Elderly parents - how much can you realistically do?

[mears]

Hi folks - here is a subject that needs a heading of it's own IMO. At this point in my life I am finding the strain of helping look after my elderly dad much harder than the issues I have with teenagers and work issues.

Dad is 87 yrs old and has mild Alzheimers which was daignosed 3 years ago. He is on medication and isn't too bad really. Mym mum is younger (71yrs) and very active. She does however have arthritis which is getting worse, especially in her hands. She is Dad's main carer and I help out when I can. He was extremely unwell at the beginning of the week with a urine and chest infection and needed admitted to hospital. The ward wanted to keep him over the weekend and mum and I met with the doctor to argue for his discharge home. Thankfully they did agree but there is still a concern about the infection he has (mainly the chest). However he has responded well to the intravenous antibiotics and is now on tablets. My concern was that his Alzheimers would deteriorate the longer he was in hospital. There will be some help arranged by Social Work regarding some kind of care package to assist mum so that is good.

However, the main problem is that he is now incontinent of urine, mainly at night. He had started having 'accidents' at night prior to being ill but he seems to be very incontinent at night. During the day, by the time he realises he needs to go, he can't make it to the toilet. He is 3/4 of the way there and it is upsetting him.

Mum does have a bottle but it is not knowing how to manage it well that is upsetting me. Should he just use the bottle and not even try going to the toilet? Will he regain control as he feels better? Can you toilet train an elderly man? He cannot go on demand- we tried that. Anyone got any experience out there? Will have a look at websites later myself.

However, I feel I want to help as much as I can but I am limited because I have a fulltime job and 4 children who need me too. How can you fit all these demands in? Feeling a bit overwhelmed by it all at the moment.

Am going out now with DD who I abandoned this morning to 'babysit' Dad.

Help!

is the toilet upstairs? or too far away from the living room? is there a possible way of contacting social sevices for a commode closer to where he spends most of the time?

{{{{{{{}}}}}}}'s to you and your family Mears. Sorry but no experience- social services should really put a full care package in place for him though- this happened to a friend of dh who has ms- your mum's a bit old to have all the responsibility and as you say you have your own family. Plus what dh's friend finds now is that the family that were caring for her before now have time to sit with her because they're not looking after her as much as they were IYSWIM

Sorry to hear this mears. It sounds to me as if you need some professionals to help but I have no idea how to go about it, sorry.

Don't know how similar this is but my FIL has serious brain atrophy following removal of a tumour 5 years ago. The symptoms present in a very similar way to Alzheimer's. Anyway he became very poorly at the start of the Summer and dveloped pneumonia. He started to become incontinent as the infection set in but as he recovered and regained strength the incontinence improved. Don't know if this is a usual pattern but hope it will be for you.

We don't live near my in-laws so I am not able to be of much help practically. Do think of yourself in all this too as you sound as though you have a very busy life.

Mears - this is a situation that will be happening more and more as we live longer. I too have elderley parents (83 & 79) but thankfully they're as fit as fleas and still playing golf!

I have often pondered on how I would handle a situation such as yours but I think unless you actually experience it you can't know how you would handle it. Our generation are literally caught in the middle - we just get our children off our hands and then come grandchildren and aging parents and you do wonder sometimes - when is my time?

Have you any siblings or other close relatives who could help?

mears, sorry to hear this and hope you get some excellent advice here.

No advice that hasn't already been mentioned, but my heart goes out to you, my Mum is 76 and on her won and I kow if she is ever il it will be realoly hard for me, then I feel very very selfish.

I know that you will be doing what you can, but as others have said, you need some soert of proffessional help.

hugs to you xx

Mears, I have just spent the weekend with my parents who are currently dealing with my grandmother's Alzheimers. She is pretty severe and she is now about 94, Grandad is 89 (the original toyboy) and is now finally considering an EMI home for her as the home help just isn't enough. (It has taken many years to persuade Grandad as he feels he should be taking care of her, but it is now to the detriment of his own health/lifestyle and she is getting quite nasty when it comes to changing her nappy etc.).

I no longer live at home and so do not experience the day to day issues but I am sure Mum would be happy to talk to you about it if you are interested? However, I would understand if you feel this a bit too far down the line for your particular query.

Lots of love to you xxx

Mears is he under the care of a mental health nurse? Definitely sounds like he should be. My MIL has alzheimers but not quite as advanved as your dad. She has been on a private perscriptions for the drug aricept for some years now which seems to have delayed the disease somewhat.
If he does have a mhn could you speak to her about the possibility of a catheter now? It certainly sounds like it is time for it, but can see that this other illness is confusing the issue somewhat.
My thoughts are with you. Sometimes it can really get you down, but social services can be a great help.

Oh Gawd, didn't mean to put across the comment about nappies etc. - just that Mum/Dad might be able to share their experience.

Sorry

Mears would he use pads? They are a necessary evil a lot of the time, and I know people are not keen on them (understandably). I know eldery people it has been very sucessful with, because they feel that they are taking control in some ways.

There is such a thing as incontinence training, does the DN come to visit him? Its worth having a chat with her about it, I have personally not done any training in that area, but I know that one home I worked in did work on continence quite intensivly and had some sucess with it.

I think the idea of a comode sounds good, maybe if it is there he can get there more quickly, but I know it doesn't really solve the problem.

Incontinence can be temporary, after a period of extreme stress, or illness, but it is also pretty common in old age and those with altzimers, so really it might be temporary and it might not.

libb - no problem about the nappies comment - Dad has been given them. He was in them all day in hospital although regularly taken to the toilet. Thing is they are a bl**dy pest to get off as he starts widdling . He has one on at night but it is soajed through. We have tried putting a couple of incontinence pads on the bed at night but he scrunches them up as he slides in. He can't co-ordinate his movements well just to lift his bum to sort them. Mum has a bit of difficulty with it but practice makes perfect. He has only been home 2 days and his continence has improved during the day than when he was an inpatient. That was another reason we wanted him home.

I suppose this site really is geared to parenting rather than problems with the elderly. I don't suppose there will be many parents on here facing this problem at the moment but you never know what experience others have till you ask.

I have 4 sisters but I am the only one who lives in the same time so it is more sensible for me to 'pop round'. One of my sisters is arranging time off to come down and help me because my mum is going to a conference next week for 5 days. I will discuss with them how we are going to manage things though. Also we may well get a lot of useful help when the care package gets set up. A letter has gone to the district nurse as well.

Dad does not have a mental health nurse - he is reviewed regularly at the memory clinic.

He is an intensly private and proud man - heartbreaking to see how much he has deteriorated in the last year. Am taking the kids round for dinner which always cheers him up a bit.

No problem Mears, the offer is still there if you wish. I know Mum won't mind.

I can understand some of what you are going through. My Mum is bedridden, and uses a commode and pads. She has a carer, who comes in twice a day, even at week-ends.

When she is off, I take over, though it is hard with a large family, and work too. I constantly feel torn between my mother and children.

I find it hard to visit more than once a week, and when I do she prefers that I come alone, so dh has to be home to mind the children. I constantly feel guilty and even resentful of her and that makes me feel worse.

She doesn't understand how busy I am, and how hard I have to work to keep it all going, work, kids and the house. Maybe she is right, certainly I feel like I am being selfish in not doing more for her.

Mears have you tried a kylie bed pad? They are not like the papery sheets, they are like blankets. A lot of people seem to prefer them. And they don't bunch up.

I'm not in your exact situation, Mears, but we have reached a stage with 84yo MIL where she's already had a stroke and although fine atm, the possibility of her needing more care is looming on the horizon and it's very worrying. My mum is 76 and hale & heart atm but even though I am one of four, I know the burden will eventually fall on me. It's a b*mmer, so I sympathise a lot.
I think it would be worth you asking Social Services or Occupational Therapy to see what other choices there are. Ime, with my dad, they don't offer these things, you have to ask. Thinking of you.

speak to social sevices for a home assessment. look for adult care services.

hope you get some help.

mears, there should be a continence nurse available for advice, who will have seen all this before. If your GP surgery can't get hold of one then the Care of the Elderly ward should be able to.

HTH

Thanks Tissy - would be good if that contact was made on discharge from ward wouldn't it? Is it perhaps because it is too soon and the District Nurse would refer if needed?
Care was really good in Ayr hospital (except the length of time in A&E - find that sooooo frusstrating for GP referral)

He seems to be doing pretty well this evening compared to yesterday

Mears sorry just re-read your first post and see that your dad's alzheimers isn't too bad yet. Sorry I misunderstood. Is he on aricept too? I would highly recommend it.
Try not to shoulder too much of the burden yourself otherwise, and speaking from experience here, you could start to resent your df.
Social services are a good starting point in terms of doing an assessment of how much help your mum and dad need - so it's good they're getting involved.
Keep in mind that the more hands-on that you are the less help you will get.
Still doesn't stop you getting overwhelmed now and again, but believe me a cleaner, the odd visit from a carer and regular visits from the mental health nurse really help.
I hope your mum is looking after herself too and organising some respite for her on a regular basis will probably be the most helpful thing that you can do.
Think it's also important to let your other siblings help as much as possible. (eg one of my sils does the finances and another visits mil more often if we are away.) Have found it's best to shout LOUDLY when things are just getting too much.

Thanks Cab - he is on Galantamine which slows the progression. It will be interesting to see what help is being offerred. SW will visit on Tuesday. We were desperate to get him home but care package could not be arranged before Tuesday so we did jump the gun a bit. There is no way he would have been able to settle in hospital over the weekend. My sister is coming tomorrow so that is good. Thanks for all your posts.

Forgot to say Cab that he was catheterised on admission to hospital in the early hours of Tuesday morning. The catheter was removed in the afternoon so perhaps that is why he is worse continence wise. Hopefully he will be able to regain control.

Mears, both he and your mum, as his carer, should have their needs assessed by social services (I assume - are they in Scotland too? - the arrangements are the same in Scotland).

The Alzheimers Society helpline is 0845 300 0336, and I think it would be worth ringing them too.

Email me direct if there is anything I can do to help.

mears, if he has had a catheter, get his urine checked for infection. Even if he has no infection, the catheter can irritate the lining of the bladder and urethra for a while- that may be why he's having accidents.