Don't know what to do!

[katdan]

My Dad is 90 and has vascular dementia, he still lives on his own but over the last few weeks his dementia has worsened. He has been seen by a doctor from the hospital who has referred him to the OT who cannot see him until next Thursday. I am also waiting for SS to contact me to arrange an assessment for Dad but is so hard to speak with anyone. Dad has meals delivered to him every day but recently the driver is finding it hard to get him to open the door and it is taking from 20-30 minutes, they cannot afford to spend this amount of time on one person.

Dad has become more aggressive and shouts which he has never done before and he talks to himself - has a conversation where he asks the questions and then answers himself. He says that people are in the house when there is no one there and he is becoming peranoid (I think as I am not a doctor)

I love my Dad very much but think that it may be time for him to go into a home. I feel very guilty about this but I will know that he safe and being looked after 24 hours a day.

Sorry to go on but I needed to get this off my chest.

Katdan.

 

[Royalslady]

Hi Katdan

I won't be able to take the guilt away, because we all suffer with it! All I can say is that nobody knows your Dad better than you and if being in a home makes life safer for him, then it certainly worth considering.

Talk to the SW and his CPN if he has one. They will be able to help you with this.

Good luck x

 

[Canadian Joanne]

Hi katdan,
It does sound like your dad needs more care. In the short term, is there a neighbour who would accept the meal for your dad? You might even make a financial arrangement - it wouldn't have to be big, but it would make it more business-like and the neighbour would not feel imposed on.

Is your father on any medication to ease his agitation? You are probably right about his becoming paranoid - dementia does create suspicion and uncertainty. You do know your father best.

I love my Dad very much but think that it may be time for him to go into a home. I feel very guilty about this but I will know that he safe and being looked after 24 hours a day.

Please do not feel guilty about wanting to ensure your father will be safe, secure, clean and well-fed 24/7. I know - the guilt is always with us. It does gradually subside. I still have the odd guilty feeling and my mother has been in care over 8 years now. Actually, now I have guilt about what I could have done instead of what I did. Which is not reasonable on my part I know but human nature is what it is.

Take care and keep posting.

 

[katdan]

Thanks for all that, he does not have a CPN and I don't know what SW is! I have had no support in 3 years. Dad is on no medication at all and about having a neighbour take the meals in, I would be nervous for them as although I do not think he would become violent he would not recogonise the person and that could make him more agitated.
He does not know me sometimes and thinks that I am his Mum or sister, his Mum passed away in 1960.

Katdan

 

[gigi]

Hello Katdan..

SW = Social Worker.

Social Services will send a Social Worker out to assess dad..and it sounds as though you need to ring them back ..speak to the Duty Officer and ask for help now.Sadly if you leave it to them and don't make a fuss they may take a long time to respond.

A keypad can be fitted outside dad's house with a code number. This would contain a house key which would enable Meals on Wheels to let themselves in..but again these things take time.

Dad should have access to a CPN...I'm wondering if you can contact the doctor at the hospital..via his/her secretary..and state your concerns again...and ask if dad has a CPN..or could be allocated one. Explain that you need a point of contact. It's worth a try.

And please don't feel guilty...give yourself a huge pat on the back for caring enough to care what happens to your dad.

Love xx

 

[Helen33]

Cear Katdan

In some respects you could be talking about my husband who I care for. My husband can no longer answer the door because he is afraid of people. He cannot answer the phone. He is afraid when he hears the answering machine. He is paranoid but it is managed and monitored by me. It can only be managed because my husband lives with me and I do the managing. There was a question of whether he should be medicated but I felt that I would prefer management and monitoring initially which works at the moment.

It seems that your father needs to see a Psychogeriatrician who is supposed to be the expert in medication. You could ask your father's GP to request an urgent appointment and I would think this could come through quite quickly. If, however, you think that it is not quick enough then you need to contact Social Services and ask them to do an urgent review. In the meantime, do you think you could persuade Meals on Wheels to keep on delivering until a more suitable arrangement can be made? I think they may be agreeable if it isn't long term.

You are right to be concerned that your father gets the right care for the circumstances. It is not his fault that he has become afraid to answer the door and he shouldn't have to go through this trauma every day. Well done for trying to sort out some more suitable care.

Love and best wishes

 

[katdan]

Thanks Helen

The good news is that the SW is seeing Dad tomorrow. Heard nothing from Meals on wheels today so hopefully they were able to deliver his meal with no problem. It is difficult to monitor Dad when I don't live with him, it would be difficult if not impossible for Dad to stay with me as I have a husband and son at home and I have just started a new job. Dad would be in unfamiliar surroundigs and I think that would make hime worse as he would on his own all day. It is diddicult to know what will be best for him, sometime I think that I am being selfish and thinking more of myself but Dads quality of life in zero and maybe with 24 hour care and more company he may have a better life. I would see him as much as I do now but maybe we would have more quality time together.

Sorry this is so long but sometimes I think that you need to say how you feel, it is sometimes telling family.

Katdan
x

 

[Helen33]

Hi Katdan

I wasn't at all thinking about your father coming to live with you Katdan. I was hoping to get across that my husband manages because he has me present otherwise he would need residential care. Your circumstances are completely different and I think you are being totally responsible by trying to sort out what are the realistic needs of your father now and whether it is time to think about residential care

I will be very interested to hear what the Social Worker has to say and I hope it is all positive.

You are doing well in dealing with all this and having to work. I know some of the strain this causes

Love and hoping that you will update us

 

[Margarita]

It seems that your father needs to see a Psychogeriatrician who is supposed to be the expert in medication. You could ask your father's GP to request an urgent appointment and I would think this could come through quite quickly.

I was thinking that also.

Dad has become more aggressive and shouts which he has never done before and he talks to himself - has a conversation where he asks the questions and then answers himself. He says that people are in the house when there is no one there and he is becoming peranoid (I think as I am not a doctor)

become more aggressive and shouts which he has never done before

As I find my mother behaviour very unpredictable with her vascular dementia

My mother also became like that, AZ day centre advise to see a the doctor to do a referral to the Psycho geriatrician

Which was the best thing I ever done, because if was from a report from the Psychogeriatrician that supported me in getting higher support for my mother needs from Social services.

It does take time to get the appointment with the Psychogeriatrician
The following year I found out I could do self referral

Psycho geriatrician can come to your father house to do memory assessment on your father, you can arrange an appointment time with the person . So you can be there when the assessment done on your father memory, care needs that will enable your father to live independent at home or not .

What your father attitude with having an assessment on his memory?

I found the Psycho geriatrician was the back bone of pushing SW to give my mother higher care needs, as my mother Demetria change over the years.

He has been seen by a doctor from the hospital who has referred him to the OT who cannot see him until next Thursday. I am also waiting for SS to contact me to arrange an assessment for Dad but is so hard to speak with anyone.

what type of doctor did your father see at the hospital, was it to do with anything to do with his Demetria?

I am also waiting for SS to contact me to arrange an assessment for Dad but is so hard to speak with anyone.

The good news is that the SW is seeing Dad tomorrow.

That is good news to read, please let us know what support your father going to get from them

 

[linda js]

Hi Sorry you are in this situation too.I agree with earlier person Ask the SW for a keysafe so Meals on Wheels can let themselves in if dad wont open door.I found they were very quick to fit mums(though it hasn't been used yet as worryingly she is the other way and will let anybody in even though she has an entry phone and wont use it)
Also if ever your dad need urgent help and you cant be there you can tell services the code number and they will be able to get to him.
Hopefully meeting the SW tomorrow will get help he needs quickly.
Good luck and let us know how it goes,Dont be afraid to say all that you feel you need.They should come up with some ideas for help. Linda

 

[Squibbs]

I know just what you are going through too. My 87 year old father was living on his own until 4 weeks ago when he was admitted to hospital with a chest infection. We were getting calls nearly every night from his neighbours and the police to say he had been found outside in his pyjamas and despite my son and I spending hours with him each day we knew he wasn't even having a drink when we were not there. He refused to have meals delivered. Now the hospital have told us he is ready to be discharged and needs to go to an EMI registered nursing home. As he will be privately funded we haven't seen a social worker - the nurses on the ward have told me 'it's up to you where he goes'! We have found, thanks to a brilliant CPN, a home which we are going to see tomorrow. I keep wondering if we couldn't manage him at home but I know it's just not possible - I have no doubt I'll feel guilty whatever the home is like. You're not alone and just remember everyone here is on YOUR side !! Sue

 

[Sandy]

Hi Sue,

Now the hospital have told us he is ready to be discharged and needs to go to an EMI registered nursing home. As he will be privately funded we haven't seen a social worker - the nurses on the ward have told me 'it's up to you where he goes'!

You might want to take a look at the Alzheimer's Society factsheet on hospital discharge:

http://www.alzheimers.org.uk/factsheet/453

The fact that he will be privately funded should make no difference regarding the services of a social worker.

Your father should be entitled to an assessment of his needs for NHS Nursing Contribution (should be granted if they say he needs to go into a nursing home) and also NHS Continuing Care (full funding of care for higher levels of need).

Hope the visit to the home goes well tomorrow.

Take care,

Sandy

 

[katdan]

The SW came yesterday, at first he was quite and did not seem too bad but after a while he started talking to himself. He thought he was going to school and that he was not in his own home he even asked th SW to take him home with her!

At first the SW was thinking about sending carers in but I said I was not sure how he would react to this. At the end of the visit she agreed that she thought that 24 hour care is what he needs.

She is going to arrange a meeting with the hospital doc who I think is a Psychogeriatrician and the OT once she has been to see Dad next Thursday, she said I would be invited to go also.

I have been today to see him and again he is not dressed or had a shave. He told me to go or "he would slap my face" this is just not Dad and it upsets me so much, he even had to ask my name today I don't think he knows that I am his daughter.

I will let you know how the meeting goes whenever that will be.

I would just like to say THANK YOU for all your support it really does help.

Love
Katdan
x

 

[Squibbs]

Things have moved on for us today too Katdan - two of my sons and I went to view a very nice EMI Nursing home and as a result my father is moving there on Tuesday. Thank you very much for the link Sandy - somehow I dont think things will be quite as good when discharge arrives as the link suggests - the ward sister wasn't too thrilled we wouldn't be moving until Tuesday and we have been told it will be 'best' if we transport my father ourselves - oh yes it has to be before 10am too! The best thing is that having made a decision I now feel much happier and more settled myself - the guilt will probably always be there but I know I've done the best that I can for him and me. Try to keep positive Katdan. Sue

 

[patmarcowie]

Oh Dear katdan, I feel for you. My Mum gives me the same worry! She lived alone but things got so bad it meant her having to go into care - but - I have always promised her I would never do that, so, my Husband and I brought her to live with us. It is hard work looking after her, and I know it will come to the stage where I will no longer be able to give her the care she needs! She has hallucinations, she also becomes very aggressive. She also thinks I am her Mum (and even sometimes her Dad). It will break my heart to let her go, but, we have to do what is best. The only consolation is - your Dad and my Mum won't really understand what is going on!
I hope it all works out for you

=katdan;202945]Thanks for all that, he does not have a CPN and I don't know what SW is! I have had no support in 3 years. Dad is on no medication at all and about having a neighbour take the meals in, I would be nervous for them as although I do not think he would become violent he would not recogonise the person and that could make him more agitated.
He does not know me sometimes and thinks that I am his Mum or sister, his Mum passed away in 1960.

Katdan[/QUOTE]

 

[Margarita]

patmarcowie.I have always promised her I would never do that, so, my Husband and I brought her to live with us. It is hard work looking after her, and I know it will come to the stage where I will no longer be able to give her the care she needs! She has hallucinations, she also becomes very aggressive. She also thinks I am her Mum (and even sometimes her Dad).

Warm Welcome to Talking point patmarcowie.

I always promised my mother also, now I am at the heartbreaking point that I am going ahead am going to put mum in a nursing home, what is so heartbreaking she does not want to go, but I can't cope anymore of 7 years of coping with the symptoms of aggression, it’s all to challenging for me. It’s not so bad now, but my mother is very Unpredictable in her behavior it pops up now then.

Have you seemed anyone at the memory clinic, the person that looks after your mother Dementia, I do that when I notice changes in my mother Dementia. I know they are nothing they can do, but they can get more support for you. Do you get any support to help you, support your mother while living with you beside yourself and your husband, Or do you already get outside help , also any medication if the hallucinations are to distressing for your mother ?

katdan

I have been today to see him and again he is not dressed or had a shave. He told me to go or "he would slap my face" this is just not Dad and it upsets me so much, he even had to ask my name today I don't think he knows that I am his daughter.

So sorry to read that. I have to remind myself that its the brain damage from the disease that making my mother like this towards me . I hope when your father not go confused from being in hosptail , as I find a change in My mother Environment can make the dementia symptoms worse, then when she more settle the symptoms are not so bad, wishing that also for your father, when he is out of hosptail .

Squibbs Things have moved on for us today too Katdan - two of my sons and I went to view a very nice EMI Nursing home and as a result my father is moving there on Tuesday.

Wishing your father all the best with the move, let us all know how it gos.

Squibbsthe ward sister wasn't too thrilled we wouldn't be moving until Tuesday and we have been told it will be 'best' if we transport my father ourselves - oh yes it has to be before 10am too!

Do you not have social worker or CPN who can organize transport for your father ?

 

[katdan]

Up date

Thought I would give you an up date on dad, I went down on Tuesday to see him and he kept telling me to do odd things like taping on the window, turning to face the wall .... I did not stay long as it was too upsetting. When I returned home one of my Dads neighbours had left messages to say that he was wondering in the street, she and her husband had tried to get him back home but he was shouting at them. To cut a long story short I rang an ambulance and Dad was taken in, his behavour in A & E was awful, he was telling me and my husband to do things and when we did not he kept shouting!! In the end I could not take any more and we left him there, I felt like I was just dumping him there but the nurses said it was ok. I think that we were making things worse.
He is still in hospital where he is on antibiotics, he had a CT scan yesterday but the report said that there were no sign of stoke or bleeding in his brain.
I have just returned from the hospital and he is still hearing voices and did not really know who we were - me and my brother went.
Nothing will be done until Tuesday as it is the long weekend I don't think that he will be able to go and live on his own again, but I am worried that the SW will say that he will be able to manage with careres. I would rather he had 24 hour care so that I knew he was being well looked after.

I will let you know how it goes.

Katdan
x

 

[Margarita]

but I am worried that the SW will say that he will be able to manage with careres. I would rather he had 24 hour care so that I knew he was being well looked after.

don't forget that social workers can say what they like. but your, your father next of Kin so you know what in your father best interest in where he lives .

so make sure before you father discharge from Hospital your father has an assessment on his needs, living environment and support network .

also bring in someone like a consultant from the memory clinic that look after you father Demetria to do the assessment .

The hospital discharge process should include:

* an assessment of the person's needs, living environment and support network (see below)
* a written care plan that records these needs
* confirmation that any required services are in place in time for the discharge
* a system for monitoring and, if necessary, adjusting the care plan to meet in any change in needs.

http://www.alzheimers.org.uk/factsheet/453

 

[TinaT]

Hopefully his competancy to live at home or not will now be taken over by the medical staff. If the medical staff consider he needs a full care package and nursing home, then the Social Worker would have to go along with that. I hope that you see some improvement in his condition and that the doctor's can help him.


Let us know how you go along as there is a wealth of help, experience and advice on such things here on TP.

xxTinaT

 

[living in hope]

Hi
I'm sorry your having a rough time with your dad at the moment. My husband went in hospital recently then went to respite care as I wasnt sure I could still cope as he had deteriorated. He was assessed by SS last week and is now to stay at the residential home on a permanent basis. I hope you have the outcome that is best for your dad to ensure he is safe! then you will be able to relax. Let us know how things go.
Love
Lorraine