Elderly mum needs someone to come in to see her but she doesn't agree.

[Busywithsomething]

Ok so mum is 86. I live approx half hour away. According to the GP she doesn't have dementia, just impaired mental faculties. This is based on appointment at a memory clinic for tests and one follow up since last autumn. She's gradually getting quite absent minded, has confused thinking, ( it seems to me anyway) but wants to live in her flat independently. I visit once, sometimes twice a week.

Her meds consist of-

morning - 1 pill for mini stroke
evening - 1 for neural pain ( increasing gradually, long back story here), statin plus twice a week, vitamin D.

Due to changes with evening meds I have tried, this week, to set up a system with a pill box but she's not really got to grips with it so far. I don't think missing the odd day's pills is that serious but I do want to be sure we get her more on track with this.

She is quite mobile, walks into town most days. Short-term memory pretty poor. No helpful dependable friends close to her, or at least none she likes to ask for favours. No family besides me close by.

I want someone, as in a carer, to come in a few days each week just for companionship and to check that she's taking her pills and see that she's making herself meals, help with any light household chores etc.

How can I sell the idea to my mum if she is dead against it? Many thanks to anyone who's read all this and feels they can help.

I feel your pain.
If pills are the biggest issue, can you ask the GP to prescribe a weekly dossette ( or dosset in some places) box. Wherein the pharmacy sets the pills into sealed compartments by am/pm etc. it may not remind your mum, but you will see at a glance if she is missing doses. My MIL had 4 x weekly boxes delivered at a time. Made a difference.

Would she accept a housekeeper/ cleaner person, initially once per week?

My MIL refused outside help, with the very common response ‘ my family take care of me’. In reality that meant DH & I in most cases, and I had to remind myself to say no at times.

Loss of independence is hard to accept

Go to the Elderly Parents board, lots of help there

@Dearg thanks, it's lovely to know you understand this.

I don't think I've expressed my main concern clearly and it's probably because I'm not sure exactly what I'm most worried about. I know she isn't thinking straight. For instance once or twice when I've called recently and she's looked at the clock she's been surprised at the time and says she's forgotten to make tea- about 8pm or so.

Her GP has said that the chemists over there no longer offer the dossette ( spelling?) service so yes, the pills are definitely a significant problem. Hopefully she'll get into a rhythm with using pill boxes in time .

It's really that I want another person to keep an eye on her I suppose.

Immediate helps can be a dementia clock - tells the day, time and if it's morning/afternoon/evening. And kept somewhere very visible - one by their chair, another by the bed if you can manage two of them.

With elderly parents, the only goal is to avoid crises. So every step you can take to do this is a win. The reality is that as your Mum declines, she's not going to manage and isn't going to be able to stay at home alone so the sooner care goes in the sooner it becomes familiar. I don't mean that bluntly, but I worked in elderly care for a long time and relatives are so carefully treading on eggshells that things DO go badly wrong. It's OK to tell her you're worried, she needs help and it's for her benefit not yours.

The key question is whether she has mental capacity to decide.

If she had mild cognitive impairment last year, she could easily have dementia now.

I'd ask the GP to make her tablets as simple as possible - does she absolutely need all of them - almost certainly not, could they be once a day instead of twice a day?

If she loses track of time then tech may help. I have a patient with a giant digital clock that speaks to him during the day 'time to take your tablets' 'time to have a glass of water' and so on.

I'd also concentrate on getting LPOA for both finance and welfare if you haven't already, and having her permission for the GP to share her health information with you.

Could you call her at the time she usually takes her medicine to prompt it?
Leave medicines on top of a piece of paper with clear instructions that it is evening medicine and ask her to put them back on top of the paper?

Alternatively I believe there are medicine reminder products that can be purchased.

Sorry realise I didn't answer your question.

Yes it's a concern but I don't think a carer is needed.

Automatic pill dispenser
And electronic pill reminder are useful.

concentrate on getting LPOA for both finance and welfare

I agree. And it needs to be done while she still has capacity.

Alexa can be useful for setting up reminders for daily/weekly tasks.

I found the dossette box was an absolute lifeline with my MIL. If the Pharmacy doesn't offer this, ring round the others until you find one that does that also can deliver to the house. Even if they charge a bit extra it's worth the money. (Try claiming Attendance Allowance if Mum doesn't get that already to offset any charges).

You won't really get qualified professional home carers just for companionship and pill taking though due to there being a massive resource issue in the Social Care Sector, they'll be prioritising people with severe care needs and under palliative care.

Might be worth speaking to the GP again about the forgetfulness, it's not a natural part of aging and will have an underlying cause. You might find Mum would listen to the Doctor about getting additional help as our elderly parents tend to think they know best with their own offspring but believe what the Doctor tells them!

@LizzieBennett73 thanks, yes I agree I'm going to have to push her to get something set up.

There are various pill dispensers available on Amazon - some with alarms on. Would they be any use? Obviously you'd need to be able to set it up once a week.

Persuading older people to accept carers is a whole different ball game. My parents would never accept outside help until the day my DF died suddenly and my DM had no choice but to accept a cleaner and carers - initially twice a week but gradually increased to daily. We were 1 1/2 hours away though so couldn't take the role on which DM knew and Social Care accepted.

@AnnaMagnani thanks the talking pill reminder sounds like a good idea.

If she has enough money you can pay for private carers to come in. At the beginning they may just check she is ok with her medication, have a coffee together, iron a few things, whatever she wants. This means if she deteriorates, they can increase hours and undertake personal care. They are fairly expensive, about 28/30 ph through an agency, but good carers are totally worth their weight in gold. Check if she qualifies for Attendance Allowance. Can you sell it to your mum as reassurance for you and planning for the future to allow her to remain in her own home.

Head over to the Elderly Parents board - there's a lot of people dealing with this kind of thing!

Mum has a pivotell which only has an alarm to remind her and she can't get at the rest of the tablets. Dossette boxes didn't work because she would get muddled about the day/time of day and take 2 days worth in 1 day - worst was when she got through a week of tablets in 2 days. They hold 28 doses so for twice a day it's 2 weeks worth.

With my similar sounding parent, we sold it to her as for our peace of mind. She now has a carer for an hour first thing, which leaves her ready and able to do her own thing for the rest of the day. The care company calls us if there are any concerns. It's not cheap though!

I'd ask the GP if the tablets can be taken just once a day, I did this with my mum, and although in an ideal world they would have been better spaced out, the GP felt it better to have them than not.

I found it very difficult to find a pharmacy to do the dossette trays - really struggled. I eventually found one, but had a similar experience to another poster, when mum took several days worth of tablets in one day! You can buy automated pill dispensers from Amazon or Age UK.

The dementia clocks are great, certainly early on, not much use when dementia advances. There are some where you can set alarms/reminders to take tablets/make a drink etc.

However, all that said, I would find a way of getting a carer in, even for 30 mins each morning - to make sure she takes her pills/has had breakfast/is safe etc.
Then as and when she declines she is used to the idea of someone coming in each day and you can gradually increase their visits.

Also, and I know this sounds rather sexist, but if you have a husband/brother etc. who could chat with her, explain that they are worried about YOU, it sometimes helps more, they seem to take it on board more from a bloke!

@BrandNewBicep ooh, I like that idea. Get my husband to tell my mum how much I worry about mum- which is utterly true. I think she really would listen to that reasoning. Many thanks.