Elderly PILS refusing home help because carer has MH problems.

[DiemenSniep]

Name changed for this. Not sure this is the best place, but need the traffic.

What on earth can we do about very frail and vulnerable elderly relatives who flatly refuse to accept domicilliary care (personal and housekeeping), because their carer has mental health problems and hasn't allowed anyone to clean or visit the house for the past 4 years?

PILs have multiple serious physical problems, very limited mobility and are virtually housebound. SIL is mid 40s, has never left home and it's become apparent she is no longer able to care for her parents. She has very severe contamination OCD, has been unable to clean the house for the past few years and refuses to allow anyone else to do so and now won't to allow anyone into the house apart from the doctor. The house is full of clutter and rubbish. She refuses to let them into her car, so they are virtually prisoners in their own --filthy- home and are completely isolated from family and friends. They are not allowed to stand up or move around when SIL is in the room. They have to use taxis in emergencies and last weekend MIL was taken ill and was advised to go to hospital. SIL wouldn't take her in the car, nearly-blind FIL tried to get her into a taxi and she fell down the front steps. When DH found out he was desperate to go and visit his mother (they live several hours away). But his parents begged him repeatedly not to come and SIL was crying down the phone asking me to make sure he stays away. She is afraid he will bring 'contamination' into the house.

PILs comply completely with SIL's demands because if anyone breaks her 'rules' she has panic attacks and cries for hours. DH has been banned from coming to the house for the past 2 years. He has been booking into a nearby hotel every few months and sneaking round to visit his parents while SIL is at work, but badly mistimed his last visit and was there when she got home, resulting in hysterical scenes from SIL who jumped into her car and drove off, while PILs locked my DH out of the house.

SIL is (just) able to work part-time and is receiving CBT, but says she is unable to take any type of medication to modify her moods and behaviour because she is on tablets for epilepsy. She feels desperately ashamed of her illness. I cannot believe her therapist has any idea about what is really going on at home. SIL allows me very rare and sporadic contact via email and phone. DH has reported the home situation to the family GP on 2 occasions now, asking it to be flagged up as a safeguarding issue,and nothing has ever been done. I suspect things have to get really really bad before SS get involved, and PILs always swear that everything is completely OK. They will never admit in a million years, even to DH, that things are terribly wrong at home.

PILs inherited a lot of money 2 years ago - more than enough to enable them to afford the homecare that SIL can't provide, except she won't allow anyone into the house! PILs just go along with it - DH got screamed at by MIL for cleaning the unbelievably filthy loo, because it would upset SIL.

PILs GP will phone DH next Friday, but FIL had yet another fall today. Any suggestions? DH is at the end of his tether with worry He know his family will probably cut him off completely whatever he does.

Social services? Sounds horrendous. And going to GP again.

Omg!!!

The GP is not the first port of call, social services are.

Ring social services

Oh gosh this sounds awful. I think this is a social services issue and is fairly urgent. Can you speak to the GP on the phone?

Who went with mil to hospital in the end? Usually they will not elderly patients go home before they are certain that there is adequate care at home and they will involve social services

That does sound horrendous. In Scotland, local authorities have a "vulnerable adults" team who are duty bound to investigate reports of safeguarding issues. Have you tried going direct to your council? You could report anonymously if you fear the repercussions for your DH.

Oh my goodness, what a situation.

There needs to be some sort of intervention. SIL may even be sectioned, especially since she not only seems to be a danger to herself, but certainly a danger to her parents.

I would speak to the GP in the first instance.

Same thing in England, Agent. Ring social services and mention the word 'safeguarding'. the PILs are 'vulnerable adults' who are technically at risk from SILs behaviour. SS will have to investigate it. GP, unless very proactive, is of limited use here.

Although Gp can safeguard them, anyone can really do this directly with social services.

I would see this as a potential adult protection issue and social work certainly need to look into it further. I would really press the gp to refer if you don't want to do so yourself.

MiIL had a home visit from GP and went to to a daytime outpatient assessment unit by taxi 2 days later and had some investigations carried out (no A&E at local hsopital). We are waiting for the results.

The action on Elder Abuse website is pretty clear that this is what they call 'passive (ie inadvertent) family abuse due to a carer's MH problems.

No way would SIL be sectioned - she is still able to work, drive, order online shopping for PILs etc. But her MH is extremely fragile. OCD is such a horrible illness.

That sounds dreadful. I think no matter how much sympathy you have for your sil she is simply not able to care for your pils in the way they should be cared for and the situation can't be allowed to go on. You should get social services involved but you could start with a visit to the GP and he/she might be able to advise if they know about the state of the house.

I totally agree that they are at risk from your sil's behaviour.

What a difficult situation for you all. DH needs to report this to SS as a Safeguarding issue. PILS and SIL need help.

No she doesn't sound sectionable, but this is definitely a Safeguarding issue. Speak directly to social services - ask to speak to the Safeguarding team and don't minimise the risks or the abusive behaviour. You have already identified - correctly - that PILs are being abused. Most GPs are, unfortunately, pretty useless in this kind of situation.

So the GP saw how filthy the house was and took no action? That does not bode well as PILs would simply not let social services in if/when they call. Nobody can force them to have the help they need, however much you think they should. The only thing you can do is to keep a close eye and step in when they want the help. But if they are adamant they don't want the help there is not a lot you can do.

Yes, ring Adult Services and ask to discuss a safeguarding issue.

Social services. It definitely sounds like a safeguarding issue and your PIL's should be classed as vulnerable adults.

The gp should have acted, all health professionals have a duty to raise safeguarding concerns. Go straight to social services and bypass the useless gp.

again, Social Services

My DS (DH's stepson) and I have not seen MIL or SIL since my wedding 12 years ago, nor have we been allowed to visit the house, even though we lived less than 40 miles away for 7 years. MIL and SIL have always been 'too poorly' or 'too stressed' for visitors. DH used to visit them on his own. I have seen FIL once when some relatives brought him to see us for the day 2 years ago.

FIL had a fall today and was found on the path by his next door neighbour who then rang DH. He said he helped FIL into the house and MIL made him leave immediately. He reported that the place is an awful mess. We have had some distressed phonecalls and messages from SIL this evening asking for reassurance that DH hasn't 'talked to the neighbours about her problems'.

There doesn't seem to be much point in alerting social services as they will still refuse help.
Is there any mileage in standing up to SIL and saying:"Of course we have spoken to the neighbours about your 'difficulties' as we are very worried about elderly parents. And we have spoken to the GP and social services, because the way you treat them is just awful". This of course has to come from your husband to his sister and will not be welcomed. But might be the lesser of two evils.
It is the most awful situation and I think you are being very brave in staying with the problem rather than wash your hands of it.

Social Services need to be informed now as this is a safeguarding issue.

This is a safeguarding issue and now there is a possibility your FiL is injured but SiL's issues will prevent help. They are vulnerable adults, make a call to Social Services. You can make this anonymously if need be: just state what you've said here. They are used to these kind of situations and have seen and heard it all before, and SiL may actually, deep down, end up relieved if someone not emotionally involved steps into this situation and says this cannot go on as it is.

As a safeguarding referral, social services involvement would not be something optional that PiL have to take responsibility for signing up for, any more than it would be for a child potentially at risk. Someone will objectively assess are they safe and have everything they need in the situation they are in, and stand up for their interests rather than prioritise SiL's. They are also gatekeepers for other support agencies that they may be able to involve to help all three people in this situation.

Sorry, posted too soon.

If you google your LA Social Services help desk there will be a phone number, you can make an emergency referral by phone direct that way. Emergency referrals are processed down a different (and quicker) route than the standard social services referrals that GPs/hospitals/physios etc make for teams providing assessment and care. This absolutely warrants an emergency referral.

Another tip: if they do not act enough the first time you refer, then every time a fresh concern arises, make a fresh report to the emergency desk. Again the emergency teams work differently, they look objectively at the whole picture (they are the frog straight in the boiling water that jumps rather than the slow simmering frog) and as the evidence stacks up they often are very helpful to get a situation moving.

So sorry for every single person in this horrible situation.