Mental capacity assessment

At what point is if appropriate to talk to my mum’s GP about a mental capacity assessment? Examples that concern me are

1.Recently a friend of hers contacted me because he was worried rhat she keeps asking him for diarrhoea tablets. She has IBS and been seen recently by a consultant and told to take them as needed. I usually get her a packet when I do the weekly shop. I spoke to her and she said she has only asked her friend for them once but he say she asks him twice a week.i believe him
2. The lady who does her cleaning says some days she is confused, but some days sharp as a tack
3. She dropped a packet of tablets and threw tgem in tge bin but denied all knowledge of it to her morning carer
4. She has muddled up her covid vaccination appointments. Her short term memory is poor and she writes everything on a calendar
5. She can’t use automated telephone systems where she has to listen for options such as telephone banking but can quite competently phone a tradesman to come and fix a leaking tap

When I challenge her she just says I am muddling her and she won’t talk about it. She admits she sometimes gets confused and this week asked me to enquire about assisted living. She then changed her mind the next day. Most of the time she seems to have capacity but she has always told tales to get what she wants and I can’t tell if she is lying or can’t remember things.

I think she knows she is getting worse but doesn’t want to admit it, she certainly won’t consent to me arranging an assessment.

She currently lives on her own and has a morning carer to help with showering as she fell and broke her hip 5 months ago. She was aseessed as being OK to live on her own then but I think she is slowly deteriorating. Personally I don’t think she is quite ready for a care home but I am not sure if assisted living is a good idea either as if she gets worse she would need to move again into care.

Thanks for listening

Hi & welcome Jo

Yes, it’s a tricky one. I would start to write a diary of events. At a later stage this is a good guide for having conversations with health professionals.

Unless Mum gets to a point that she is a danger to herself and/or others. You can only support her with each event as it arises. I am afraid conversations can be difficult. No one what’s to know if they have a memory issue.

Mum could consider an independent living scheme. Where there is a warden and Mum could have a pendent alarm etc. And she could have a care package.

Instead of discussing an assessment for memory. Have an O/T come and do an assessment. It’s surprising what an O/T can pick up on.

Are there any medications that are having side effects. As there been any water infections.,confusion%20known%20as%20’delirium’.

Thanks sunny disposition A list is a good idea. I know I can’t force the issue and moving is her choice. She has a lifeline alarm, keysafe and morning carer and I have told her very clearly if she wants more she has to move.

I have learned to let the carers deal with her, they rang me one morning to ask if she had taken her medication. I told them I had no idea as I didn’t live with her and now let their calls go to voicemail. The biggest challenge is her friends keep ringing me saying they are concerned expecting me to do something about it. The guy who does her garden rang me this week about an issue saying he didn’t want to bother mum. She wasn’t very happy when I told her. I am not sure what to say to them.

She can be quite unreasonable particularly with me but she is not stupid. I have done a fair bit of work on Alzheimer’s so am familiar with the symptoms and prognosis. I hope she decides to move before she has another incident

Do you have Power of Attorney sorted out?

Maybe conversations should be around what type of accommodation. One needs to move to when aging and requiring more help in the future.

At what stages older people consider later life accommodation.

Conversation on how to remain semi independent longer.

You need to also start to be clear with Mum. About your long term plans. In being able to support her as she gets older.

Regards Mums friends I would be inclined. If they continued to keep informing you. Thanks for your interest in Mum’s well being but Social Services are aware of Mum capacity. Regards the carers they should already be reporting back to their managers.

Yes finally arrived today. It took nearly 5 months thanks to covid. I also now have the attendance allowance sorted

Thanks, I have been crystal clear with mum about my level of support. My position is if she stays at home she needs to manage with a care package not me. Have told her I will help her sell her house and move to assisted living ehich she can afford. I haved been gradually reducing my input over the last 6 months. I now only do her shopping once a week and check her finances for her. I have started putting my phone on silent in the evenings and overnight. This may sound harsh but my mental health was suffering.

We don’t get on well, more than 10 minutes in her company and we usually end up arguing and I have to leave. She likes to push my buttons and I have a short temper. I am actually considering moving away to be closer to my in laws (hubby no longer with us I am afraid) They are my only family. She has always told me to live my own life and this will force the issue for her. I used to live overseas and if I still did she would have moved to assisted living by now, I genuinely believe she would be happier there as she is a gregarious person.

Well it seems you are fairly on top of things. Although I suspect it took some doing to get to this place.

I think you are right by withdrawing as much as possible.

I could have written this! It’s a tough position to be in - I too am limiting what I do as I won’t be carer to my mum.

I had an appt with Mum’s GP last summer and she asked me to keep a diary/list of anything out of the ordinary. I complete this nearly every time I see mum and have emailed it to the Dr a couple of times. This has helped as now the GP has organised a Community Mental Health Assessment, which will be a hurdle to clear to be sure.

Thanks for the advice all, good to know I am not alone