Towards the end of her life, my mum was in hospital many times. On one occasion the OT took her back to her bungalow to see how she would manage. There were several steps involved. I was told mum could manage them without any problem. Maybe she could with an OT stood next to her encouraging her, but she never did on her own ever again. Even the ambulancemen found it difficult to get mum in and out!
Take every supposed achievement with a pinch of salt, only believe what you are told if you see it for yourself.
Thank you for that. Yes, I have a feeling that there is a lot of uncertainty here. Nothing like steady progress at this age and with her conditions. We don’t expect miracles. She is fed up with the hospital though.
My Mum had several bouts in hospital, often lasting months. Occasionally she would try to escape. Sometimes that got…interesting. Fortunately she didn’t have the mobility to get far enough to escape the ward, and the nurses learnt not to put her in a bed near the door, just in case her mobility - or her stubbornness - improved.
Hi Jolanta
Sometimes there’s a silver lining with a hospital admission & I’m glad there’s been some respite & hopefully some progress towards getting support.
My own dad has just been ‘released’ after a back fracture and it definitely added to his list of ailments. He got really delirious while in hospital, having to be held down by 2 security guards because he was trying to escape when they were trying to prevent him from moving at all. He’s back at the care home now but he has to wear a brace which is never fitted correctly and can only walk / shuffle a couple of steps. He’s now deemed to be incontinent & wearing incontinence pants (still not sure if this is partly down to people not getting there quickly enough) & he still has a ‘hangover’ from the delirium. He’s lucid most of the time but he makes mistakes & can get stroppy & irrational about certain things related to events that he hallucinated. If he wasn’t already in a nursing home, I wouldn’t be able to manage as he needs strong help to stand etc.
Don’t let them (or your DH) allow her home without suitable care in place & once she is home, don’t let them get to the end of the agreed time (which is usually now 4 weeks) before doing an assessment. If you need further help you need to have time for them to put it in place or they’ll withdraw the help and ask you to fill in while they find something…
Thank you Henrys Cat for sharing your experience.
MIL (94) has been back home since Tuesday. After 2 relatively quiet days (with my OH overnight with her temporarily just in case), she started complaining a lot about carers, the fact that they have the key to her house, the wash they give her, food etc. She denied eating and taking meds (“These people come here without my permission and give me narcotics”). This evening carer’s supervisor said she was behaving aggressively so they felt threatened and left. I’m so sorry for my husband because this is all on his back. MIL says she will sort out care for herself. Well, OK but until she does it, she needs people who help her now. From time to time she is confused like not recognising her own house, so perhaps it’s high time to ask for a dementia assessment (?) My husband will tomorrow call Social Services urgently. He hasn’t got POA (MIL doesn’t trust anybody). I honestly don’t know what to do: be kind and reassuring but at the same time really firm about her needing carers? Tell her that she will go back to the hospital if any accident happens? If she keeps throwing carers out, I see only two options: our family moving with her or she moving to residential care. Thank you for reading that. Writing helps me calm down.
They key here is the carers situation, who felt so threatened that they left.
What should happen now is that the carers manager should take this up with Social Services.
You also need to flag this up as a “Safeguarding issue” with Social Services. (A quicker route to action than a dementia assessment).
Your husband really isn’t helping resolve this issue, sleeping there “just in case”.
He needs to let her “sink or swim”.
His mum is NOT his ultimate responsibility, no one can be forced to care for anyone else, not even a wife for a husband.
If he doesn’t step back, then he is going to end up living there until mum dies.
Are you going to refuse to go with him? That’s the last thing you want. It’s an awful mess. Is he considering his own health at all?
It’s doubley hard when the caree doesn’t appreciate what needs to be done or stands in the way of help that is offered. Is there a medical person that she trusts such as her GP or someone? Often hearing things from someone ‘in authority’ can help things to hit home, whether that’s the need for a POA or the need for care. A POA can be difficult to get if the person is losing capacity (because the certificator, solicitor & any other ‘interested’ parties need to accept that the person is totally aware of what it means). It’s not impossible to deal with someone’s finances etc without a POA in place but it’s a lot more involved once they lose capacity.
The major issue though is her accepting care. Paid carers will put up with FAR less than we would as family, especially when it comes to aggressive behaviour, and I don’t know what happens in these situations - it might be worth asking as a separate question on the forum. I agree with Bun though - all the time your husband is there they will use that. They will only step in if you refuse. You should be able to access the care records either in paper form at her home or via an app. This should state medication given, state of mind, any personal care or food etc.
With the confusion / hostility, it does sound like my dad in the sense that he appears fine but in the right circumstances or over the right (or wrong!) subject, things are not so straight forward. These types of ‘event’ are never going to be discovered by dementia screening because they rely on a back story or an issue personal to the older person. It’s only when things progress that there’s enough ‘points’ showing that something isn’t right. Dad had a brain scan when he first went into hospital after the fall because he hit his head really hard (that’s why he was there, they discovered the back fracture 5 days later!) It didn’t show any further issues from his last scan about 4-5 years ago. He’s always been stubborn but in the last few years (due to the Parkinsons maybe?) he can be irrational with it - “If you don’t help me to go back and live at home then I’ll go and live in a tent somewhere, I’ll find a way and that’s how it is!” type of thing. You can’t reason with him, he’s like a toddler and believes that if he just keeps saying the thing that he wants / doesn’t want then someone will make it change but doesn’t have the answers as to how that will happen. I’m not sure if this is just an old age reaction to not having control over his life or if there is something more to it, but it’s really hard to get that across to medical folks, particularly if they don’t know them. Dad has been visited a few time by an Older Person’s Mental Health Nurse and she is building up a rapport with him & can see this random issue. I would definitely recommend asking for a referral for this. She initially visited to do a dementia screening after he went blind because I had questioned his lucidity while he was in hospital (now I know this is just what happens to older people!) I thought she was there because he’d been talking about suicide but that referral never got passed to her so she dealt with both at the same time. If MIL is showing such aggression that carers are feeling threatened then you might be able to use this as leverage to get OPMH involved.
Thank you for your replies. My husband has raised safeguarding issues with SServices and carers’ management liaises with MIL to sort out most inflammatory things like personal hygiene. It’s all quieter now, thank goodness. I’m glad my OH stepped back a little, not staying overnight as MIL is relatively safe on her won (alarm pendant, commode just at the bed, walking frame). Of course, she will have good and bad days but hopefully, she will get used to carers and feel more comfortable with them.
Hi Jolanta
I’m glad to hear this: hopefully you’ll have less stress for a while.
After two weeks or so of relatively calm time with MIL, yesterday she said she was fed up with carers “giving her god knows what drugs” and “stealing” from her. She is paranoid about the key safe. She talks about carers with a lot of contempt. She told them “my family will look after me” and that practically means my husband.
When my OH popped in with shopping, guilt trips began: “I sacrificed so much for you as a mother etc.” My OH was very upset and he made a mistake telling her that he also did a lot for her. Then she said she has done more… Good grief!
The positive thing is my husband finally stood up to himself, he has started setting boundaries and he has got support from Social Services. But he also shows symptoms of burnout.
Mum has carers 4 times a day but my husband, her only child, drops in for a while every day with shopping, laundry etc. Sometimes he brings our boys so mum stays in touch with the family. Of course, he does all the GP calls, admin etc.
So the plan is carers as usual throughout the weekend. If MIL throws them out every time, then SServices have evidence that something is wrong. SS does another assessment of her capacity to make decisions next week.
My OH does not have POA.
Thank you for reading.
hi Jolanta
Such a complex push-pull of emotions and frustrations and apron strings.
POA for finance i would say is essential and for welfare, however under the circumstances for the latter, it could work in your husbands favour not having POA because the authorities would call the shots and put her in a home if they deemed it necessary and he wouldn’t be able to stop it, they would be acting as her agents in her best interests.
If she is accusing the carers of stealing from her, it could be a good time to raise the issue of POA for money for him to look after her finances for her. but don’t hold your breath if she is so stubborn.
Glad to hear he has set some boundaries and I hope there isn’t creepage ending up back to the previous satus quo.
(edited by moderator to separate quote from Jolanta’s post)
Thank you very much for your reply Breezey. I’m not sure if I understand the POA issue here. Do you mean, if my husband does NOT have POA, then Social Services have more room for manoeuvre if MIL is unable to decide in her best interest? So it would be better for him not to have POA so he does not have to make difficult decisions about his mother? She hesitated about POA, she was too scared to trust her son (she has had trust issues for years with many people). At the end of the day, she is now probably too frail to be able to appoint POA herself.
My meaning was that if he does not have POA and she needs to go into a home but is refusing, then the authorities can intervene and place her in a home if she doesn’t have capacity, thus he wouldn’t have to be trying to coax or convince her to go or fighting the authorities to get her placed.
She will be their responsibility for her best interests.
That is the impression I got and my understanding of POA/no POA.
My apologies if it wasn’t clear, my dyslexia sometimes works against me there.
edited by moderator to separate quote and Jolanta’s post
Thank you very much for your reply Breezey. I’m not sure if I understand the POA issue here. Do you mean, if my husband does NOT have POA, then Social Services have more room for manoeuvre if MIL is unable to decide in her best interest? Yes, especially if she refusing but he won’t have any say in anything for her.
So it would be better for him not to have POA so he does not have to make difficult decisions about his mother?
No, that’s his mother and POA would be great so he can make decisions for her no matter how easy or difficult they are or how much she blames him for them.
She hesitated about POA, she was too scared to trust her son (she has had trust issues for years with many people). At the end of the day, she is now probably too frail to be able to appoint POA herself.
Frailty is not an issue, if she the capacity to make the decision she can do it, the trust issue is the problem.
If he can get POA done all the better because he can have control and decision making as best as he can in her best interests. Without them he is powerless, next of kin, son, counts for nothing when the authorities are making their decisions in her interests.
If he can play to her fears and get her trust in him to protect her interests against the authorities and do the POA all the better, but then he will need very broad shoulders to carry the can and all the blame for decisions, some of which may be out of his hands, that have been made for her welfare.
You can take a horse to water…
If she flatly refuses and he never manages to get POA, he tried and did his best, it was her choice and her decision to have the authorities make decisions for her instead of her son.
Not at all Breezey.
English is my second language so my understanding is sometimes messed up. I’ve got your idea of the POA. Sure my husband’s right to make decisions about his mum is limited. She blames him for “putting her in hospital” and for inviting carers to her home. This is not an easy one. She wants to have what she had before: my husband coming for a couple of hours for lunch and sometimes more. But she is definitely frailer now, that would not be sustainable. I hope SSerivces will be able to convince her to accept at least 2 visits of carers a day.
Thank you for your replies again.
hey no worries Jolanta
It is not an easy situation for either of you
I hope you saw my other reply to you which made my response clearer.
Yes, I saw it. It’s very informative, thank you.
Your English is great Jolanta
I love your name, it is very nice and I am sure I wouldn’t do anywhere near as well writing in your first language!
I am not sure, you will need to google it, but social services or the GP might be able to override POA to place a person in a home, I could be wrong but it’s worth doing a search.
If she absolutely adamant about not having POA, it needs to be clear to hear what happens without it.
He needs to have the forms ready in the car to sign just in case she agrees to it but there also needs to be an independent person who has known your mother for more than 2 years to double check she knows what it means and she isn’t doing it under duress and has the capacity to make that decision.
That needs to be done as soon as possible after she agrees and signs the forms so she doesn’t get cold feet and change her mind.
Then if she is still opposed to it, she has made her choice and it is out of your husbands hands.
We’re in a slightly different POA situation but I thought it might help to explain the options to her. At the end of the day, SOMEONE has to look after her finances & property (leaving aside the Health ad Welfare one for now). She can either choose someone to appoint now, while she can, or she can leave it in the lap of the gods if time runs out. She can also opt to continue managing her own finances but revert to her attorney at such time as she loses capacity - you can’t do it in retrospect.
If she chooses to wait until it’s too late the courts will appoint a guardian which could be her son if he wants to but it could be an organisation that specialises in these things & might not really get to know her. Either way the court supervises and oversees the dealings by way of regular reports etc. If she’s a bit paranoid about people in her business, this is probably not what she wants.
Thank you, that’s very kind of you.
As for POA, I think there may be some doubts if MIL is in capacity to do that. She is usually of quite a sound mind, but not always. She has had months of in and out of delirium (infections), that’s why she was deprived of liberty at hospital. I think her GP would have doubts. So the time for independent decisions is gone, most probably.