New to being a carer saying Hi

Hi, I’m Richard. I’ve just become the fulltime carer for my 81yo Mum. I moved in with her last October, but since May she has had mobility issues meaning she is currently unable to walk and can barely stand with assistance. The past 4 months she has been in hospital 3 times for over 70 days in total - the first was to investigate her mobility issues, but no conclusion was reached. However, she was started on insulin injections for type 2.

After a few days from discharge the first time, she was rushed back in with sepsis, for another lengthy stay where a little more testing was done on her mobility, and a suggestion of diabetic neuropathy. She got an occasional visit from a physio who would keep asking her to lift her legs into bed, despite Mum being clearly unable to, and then the physio would go. A mobile commode was delivered to the house to save Mum having to need to walk the 5m or so between her chair and her en-suite, which she was losing the ability to do.

Just under 2 weeks from discharge the 2nd time, she went back in with a kidney infection and contracted c.diff whilst in hospital, so the 3rd stay was again quite lengthy. This time she was struggling to stand, let alone move her legs, so she was introduced to a rotunda, and the physio this time (a much more attentive physio on the ward Mum was on this time - apparently there are ward physios?) was patient with Mum and worked her through some bed and chair based exercises, as well as getting some orthotic boots to help support her left ankle. A rotunda was delivered to the house before Mum was discharged.

So Mum was discharged after her 3rd stay, just over 2 weeks ago. I am just about managing to help her use the rotunda to swivel from her reclining/ejecting chair to the commode and back, but she seems to be finding it more difficult especially the past few days. Carers usually just do washing and dressing as Mum doesn’t need to go when they are here… Luckily Mum has a urostomy (for over 40 years now) so doesn’t need the commode to pass water.

At the weekend she was showing signs of another infection. She refuses going back to hospital on the not unreasonable assumption that it is hospital giving her the infections. The GPs (does anyone have a consistent GP nowadays, or just a rotating bunch of them from their surgery?) were waiting on a blood test, which we mistakenly thought was done last Friday by the district nurse, but that was actually for B12 and folate deficiency, and not for inflammation markers indicating a possible infection. So no antibiotics, but I do think Mum is getting over this latest infection just by waiting it out.

She is very despondent though - although we have this diagnosis of diabetic neuropathy, it was the stroke doctor telling us that after he looked at a nerve conduction study results, but he caveated that it was not his speciality, which leaves some doubt in our minds naturally.

I have pushed for an appropriate expert (neurologist) to explain what the long term outlook is - will Mum regain mobility if she gets some decent physio and puts the effort in, or is this as good as it will be and is likely to worsen to a point where she can’t even stand up to use the rotunda? If that happens, then what? How can we cope? Do we need a hoist? Make the bungalow wheelchair friendly?

At the moment Mum spends 24/7 in her chair, and is getting a sore bottom naturally. She refuses to use her bed because she can’t move herself - her arms are too weak and her legs, especially the left, have very limited movement and strength. She has just bought an electric bed that can raise the head and/or feet, but so far not even touched it, let alone used it.

She is also crying out in pain and occasionally confused during the night which wakes me as I have to go and check in case I am needed. It is very hard seeing my Mum so upset and angry with herself and her new limitations. Our only other family are over 200 miles away and most of them in their 80s too, and no friends nearby, so I find it difficult to feel I can leave Mum to head out to shops or the gym.

The STEPS care package is for 2-6 weeks, intended to help someone settle back into home life, but they are beginning to struggle because my Mum can’t stand to use the rotunda without significant help, and they are not allowed to physically help lift (for fear of back injuries which is fair enough although less than helpful). I am waiting for a callback from the case manager to see what she can suggest going forward.

All the best to everyone, Richard

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Hi @rbk4321

Goodness Richard, you and your mum are dealing with a lot.

Your mum needs a needs assessment asap so that the appropriate level and frequency of care visits are in place and ready to take over when the STEPS care ends.

Do you have a date for the neurologist?

I’d be pushing for physio now - and an OT assessment. An OT can supply a pressure relieving cushion for her chair and an alarm she can press from her bed in the night if she needs help. She’s probably in pain at night due to being sat for so long.

You also need a carers assessment - you may be able to get a sitting service for her.

Does she have a care line alarm?

@Chris_22081 has set up Alexa so his husband can phone him in an emergency if he is out walking their dog etc

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Yes we have an Alexa and I added “Echos” in every room - mainly so I can play music or listen radio etc, but a spin off is that as it’s linked to my phone, it can access my phone list so I can just say “Alexa - call John Smith” and it phones John Smith. So Graham can simply say “Alexa call CHRIS” (followed by my surname) and within a couple of seconds my mobile rings and we can have a two way conversation. It doesn’t HAVE to be an emergency - it could just be to ask me to pick up something while I am out, but if he was to fall, he can just call out and be connected - without having to reach for a phone or dial a number. It gives ME a great sense of security. Also the calls are free !

The other advantage of having these around the house is they can be used to “announce” something (“I need a pad change!” or “dinner’s ready!” or even “HELP”)

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Hi @Melly1,

Thank you for your reply (and @Chris_22081 too).

Mum has a pressure relieving cushion but she finds it uncomfortable so refuses to use it. The STEPS case manager has called back and is requesting their OT to visit ASAP - so next few days I hope.

I was given a long list of care providers in the area by the first STEPS case manager. They are not allowed to recommend anyone in particular, and we will not qualify for council provision as my Mum’s finances are above the low limit, especially including the house.

Although I now live with Mum permanently, I believe I need to be 60 before the house (in Mums name) is no longer counted as an asset? Does anyone know when the calculation is made and if updated? For instance, if Mum needed care now and after running out of ready money, the council would potentially be forcing my Mum to sell up, making me homeless, but if in the meantime I reach 60, would that change the original calculation of Mums’ assets?

A sitting service sounds useful, although it might take a while for Mum to accept a stranger if I’m not around. She has a fall alarm, which we got for my Dad, but she doesn’t routinely wear the bracelet with the emergency button on it, although it is on a table beside her. OTOH she is not able to leave her chair unattended so unlikely to fall.

We have been using FaceTime if I am out in the garden - with the advantage that I can show Mum how the flowers are growing! The house is small enough and a bungalow, that we don’t really need anything more elaborate.

I am finding it frustrating and feeling guilty that I am starting to think that Mum is not trying her hardest. Yes it is uncomfortable to sit on a pressure relieving cushion, but if it does you good? Yes drinking leads to painful leg swelling, but dehydration is dangerous. Yes the physio exercises seem pointless and minimal, but it will take a long time and you have to start slowly.

I try and encourage her but she feels like I am badgering her. She has made suggestions about giving up, although I think that is just down to pain and frustration at having to rely on other people for everything. I have had friends get swallowed by the mental health system just by saying the wrong thing and then taken at their word, so I really do not want to open that can of worms.

I think if a Doctor can take the time to talk Mum and I through what is wrong with her mobility, and the long term prognosis, and then some advice on how to manage going forward, we would be in a much better place. As I am sure many on this forum experience, getting a hold of a Doctor for more than a moment is so difficult.

Hi @rbk4321 its my understanding that the value of her house is only taken into account if she moves into residential care. If her savings are over approx £23000 then she has to fully fund her care. There is a sliding scale under that of how much she’d need to contribute- it’s worth contacting the Carer’s Uk or Age Uk helpline to get the exact figures and have it explained to you. They can also explain re the house and your situation.

Your Mum’s leg swelling, painful bottom and stiffness would all be helped by spending some time in bed. It’s good the OT is coming out. Have a chat with them out of your Mum’s ear shot so you can explain about her not using the pressure cushion and bed etc. She maybe more likely to take advice off the OT.

An appointment to discuss her mobility would be helpful to you both are you referring to a neurologist or GP?

Lots of carers struggle with motivating their carees to comply with physio etc you are definitely not alone in this.