Please read - not sure what to do…

Hi, I have posted on here on occasion due to the stresses associated with caring for my 96 year old mother in law (MIL).
She is quite stubborn and very self focused so it is very hard to get her to see she needs help as she really thinks she does everything and whenever asked will say “ I do my own cooking and washing “ - but she doesn’t. We do, but we let her wash out a few bits of underwear or do toast just to keep her doing things.
She has carers twice a day but says she doesn’t really know what they do - I think it’s because we got them in to do wellbeing checks as she was constantly phoning saying she couldn’t make a cup of tea or something wasn’t working for example, her tv remote, telephone, hot water… it was always ok.
Anyway, things have muddled along with us doing most things and carers keeping an eye on her.
However, there is no doubt she has declined in terms of her physical strength, and her cognitive functioning.
Does anyone know if the loss of logic is linked to some sort of dementia. She forgets how to use things but will says it’s what we have told her to do…!( very annoying). She will ask what day it is, and most recently, I have noticed medication not being taken - something she was almost obsessive about given her health anxiety.
Also , on Saturday she tested positive for Covid. Surprisingly, she has it very mildly ( we were worried about her age) but she worked herself up and eventually said she needed to go to the hospital. We took her to A&E who have a “ hot clinic@ for Covid. I thought they might keep her in but they called us at 11.30 that night to come and get her as overall, she was ok.
Yesterday morning when I went around there , I found that she had fallen , cut her head and leg badly and was very confused. We called an ambulance and she was admitted to hospital.
I was allowed a very brief visit to bring her some toiletries and her meds, and she seemed a lot better. She has no idea how she fell but is really trying to rationalise it as initially she said she couldn’t get through the door ( she was trying to push through the wall!)
I am at the point now where I am convinced that she really does need care full time. The hospital mention carers 3 times a day alongside us, but I worry about the night time hours.
Anyway - to my question: will the hospital involve us in any assessment?
On speaking to her, she will say she does x y and a, but really doesn’t. More worryingly, is the decline in her memory and her logic. However, you need to either know her well or be with her for a while before this is picked up.
I feel they are going to discharge her now that the physical bit is done .
I feel that they need our input to really know how things are, and to recognise that at 96, declining cognitive ability, she is quite weak, has a very slow gait and has lost the sight in her right eye due to a TIA that she needs to be properly looked after all the time. I actually think she would enjoy being looked after, she’s always calmer in hospital as she knows people are on hand.
Also, am I being unreasonable to worry about taking care of her with Covid, my husband is 68 and classed as vulnerable due to his own health issues. I’m no spring chicken either and heart and kidney issues.
Any advice would be greatly appreciated.

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I just want to add that her neighbours have been asking about her and feel like us, that she needs more care. However, they don’t seem to realise it’s her decision!!! It’s very anxiety provoking.

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Jane I have no advice as such but pray that someone else will be along. However you deserve a response and I am sending you huge hugs.

My personal opinion is that hospitals want the beds so will discharge her asap. But if she has been in hospital then discharged and gone back in again, surely the initial discharge was ‘dangerous’ if I understood your post correctly? She is becoming a danger to herself? Hospitals do not usually do ‘mental capacity’ checks now or this is what I was told back in April when my husband was discharged. I had no input - he just told them that his much younger drudge sorry wife wanted to take care of him. So I would expect little from the hospital team.

Any chance of her GP intervening? Could you tell the hospital that you WILL NOT care for her due to you and your husband’s health issues?Stress it will be a SECOND dangerous discharge. Any point in talking to PALS? Tell them that you are worried about night time care as she will only have 3 carers day so there will be long periods where she will be unsupervised.

Sadly we carers do not matter to a crumbling NHS so I would really urge you to be strong and fight for her not to be discharged. Do you have her keys? Would she be able to get into her home from an ambulance if you refused to be there or to collect her. I realise this post makes me sound hard but you sound at breaking point.

The hospital should speak to you, as by the sounds of it, that she needs full time care now than later. The gp and the carers should advise you if she need extra help.
I would speak to someone for help.

Yes loss of logic is very much like the vascular dementia my Dad had. No A to B to C and random Zs cropping up in his logic
Yes they tend to mask they REAL symptoms and feelings because dad was a very proud man, who was embarrassed and tried to look better than he was. Even with a diagnosis or semi diagnosis he still made himself appear better than he was. Can you push for a psychiatric evaluation or psychologist/neurologist assessment whilst in hospital?
Hospital- as you suspect, in my opinion, do the best they can to transactionally achieve a target-goal of health - whether that’s ensuring wounds are stable, first bowel movements post surgery or walking the length of a corridor or stairs… The target is part of their ‘fulfillment’ targets, and to clear beds for the next patient…
With or without a dementia diagnosis as per @selinakylie and your own worries about nighttime cover/monitoring, I agree that it’s better to say that she Doesn’t have enough care, that you’re not involved or must step back so that your MIL can get more support. If you are part of the equation people will ‘assume’ no nighttime cover is needed or that she is ok at home…which from what you say is clearly not the case now beause things have advanced.
So my thoughts I hope you can get a cognitive ability diagnosis done for her, and that by ‘stepping back’ from saying you are her carers you can enable her to have more support with other carers or to look at care-home support if that’s an option you

Trust your instincts, which from my reading seem on-point! You can’t be there 24/7 but she may get more care if others feel that you aren’t her full time support AND esp if she has COVID.
Hope that helps a bit


Tell them that you have to shield for your husband and can’t offer your mum the care she needs. And stick to that. No further explanations needed.


Many thanks everyone for taking the time to respond.
It’s so difficult- I don’t know whether it’s my own hospital or whether it’s more common place.
Any notion of treating the whole person and assessing need seems to have gone out the window. Even the ambulance staff, when it turned up, seemed to be trying to think of a reason not to take her in. On what planet is it when a 96 year old with a head injury, confusion, torn skin on her legs and Covid not deemed serious enough to take to hospital. As for trying to explain her increasing confusion, it’s almost like staff are scared to acknowledge it in case you ask them to do something.
Helena, I do not think you appear uncaring, in today’s climate you are a realist.
Victors, many words of wisdom there too.
Charles, short and to the point - but you couldn’t be more right.
Basically we are older people looking after the very old and it’s very hard, but seems harder in the absence of anyone willing to help and support.


Victoria NOT Victors!

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@Jane_22031234567 Short and to the point leaves no wiggle room for the hospital. You have to protect yourself and your husband.

Re: the ambulance team trying not to take her in. With her age and the situation she was in they would have known that there really was no choice, but they would be reluctant as people at that age rarely do well in hospital. The change of surroundings can be a big shock to the system.