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Guest post: Dementia Awareness Week: "My beloved parents struggle on, negotiating a system they don't understand"

53 replies

MumsnetGuestPosts · 20/05/2015 12:46

It's Dementia Awareness Week. Have you seen all the memes doing the rounds on Facebook? About how we can fight this, or the huge strides in the treatment? No? I didn't think so. One of the things I've learnt about dementia since it rudely interrupted our lives is that no one wants to even think about it, let alone talk about it.

This is probably because there's never a good ending – nobody survives, nobody gets better. There's no cure for any type of dementia, and there usually isn't even a diagnosis of what strand you've got until you die.

When you think about dementia, what do you think of? Perhaps a white-haired great granny, with memory loss that is almost endearing – she struggles to remember the names of all her grandchildren, but she loves to chat about years gone by and if you put on some Vera Lynn, she'll sing along.

That's not my mum. When she retired from a lifetime of teaching, mum was looking forward to enjoying walks with her friends, volunteering, and rereading her several thousand books. A lifelong bookworm, her shelves are crammed with theology texts, history books, and other less highbrow novels, including all the Terry Pratchett books published before she got ill. She was also looking forward – as she told me repeatedly – to being a grandmother. She was the only granny-wannabe I knew with a stock of children's books hidden away for when the day came, and when I was pregnant she sewed the most beautiful quilt for my son featuring the Very Hungry Caterpillar.

But when my son was 14 months old, we noticed her personality changing. She shouted at her grandson for chewing the zip of his cardigan. For a woman known for her placid nature, this was a warning sign. She began to lose all social inhibitions and said whatever popped into her head, much to the mortification of everyone around her. Then it became apparent that she was having language problems – she couldn't find the words for things, or connect a written word with an object.

Mum was finally referred to the memory clinic after a disastrous admission for spinal surgery resulted in a massive downturn. A CT scan showed shrinkage of her brain, especially in the areas responsible for speech and language. There are only three medications used to treat dementia, and none of them worked for mum. This is hardly surprising because they only work even a tiny bit – and that means slowing down progression, not reversing it – in less than a third of patients.

So that's it. My beloved parents struggle on, negotiating a healthcare system they barely understand, trying to cope day by day. Dad is incredibly frail himself, and has racked up five emergency hospital admissions so far this year. And every bit of help I try to offer is a battle against his stubborn (and entirely justified) wish to cling on to their independence and the home they've shared for nearly 50 years.

This week is my son's ninth birthday. Once there would have been a lovingly chosen card and present and a rendition of Happy Birthday down the phone. Now he'll get a notelet, addressed to the wrong person in spite of dad's best efforts. Mum doesn't know who he is, or who I am. He doesn't remember her before she got ill, but he shows immense patience with her, reading the menu, explaining what things are and never getting annoyed when she grabs from his plate or gets angry for no reason.

Emotional support is hard to come by. My friends don't want to think about their parents going through it. The best it gets is "oh, I don't know what I'd do - I'm so lucky with my parents". Their mums are a similar age. They are having the grandchildren to stay for a week, holidaying in New Zealand, hiking in the Lake District, and not spending their lives on a treadmill of medical crises. The unfairness of it all is sometimes unbearable.

Without the support of Mumsnetters in the ever-wonderful Dementia and Elderly Parents areas, I honestly don't know how I'd cope. To have people who understand what it's like trying to come up with present ideas for a parent who has no interest in anything, and can't be taken out anywhere, or telling your compos mentis parent that their house is a health hazard, or tackling the all too common issue of the sibling who chooses not to care, is a gift. We travel this awful, heartbreaking road together, and every day brings a new way to have our hearts broken. But we're not alone, and that means so much.

OP posts:
twentyten · 21/05/2015 16:54

Excellent post NMS.
And ESmum- I hear you.As you say,filling in all the gaps and needing help-which is not aromatherapy for carers but reliable caring support and systems to free us up to focus on our children and their needs-and our own lives. And having to fight systems for support- with its toll on our health too. join us on the elderly parents board- loads of kindred spirits there to listen.

springalong · 21/05/2015 21:48

NMS excellent post. My dad has assets but no capacity to make significant financial decision. My mum and I are so worried about him being taken advantage of.

Blondieminx · 21/05/2015 21:57

cmot thank you for a great post.

We lost STBXH's granny to vascular dementia last weekend, it's a heartbreaking disease.

That "vulnerability" classification is so pragmatic and sensible, I wish we could see it adopted.

I fear that the reason there isn't joined up care, proper teams in each area is that women are struggling on to cover their relatives needs, and are then too worn out and exhausted to campaign effectively. Perhaps this is an idea for MN's next campaign?

ssd I was hugely grateful for the support I got on the board when my dad was dying last year x

Rosa · 21/05/2015 22:01

And another terrible fact is that its not going to get better for those suffering or those caring . I hope I am proved wrong but I doubt it.

Hypotenuse · 21/05/2015 22:39

Very accurate and sad too, I have three family members with Alzheimer's and all three have a family member acting as almost a full time carer. I feel so much more sorry for the carers than those suffering with Alzheimer's. I can see the rest of the family stepping back. Like it's too inconvenient to be involved in the care, or too hard to help. I'm struggling to know what I can do, and to understand the law with regards to assets and social care so I can explain it to everyone. There needs to be better provisions!

Esmum07 · 22/05/2015 18:07

Twenty Ten - totally agree. It's fine having a week or two's respite now and then, it's fine offering massages and aromatherapy to carers. But, you still go back into the fold. It's like you're given a little look into what your life could be like if you didn't take on the carer's role - time to yourself to have the odd massage, time to enjoy a holiday like everyone else does without having to fight to get help for a couple of weeks, time to enjoy your life like most people without a caring role. Then it's snatched away and you're told, in not so many words 'there you go. Good girl, now get on with it. See you next time it all gets too much'.

What carers and patients need is proper help. If you have a diagnosis of dementia you should automatically be given a trained carer. That person could just be used for now as a way of pointing your family towards help, or could pop in every day to check the person is OK (which saves family worry), or later could be used to provide practical help in the home (personal care, etc). It should not be left to the family who have no idea most of the time what they are doing, have other commitments and, unlike social services, can't go home and relax in the evening. The family is on duty 24/7 when there is dementia lurking.

I have an Admiral's Nurse, she's helped me get a blue badge, she's sign posted me to help (though I still have to do the contacting) and that's fine. But I need someone to check mum's taken her tablets - social services can't help until she is doing this regularly. Meanwhile I have to do it. The service for carers of dementia patients is abysmal and a little bit of 'repair' every time you breakdown, like massage and aromatherapy is actually pretty patronising really. It's the equivalent of giving your kid a pat on the back when they are upset without actually helping them solve the problem that upset them in the first place.

Rosa · 22/05/2015 18:52

ESmum07 - How very well said . I agree so very much .
Out of interest I posted a link to the fact that it is dementia awareness week with a crypic ( scarcastic) message with it. Its been there 10 hours I have 213 friends and 4 have 'liked it ' despite another 40 or so have been on today .

CMOTDibbler · 22/05/2015 19:13

Thats a sad reflection on peoples feelings isn't it Rosa.

My dads only respite is that once a week, mums friend of 40 something years, who is 95 herself has mum round for a cup of tea. Thats the only time she's out of the house as other friends of very long standing either just stopped calling, or have said explicitly that they can't cope.

She utterly hated the day centre that was the only thing on offer in their town, and theres no one available to try and persuade her into it.

They do have a wonderful (private) carer who does a huge amount for them, and has scaled that from twice a week for half an hour just to 'help with the bed change' to a daily visit now where she does much more. But dad finds it hard to think about paying someone to socialise her iyswim.

The vunerability classification would be a great idea, and I think drs always err on the side of competent when really thats not the case, and isn't for the majority of time.

fridayfreedom · 22/05/2015 19:16

Having worked in dementia care for over 20 years I have seen big changes in provision of care and support.
It improved in the 90s but is now been whittled down again. The number of referrals have increased, staff have been cut. Higher grades are replaced with lower grades. Lovely people but less experience so higher grades are left juggling more and more difficult cases.
When you know you could make a difference if you had more time and resources its ddemoralising. Those who make the decisions dont see the faces and the human cost.
yes we can go home at the end of the day, but dont assume that we too dont care for an elderly relative or diabled child. Many of my colleagues do.
Also many are taking early retirement because they can no longer do the job they trained to do. This means a great loss of skills, experience and understanding.

Bonsoir · 23/05/2015 11:10

I recently lost my mother - not to dementia - and have other elderly close relatives at various stages of decline.

I just wanted to sympathise with those posters struggling with elderly relatives who "make their own decisions" - decisions in which are implicit huge amounts of free family (which so often means middle-aged daughters) assistance.

IDismyname · 23/05/2015 15:44

CMOT. I hear you. And all the others that have posted.

My DF has had Altzheimers for 6 or 7 years now. The meds worked for a while, and have now stopped. During this period, He's had prostate, kidney and now secondary bone cancer. My DM and I joke darkly, that due to his limited mental capacity, he has no 'worry' about any of the above.

But I'm lucky. I have a DM who is battling on, she has help several days and one night a week paid for privately, and Dads finances are no longer under his care. Mum has taken it on. My DB is good on the financial side, and I do the extra visits and general support. We will be seriously stymied if DM falls sick.

However, there is no support for the carers. DM turned up at the local hospital to their Carers Dementia Drop in, and was the ONLY person to attend. She won't be going again.

There needs to be more money and joined up thinking to tackle this terrible problem. We are all possibly heading the same way (God forbid).

IDismyname · 23/05/2015 15:46

I'm on my iPad and cannot fathom how to do links, but someone sent me a link to an organisation called Homeinstead. However, I think it's private dementia care. It may help someone.

Greenrememberedhills · 23/05/2015 18:08

Needmoresleep, that is a brilliant email and it should be sent to your MP.

whataboutbob · 23/05/2015 21:48

I feel that a fundamental revision in the way monies are allocated to people with dementia is needed. As we know if you need care due to dementia you get nothing if you have assets above £23000. It's argued that's because your need is a social one, not a health one. Nice distinction. But there is no other treatment than skilled care if you have dementia. Just because you happened to get dementia, rather than cancer, or kidney disease, or HIV- you get nothing from the state. Now imagine if chemo or dialysis or antiretrovirals were means tested. And you paid for everything down to your last £23000, including the value of your home. There'd be an uproar.
I just feel this arbitrary divide between social and health care has enabled the government to wash its hands of its obligation towards persons with dementia. Sure it will cost a huge packet. But maybe we all need to pay a bit more taxes, or maybe even hotel costs when we go into hospital, to ensure the care is shared out equitably. Until then, the government will happily let relatives struggle on.
APart from that, NMS's ideas re a regulation of the way businesses respond to the needs of people with dementia and their carers are most apposite.
Well done CMOT for starting this thread

3littlefrogs · 24/05/2015 13:04

IMO severe dementia should be considered a terminal disease.
Whether a person gets appropriate care really is a lottery.

I have/had 2 much loved family members who suffer/suffered with dementia.
The first had mild dementia - was happy, sociable but muddled and forgetful. Was dearly loved by all the family and was physically well and had a good quality of life. This person had a minor fall but due to the inappropriate actions of the care home was admitted to hospital. Having got into hospital was neglected and died from dehydration, despite the protestations of distraught family members who could not get the person out of the hospital.

The second has extremely severe dementia, is doubly incontinent, in a distressed and agitated state ALL the time, cannot eat or drink without help, has no quality of life whatsoever, and has been in this state for over 5 years. Yet - this person has 2 life threatening physical illnesses that are aggressively treated in order to prolong life. Family members have no say in this at all.

Both scenarios are very distressing. Family has no say in what happens.
The only thing that seems to be important is the arguments over money/funding for a dementia unit that costs £900 per week.

There is no sensible policy that I can see at all.

SugarPlumTree · 24/05/2015 13:50

3littlefrogs post highlights the need for people to do LPA for Health and Welfare whilst still relatively well, so can make their wishes known and give their Families input into their medical care when the are no longer able to.

My understanding is Family can be over ruled by Health Professionals if the have the POA but their wishes based on the Donor's wishes do hold more weight and have to be taken into consideration. It is the sort of thing you don't really realise until such time as it's too late. We need greater awareness about this really.

shabbs · 24/05/2015 16:16

My lovely Mam (she is now 81) was diagnosed with Alzheimers about 8 years ago. I remember her and Dad coming up to my house and she said 'Them cheeky buggers at the Doctors have said I've got Alzheimers - could have give them a slap!!' Apart from Mums mum every female close relative has been seriously affected by Dementia of one name or another.

They gave her 'the special drugs' as she calls them lol. For several years it halted the Alzheimers. Then my precious Dad became ill - he was diagnosed with Oral cancer and given weeks to live. He survived for over a year but became so ill (and would not go to a hospice because he said he had to look after Mam.) They had daily care for a whole 10 minutes at a time 4 times a day for which they paid a fortune.

Dad died just over a year ago. My heart is broken in two without my 'hero and first love.' Mum lived with me for just a week but I truly did not cope....she wandered outside many times and I just caught her before she ran across the busy road. Eventually she is now in a nursing home.

I go to see her and she throws her arms around me (like she did yesterday) and says 'Oh love I prayed to God you would come today and here you are.' She is the original 'great pretender' - you wouldn't think there was anything wrong until you watch her carefully. Yesterday I said that I liked her new bag and she wanted me to have it!! She said 'look whats in it!!' It was full of the nursing homes stuff lol lol. Cups, cutlery and across the top of the bag a lovely pink tablecloth that she insists is hers - only when I looked at all the other pink tablecloths in the dining room with one missing that I realised.

My 'real Mam' died about 2 years ago - the real Mam who would have told me off for not going to see her 'dressed up to the nines' and my hair and make up done!!! She has scared eyes and yesterday told me she had some bad news - told me Dad had died. Poor, poor lady. I feel for all of you on here who are in similar situations xxxx

twentyten · 24/05/2015 17:24

Oh shabbs what a tough time you have had and continue to have- dmil was the same- when we took her out( while we still could) dh had to try and coax her to leave the handbag( not hers) full of knickers etc behind.... It is so hard. So sorry for the loss of your dad too.

whataboutbob · 24/05/2015 20:02

3 littlefrogs I think there is something dysfunctional with modern medicine when it actively treats the life threatening conditions of people with advanced dementia.
Mt Dad is in middle to late stages. Recognises me, but has forgotten who my brother is (even though they live together), has forgotten my mum and his 3 sisters, and vast swathes of his own biography. He's on aspirin, blood pressure drugs, cholesterol lowerer, and diabetes meds (I actually agree with that as it makes a difference to his aggression. ). I'm sure all the health professionals involved with him believe it would be a blessing if he had a big heart attack at this stage. I do, because we all know worse is to come and that scares me. But the meds will not be stopped. GPs are incentivised to prescribe various preventative meds such as statins and BP drugs.
If and when it gets to the late stages and he has no discernible quality of life i will fight to have all these drugs stopped. Not sure i'll win as i don't have POA for H&W, but i'll sure give it my best shot.

whataboutbob · 24/05/2015 20:06

SPT re LPA for H&W , I agree but i also believe few people are strong enough to stare the reality of declining health in the face and think through what they would want. I know my Dad was firmly in denial when dementia was encroaching, and having that kind of conversation with him would have been absolutely impossible. Before dementia, he simply would have batted the unpleasant idea of his decline and mortality away.
However, living wills are on the increase, not least I suspect because of the experience of persons such as us who have struggled for years with unwell parents.

Esmum07 · 24/05/2015 20:18

I admit I was lucky with my mum, Whataboutbob. She has always been up front with us about what life assurance she has, where the policies are and what her wishes are for her funeral etc.

As soon as she got the Alzheimer's diagnosis and the memory clinic say to make a POA she decided she wanted us to make a financial and a health one. She has made specific instructions that my sisters and I are to make the decision regarding resuscitation or drugs if she is unable to. Bless her, she has even given me all her policies to keep at my house 'in case I move them from the usual place or do something daft with them when I finally go la la (her words not mine)'.

She also sat me down (she says my sisters get too upset for her to have a proper talk with them) and has chosen the hymns she wants are her funeral, the music she wants to 'go in to' and we've had a look at poems or pieces to be read out. She decided to do it whilst she could still tell me her wishes - I think that's a very gutsy thing to do. It's never easy talking about your own death but, my goodness, it will help us when the time comes and she will be getting exactly what she wants - we'll make sure of that.

S

whataboutbob · 24/05/2015 20:30

Wow! What a lady. I like to think I'll do that too. I am sure it will make it easier for you and your siblings when the time comes. Good to know some people really do do it that way.

CMOTDibbler · 24/05/2015 21:02

I think that your mum shows why early diagnosis of dementia is important Esmum - your mum has been able to clearly communicate her wishes, put things in order etc. My mums GP stalled so much that she's never understood that she has dementia, let alone been able to make any decisions.

I decided to post on FB about Dementia Awareness week, with a bit about what its done to my mum. No one commented, and only 3 liked it. Says a lot I think.

whataboutbob · 24/05/2015 21:31

Yes dementia is the big bogeyman now. No one wants to think about it. I didn't, until I had to. I was discussing it with a close friend a couple of days ago. She started to tell me her concerns about her parents ever developing it (they are absolutely fine now) . As she did, she folded her arms around herself and lowered her voice. Says a lot.

AliceInSandwichLand · 24/05/2015 21:52

My father died last year after 8 years with vascular dementia. My father in law has been bed bound and unable to speak coherently for over a year, or at all for several months: a man with a PhD who once had a very responsible government job. My mother is entirely lucid but frail, and I am her carer: she lives with us. The last ten years of my life have been largely dominated by our parents, and I see no sign of it coming to an end, as MIL is still living alone in a massive house and will not cope there forever. There is a huge, huge social crisis because of increased longevity at the expense of quality of life. I so feel for the rest of you who have posted; it's middle aged women who have to deal with it all, just like Victorian unmarried daughters who had to look after their parents, except that we have to do everything else now too. Hence my username.

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