in (I think) Birmingham. Sorry, can't link as I'm on my phone but if you Google it you should find it.

In my area there's a multi agency approach to working with people with hoarding behaviour, with a protocol about how to involve appropriate professionals. Your area might have something similar. It's usually coordinated by the Fire Service so if you go onto your local Fire Service website they might have something there.

It's very difficult if your mum has capacity but the local council can get involved, so it's worth trying to talk to her housing officer about minimising risks to neighbours. And do flag it up with her GP. They won't be able to have a conversation with you without your mum's permission, but they might not be aware of the hoarding issue if they've never done a Home Visit so that could be useful for them to know.

Good point above re council and hoarding- you may get somewhere quicker with them especially if you're not sure who her GP is.

Not that they can share information with you, but inter agency working.

Sorry, it's Clouds End not Clouds Edge

Www.cloudsend.org.uk

There's also a resource called Help for Hoarders which is for families as well

Www.helpforhoarders.co.uk

If your mother would agree it would make
life easier going forward if you set up
a power of attorney. She has to be of sound understanding when she agrees but it makes life much easier as you can then represent her (once you activate it) and talk to the doctor etc. I found even having it without going to court opened doors. Also if she is with you or writes a letter saying she wishes you to be allowed to discuss her health or affairs this may be useful. This all
relies on her cooperation though!