Good morning. I have been reading your excellent forum for some time and hope some of you may be able to offer advice to help my brother and I.
By way of background - our aunt is now 95 and lives alone in the house she inherited from her parents (she never married and has no children). The house, in my opinion, is really not fit for her to live in safely, and I doubt whether it would be possible for carers or even a cleaner to work there. The house was badly affected by mining subsidence not long after it was built (my grandparents got a few hundred pounds compensation in the 1950s) and the floors slope badly. She has no fridge so food cannot be stored safely (I have caught her cutting mouldy bits off food sometimes, and her solution to milk going off was to start drinking tea without milk). Her kitchen is so small (it is a 1930s semi and has never been modernised) so there is no room for any appliances other than her gas cooker, and she has no washing machine either. Her bath is unusable and she has no shower. She is very deaf and unable to use a phone (has never been willing to try although we have suggested getting one suitable for a deaf person). We eventually succeeded in persuading her to have a mobile phone just so she can press the emergency button to summon help, but it took years to get her to accept even that. She flatly refuses to consider having carers come to assist her, saying that she will not have anyone other than family, and has also refused offers from a Victim Support Scheme after she was burgled to have regular visits from a “befriending” service although she is very lonely. She does not have dementia or any other major illnesses.
For many years she had a lot of help from my sister who gradually took on more and more responsibilities until, after my aunt became totally housebound (she could move slowly around her own house but would not go outside and claimed she could not get into or out of a car) my sister was doing all her food and other shopping, looking after her banking and paying her bills, arranging all her medical appointments and whatever repairs or replacing household items became necessary, and responding to urgent callouts including numerous times when she pressed her emergency phone button “by mistake”. My brother also arranged things for her such as having central heating installed finally when her old back boiler broke down and she was found to be living without hot water (if he hadn’t forced her to instal it she would still be doing that). Tragically, my sister was killed whilst on holiday abroad at the end of June.
Since that time, my brother has kept things going as best he can (he has a very demanding job which means he works long hours, travels around the country and often has to stay away for days at a time). We have applied for and have in place POA for my aunt’s finances now, and have applied for the health and welfare POA but that has not yet come through. I live abroad and have had health problems myself (open heart surgery in 2018 and a hysterectomy due to womb cancer at the end of October this year, from which I am still recovering) so am not able to do much to help, which is something I feel very guilty about. I know that the house is becoming increasingly dirty with bad smells (she will not let me do any cleaning when I visit) and she is obviously neglecting her personal hygiene, not washing or washing her hair.
Now things have come to a head as the kind of crisis we always knew would happen someday has arrived. Yesterday afternoon my brother arrived to visit her (having last seen her on Thursday evening when he delivered her shopping), found all the curtains still drawn and could not get into the house as the security chain was on. He called the police who broke in and gained entry, and called an ambulance. My aunt was found unconscious on her bedroom floor having pulled the bedhead down on top of herself. She was taken to hospital and my brother was still there with her at 11.00 pm, she had had a CT scan and they were waiting for an X-ray. Some kind of infection (probably her kidneys) is suspected.
I am aware from reading the forum that she should not be discharged from hospital unless she is considered safe at home, but I am worried that they will try to send her home as she will insist that she is able to manage and they will take her at her word as she has capacity. Frankly, neither my brother or I are able or willing to become her full time carer. He has to continue to work to pay his mortgage and support his wife and son, and I am not willing to give up my whole life, sell my home here (I could not afford to buy anywhere fit to live in in the UK and could not live in my aunt’s house in the condition it is in).
What are our options? Can we insist that she not be discharged until a care package is in place or she goes into residential care (which she would refuse if it is put to her), and tell social services we are not prepared to provide the increased level of care she will need? Will social services visit her home and are they likely to agree that these conditions are just not suitable for a frail 95 year old to live in? With regard to my aunt’s finances, she has just over 23k in the bank (she receives the Pension Credit minimum income guarantee) and owns the house, but because of the subsidence issue I understand that the property would be unmortgageable so I do not know how we would manage to sell it to pay care home fees, and even if it was sold to a cash buyer it would not fetch very much. We are not bothered in the slightest about any inheritance we might have received being used to pay for her care, we want her to be safe, but to be blunt she is not our parent, she is an incredibly difficult person to deal with who will not act in her own best interests, and we are not prepared to sacrifice our whole lives to be at her beck and call. The paramedic told my brother that he would have to make a referral to social services regarding the need for care, which we are glad about. I have considered contacting social services about her situation before, but felt that it would be a waste of time as she would refuse to co-operate with any assessment process and insist she could cope. Even when my sister has arranged home visits from her GP and the GP has ordered hospital tests, my aunt refused to go for the tests and made my sister cancel the appointments. I have been afraid the GP would consider she was wasting his time and strike her off his list. That is how difficult she is.