When should a family carer get professionals involved

[chrisridd]

My mother (87) has Alzheimer's and is being cared for at her home. My father cared for her until he died in 2022, and told us that at some point he knew my mum would have to go into a care home. My brother (53, single) has moved back to her home to care for her, but he also works full time. We both have LPA over her covering her health and finances.

I'm worried mostly about my brother. I live too far away to provide practical help, but my mum's incontinence is getting severe. She managed to step in her faeces yesterday and tread it all the way around the house. (Silver lining: she is fairly mobile at home..) She also falls over, and has badly scalded herself. She's diabetic (type 2). She needs posters around the house to remind her not to put certain things in the microwave, use the hob, etc etc. She has one paid carer come in once a week but I think she gets asked to do the hoovering! (facepalm)

He's mentioned taking early retirement to look after her. I don't think he should, and I wish he'd get more professionals involved in her care. I'm not convinced he's able to stop her hurting herself accidentally, or to get her the right medical care when she does.

Does anyone have any suggestions for us going forward? I think it is more a case of persuading him that she'd be better off with real help, but maybe I'm blind to alternatives. I also don't want it to happen because she's hurt herself too badly.

 

[LadyLouise]

What a worrying situation for you. Please call the helpline, they can give you the information you need to be able to make important decisions for your Mum. It sounds like you are concerned for your Mum’s safety, with the falls and the scalding accident. My impression is that you are not overreacting, and that your Mum is rapidly approaching, or already at the stage, of needing supervision during her waking hours.

As LPA you have an equal say in decisions with your brother. Your first duty is making good decisions in your Mum’s best interest, not keeping your brother happy. You also sound unconvinced at his ability to be her full time carer. I would be asking him questions like,

How many hours per day would he be able to commit to supervising her?
What is the plan to cover his time off?
What does he understand the carer’s role entails?
Is he willing to take on bathing and incontinence care? Does he understand how taxing these can be?
Does he actually have the skills for this?
What would the financial arrangements look like?
As her current carer, does he even have a care plan for her?

You expressed doubt about his ability to be her carer and even his ability to get the appropriate medical care in the event of an accident.

I don’t know the situation, but if your doubts are based on his past failure to get medical care following an accident, then that in itself would be a safeguarding concern.

From the fact that he has already let things get to this state without urgently reviewing this with you, and that he isn’t managing the one carer’s time to ensure your Mum actually benefits from the carer being there, suggests to me that he isn’t adequately attuned to your Mum’s changing needs. He may just be clueless, or be in denial or downplaying your Mum’s needs.

You have every right (and the duty) to have an equal say in your Mum’s care. Get all the info you can from the helpline here and from Age UK. If possible, try to ascertain your Mum’s experience of the current set-up. And trust your own intuition.

This is a hard thing to bring up, but is your brother financially benefitting from living with your Mum? Of course it’s reasonable to have the benefit of rent and bills if she is proportionally benefitting from his provision of care. But any financial benefits he gets, including free rent, should be openly discussed and formally agreed with you.

I would be worried about him taking early retirement, what if he finds out he’s not cut out to be a carer, or that your Mum’s needs increase beyond his abilities? Early retirement is an irreversible decision. Most jobs are nothing like as difficult as being a full time carer.

Best of luck in this tricky situation.

 

[Jools1402]

It can be quite difficult when you are, like your brother, in the day to day situation and things change gradually over time to lose sight of the seriousness of a situation. Your Mum has a right to a care needs assessment by your local authority adult services. This is free and an entitlement even if she is self funding. Your brother also has a right to a carers needs assessment if he wishes. Would it be possible to come to an agreement with your brother that you request an assessment and would both abide by the recommendations of the assessment? However, if there is a safeguarding issue then adult services could enforce action.

 

[SAP]

You brother needs to have a very long hard think about what it is he would be taking on:- changing pads, providing 24 hour care 7 days a week with no breaks, dealing with possible aggression , handling physical needs. He will also reduce his own pension by retiring early , so what about his own future. He may well cope extremely well initially but as we all know dementia progresses and he could become stuck.
My own personal view is that you shouldn’t delay getting your mum assessed, her needs may be greater than you are aware of. Then you and your brother will have a point of reference to think about the future.