Caring for ILs - Advice needed, please read (long, sorry!)

[Badgerbaiter]

So I have name changed for this as I don't want to be outed as there is a lot of detail in here pertinent to my tale...

I have posted previously about issues with the ILs, FIL in particular being quite an angry, bitter old man who really dislikes me. However events over the last week have presented an entirely different problem and DH and I would appreciate some help and MNers always seem to know where to go to for this sort of thing!

I don't want to drip feed so a bit of background first. MIL has Parkinsons, has had for a long time. It has given her osteoporosis and has changed her personality where rational decision making is no longer used. FIL had a stroke a long time ago which has made his health worse although he is still able to drive and get about. However FIL is MIL's main carer and this appears to stress both of them out and they can be very brutal and nasty to each other e.g my DM has seen them out shopping shouting at each other about MIL walking too slowly and generally causing a scene.

Anyway, last week MIL had a fall, was in a lot of pain and despite an xray was told there was nothing wrong. Over the next 7 days she continued to be in severe pain and despite SIL begging FIL to take her DM to hospital again for a second opinion he refused as he wasn't going to "waste their time again". After the intervention of a family friend MIL was admitted to hospital and had a 3 hour op to replace her hip joint which was fractured in the fall. The fact that FIL thought that it was something she'd get over for a whole week before seeking a second opinion has really shocked and concerned DH and I.

She has also been put on a protien shake to bulk her up as she is skin and bone. The reason why she is so thin is becuase she had a stomach bug 6 months ago, lost a lot of weight and has never eaten properly since. Again DH and SIL both asked FIL to take her to the GP about this but he didn't bother.

FIL has been very selective about the information that has filtered out about this whole incident and about MIL's general health and their lives together and although DH does not believe there is anything untoward about the fall, we are both very concerned that FIL canot cope with being primary and only carer.

FIL refuses to get any help from occupational health or social services, their home is like a death trap and completely not set up for someone with MIL's mobility issues. We live several hours away and due to a lot of stuff in the past don't see them as much as we could do, but cannot help them day to day or persuade FIL to get help as he doesn't believe there is a problem.

I need advice. What can we do? Can we get help forced on them? DH is going to speak to CAB next week to see what they could recommend but my faith in MN tells me that someone else must have been through this / going through this and may be able to point us in the right direction to get help.

Thank you for staying with this! HAving only just read it back I didn't realise how much I'd rambled!

It can be very complicated when you have an elderly couple, one of whom needs care when the other is losing their ability to provide that care.

There are all kind of emotional complications involved because obviously your FIL feels he should be looking after his wife, despite the fact that it is becoming obvious that he is not up to it.

I saw this with my grandparents when it got to the stage that my 86 year old grandmother was effectively the main carer for an 83 year old man with advanced Alzheimer's. It was ridiculous.

In their case they lived with my aunt, so Granny had help and they were not alone, but it was so hard on her and very difficult for anyone else to take over.

Oh and she was stubborn as a mule about not having any help in the house. There was some kind of "shame" in paying for care of any kind, despite the fact that it was desperately needed.

I don't know what you can do in practical terms. It can be very hard to "force" help on people who don't want it. The problem is that the one who is refusing it is not the one who needs it most :(

Sorry, I don't have much in the way of useful suggestions, but I know other people have been through similar, sadly :(

The thing that finally ended the situation for us was that a doctor basically told the family that my Granda needed to be cared for in a home. This was what they had been refusing to contemplate (children as well as wife), but it meant that Granda got the care he needed and Granny was no longer trying to do a job she was just not able for, at all.

I think he could have stayed out of a home for longer if things could have been arranged better at home.

I'm not sure residential care is where you guys need to go yet, but some kind of intervention from a voice of authority (doctor? priest?) who can make it clear that certain things need to happen might work.

Is she still in hospital?

If so, talk to staff & tell them that you don´t think FIL is able to care for her anymore-in fact he may be neglecting her.

Is FIL even looking after himself?

I understand FILs resistance-but it´s not just about him-it´s up to MIL as well.

Diddl SIL is going to chat to the consultant tomorrow and basically tell them that they don't think FIL is able to cope. FIL is the sort of person who will listen to certian people in authority (doctors, his older sister) but not to anyone he see's as below him (us, SIL, most people). MIL is going to be in hospital for at least the next 6 weeks recouperating.

AThing we'd not thought of getting the local priest involved (they are Catholic) but thats a really good idea

Is she still in hospital?

If so they will probably trigger the OT, physio and district nurse teams into action before she's let home.

I speak from a slightly different perspective as DH (1) had terminal cancer and once we had all of this in place everything was loads easier.

I would presume that dependent on if/when she's been released there should be some community support in place (District Nurses) and I would have a word with them. FWIT I thought ours were crap when I first met them but quickly realised that they were brilliant and masters of getting things sorted!

Unfortunatly MIL is just as bad at pretending they are fine. Well at least we think she is. They did have a carer with them for a few weeks last year when FIL was recovering from a minor op. It worked really well but then they just cancelled the care for no reason.

FIL said it was becuase MIL didn't want it and MIL did say this to my DM. But as I said beofre its very diffcult to seperate truth from fact with them as we're not being told the whole picture.

FIL isn't looking after himself as well as he should according to DH. TBH he has got so angry about things recently that we did think he might bring another stroke on

Meant truth from fiction!

Noodie I hope that this will get an automatic response from the local NHS. Its not the first time though that she has broken her hip. The first time they were on holiday and MIL had to be airlifted back after an extended holiday in the hospital abroad. MIL spent a few weeks in hospital here before being allowed home but there was no follow up.

Again this is as far as we know as FIL could have turned them away and said all was fine.

Did they stop the care after 6wks when it was no longer free?

Is that what happens?? I had no idea. In that case I think they probably did. FIL did mutter something about it costing £40 a day and that it was too expensive. But he doesn't claim any carers allowance as he refuses to be means tested - though they are both pensioners.

The stupid thing is they are not poor! They could afford to get some help if they wanted to.

sorry you have such a difficult situation.
As said above you need to spell it out to the Consultant about all your concerns and the risks you see about her returning home, write it all out, re her personal care needs, nutrition, safety, risks in the house.
She needs a nursing assessment, OT assessment and Adult Services assessment of her needs, although these may change slightly if she recovers well from the op.
They should not let her go home if they are concerned re the risks, without insisting on a full care package or they may recommend residential care as a full care package will give a max of four visits a day so there will be big gaps when FIL is on his own as her carer.
They should also assess her capacity re her future needs. ie is she able to make an informed decision about what her care needs are now and therfore is she able to choose where her care is met.
Your FIL may be a proud man, older generations often don't want to accept help as they want to be independent, but remaining so can put them at risk.
If he takes her home and stops any care then he is neglecting her and this may become a safeguarding case, which would be led by Adult Services , where decisons can be made in her best interests if she is felt to lack capacity.
Hope this helps.

just read the last post. he may not be eligible for carers allowance if he is over 65, it is also means tested. But MIL should be eligible for attendance allowance, which is not means tested. It's approx £45-60 a week, depending on the level awarded. Higher level involves care or supervision at night.
you can ring teh benefits helpline to order a claim pack.

Thanks Friday, that is really helpful. The concern for us would be if Adult Services did step in if it became a safe guarding issue, would my DH and his Sis then not get a say in their DM's care. If she is deemed to lack capacity does she become a "ward of the state" if thats the right phrase?

Oddly enough, MIL has picked out a care home to move in to as it has always been assumed that FIL will die first and she'll need full time care. So in some repsects she does understand her situation for the future but not in the present.

I think it has a long way to go before it gets to safeguarding, so I wouldn't worry yet.
There are lots of opportunities to speak to the Ward Team members to put a plan in action to stop it getting that far.
If it did go to safeguarding it has to include all those involved, so other family members would get a say.
If she lacks capacity, it doesn't make her a ward of state, it just means that those involved in her care can discuss a Best Interests decision, so for example, if she was assessed to be lacking capacity re her care needs, all those involved, professionals and family would have a say in where she should live, which may be against her will, but would provide for her needs.
Capacity is assessed on one question at a time, people can have capacity re some things, eg what to eat, or what to wear, but may not have capacity remanaging their finances.

Thank you for that. This is such a horrible situation. The worst thing is that DH and SIL have suspected things weren't right for long time now but havn't been able to do anything and havn't been able to force the issue.

Now it has been forced by the fall we are so under prepared for what we need to do now. Which is only made worse by ILs refusal to accept help or the situation they are in.

hope you get things sorted out. Sometimes it takes something like this to give the chance to change things.
Don't feel you are under prepared, no one really knows what to do in a new situation till it happens. Just make sure you get all the help you can both from health and Adult services. At least if she is in for a few weeks it gives time to make decisions and get things in place and they are not rushing to discharge her. Good Luck.

I would look at attendance allowance for both of them tbh.

Sounds as if FIL is no longer able to be MILs carer & may actually need help himself.

attendance allowance

carers allowance