Hello All. I've posted before about my own dear Mum but this time it is about concerns about my mother in law. She has always been a rather histrionic personality and has always had, to my belief, undiagnosed mental health problems. She is 87 and lives with her husband who is 91. She hates her husband with a passion and the whole family are really concerned for his safety (she is verbally abusive 24/7 and has threatened him with a bottle to his head in the past) She has tantrums and calls family several times a day in an argumentative fashion. Quite often she says she wants to die. The family have managed to get someone from the GP practice to come and give her a memory test. All we know is that it involved a clock face and she didn't do well on it. The GP surgery won't discuss anything with the family because of patient confidentiality despite several long and carefully worded letters being sent to him about our concerns. My father in law has told us all not to mention his birthday coming up as she will become even more abusive so it is hard for us to talk to him. If my husband asks to speaks to him on the phone, his mum becomes quite abusive to both him and hid dad. There is a family party tomorrow (I year old!- great grandson) so all of us are going. Walking on eggshells springs to mind. Has anyone any ideas? (about the blasted confidentiality though any thoughts would be welcome.) Thanks
Abusive MIL and patient confidentiality
- Thread starter Mipsi
- Start date
I think you've got two problems (at least!).
The first is that you'd like to know if there is a diagnosis and aren't being told. For me, getting in the loop was helped by an understanding GP who very lightly slipped into a conversation with my mum the question of was it okay to put me down as a something or other. I can't remember the exact phrase he used but he made it sound very inconsequential and asked the question during a good moment, when mum was being quite compliant. On another day or asked in a different way, she might've said no. So maybe another letter to the GP dealing with your MiL asking if something like this is possible.
The second problem is her aggression and that's unlikely to change unless there is a diagnosis and some medication, and maybe not even then. Might it be an idea to ask the social services to do an assessment? If good and knowledgeable people get involved they might be able to offer your FiL, and the rest of the family, some support in dealing with these behaviours. They should also be a little bit more relaxed in discussing her situation with you, especially if they note diminished capacity.
The first is that you'd like to know if there is a diagnosis and aren't being told. For me, getting in the loop was helped by an understanding GP who very lightly slipped into a conversation with my mum the question of was it okay to put me down as a something or other. I can't remember the exact phrase he used but he made it sound very inconsequential and asked the question during a good moment, when mum was being quite compliant. On another day or asked in a different way, she might've said no. So maybe another letter to the GP dealing with your MiL asking if something like this is possible.
The second problem is her aggression and that's unlikely to change unless there is a diagnosis and some medication, and maybe not even then. Might it be an idea to ask the social services to do an assessment? If good and knowledgeable people get involved they might be able to offer your FiL, and the rest of the family, some support in dealing with these behaviours. They should also be a little bit more relaxed in discussing her situation with you, especially if they note diminished capacity.
Hi Delphie
Thanks for your thoughts.
MMMM if only the doctor was that helpful. He seems very jobs-worth and to the book which is actually hampering safety issues. I did think of social services but my father in law (who is bright and still fairly spritely, taking holidays on his own still) would not go down that route. It has been keeping quiet about anything which may have a stigma which created this in the first place, my mil should have had help decades ago. She tends to come over like a sweet eccentric old lady with strangers but changes when with the family. I'm worried about the turn things may take as it does seem to be getting worse at the moment.
Thanks for your thoughts.
MMMM if only the doctor was that helpful. He seems very jobs-worth and to the book which is actually hampering safety issues. I did think of social services but my father in law (who is bright and still fairly spritely, taking holidays on his own still) would not go down that route. It has been keeping quiet about anything which may have a stigma which created this in the first place, my mil should have had help decades ago. She tends to come over like a sweet eccentric old lady with strangers but changes when with the family. I'm worried about the turn things may take as it does seem to be getting worse at the moment.
Maybe you can encourage your FIL to take more time away? If his absence accelerates a problem that his presence is masking - everybody might benefit? And if he is with you - he can talk to his son?
As far as confidentiality is concerned, it is a minefield. It might be your FIL does not want the GP speaking to you for fear of the consequences. It might be MIL does not want anything mentioned. It could be the GP is anxious that any upset of any kind might frighten both his patients away .....
As far as confidentiality is concerned, it is a minefield. It might be your FIL does not want the GP speaking to you for fear of the consequences. It might be MIL does not want anything mentioned. It could be the GP is anxious that any upset of any kind might frighten both his patients away .....
I'm afraid legally (and, in my view, morally) the GP is right. I don't have time to go into detail but, briefly, the Data Protection Act 1998 and medical confidentiality and in particular the Caldicott Principles severely restrict disclosure. While there is scope for some limited disclosure under the Act to carers, this is limited to what is needed for their care. Your MIL is the patient, and her wishes must be taken into consideration, however awful her behaviour may be. Ultimately if your FIL finds it intolerable, he is as entitled to leave her as any other spouse (although at 91 I'd say that's unlikely!). What GPs can do is receive information. If you fear for his safety, your best course is to address these concerns to the GP (and copy to Social Services) as a Safeguarding of a Vulnerable Adult issue. Ideally this should be in writing, as it is harder for them to deny receipt.
Kind regards
Wirralson
HAve had this for 2yrs finally the doc listening??? Was quite hysterical on the phone to his receptionist!!
A friend of mine is a doc and she said when someones safety is at risk then they have to talk to family. I also rang a social worker as my mum acccused me of threatening her?? other way round anyway its not nice and I was very frightened my bro was sent up to the house to protect her???????????
My bro and sis take her side all the time but are never here its awful!
Anyway think a social worker may be able to help just a thought? Your poor father
god help him will ask the angels to protect him. If my mum EVER gets violent with me that will be that im afraid.
My neighbours mother pulled a rollerblind off the window and hit her on the head THATS WHEN HER FAMILY WOKE UP!
Take care
A friend of mine is a doc and she said when someones safety is at risk then they have to talk to family. I also rang a social worker as my mum acccused me of threatening her?? other way round anyway its not nice and I was very frightened my bro was sent up to the house to protect her???????????
My bro and sis take her side all the time but are never here its awful!
Anyway think a social worker may be able to help just a thought? Your poor father
god help him will ask the angels to protect him. If my mum EVER gets violent with me that will be that im afraid.
My neighbours mother pulled a rollerblind off the window and hit her on the head THATS WHEN HER FAMILY WOKE UP!
Take care
Appalled at the jobsworths from the surgery you have to deal with here but can’t help noticing you referred to “someone from the GP practice to come and give her a memory test”? Not sure if the GP has actually seen her / your FIL or whether your MIL was referred directly to memory assessment services and bypassed / didn’t get as far as seeing her own GP.
Whoever it was should have already set the ball rolling if things are as you say and I’m very surprised nobody has before now.
Anyway, your MIL is presenting with behaviour consistent with depression and anxiety etc, and there's clearly a risk of carer breakdown with as you say, possible undiagnosed mental health conditions to boot. She has said she wants to die and threatened to physically assault her husband for whom she is the primary carer and her “not doing well” on the memory test gives rise to further concerns which I don’t think have been considered alongside everything else.
Either way (i.e. whether or not she’s seen the GP), here’s what I would suggest you do.
Contact social services and if she has an allocated social worker, tell them everything that’s going on and what your worries are etc. If she doesn’t have one / hasn’t had one for a while etc, explain to the person taking the call you are seriously concerned your MIL is not coping and that your FIL may well be at an immediate, serious risk of abuse.
That sounds quite harsh I know but ultimately he is at risk and she clearly isn’t managing so someone needs to visit them both at home and carry out a full assessment.
Once all these things are flagged up, the confidentiality issue moves to a different level and both your MIL and FIL will be given the right type and level of support they need.
Whoever it was should have already set the ball rolling if things are as you say and I’m very surprised nobody has before now.
Anyway, your MIL is presenting with behaviour consistent with depression and anxiety etc, and there's clearly a risk of carer breakdown with as you say, possible undiagnosed mental health conditions to boot. She has said she wants to die and threatened to physically assault her husband for whom she is the primary carer and her “not doing well” on the memory test gives rise to further concerns which I don’t think have been considered alongside everything else.
Either way (i.e. whether or not she’s seen the GP), here’s what I would suggest you do.
Contact social services and if she has an allocated social worker, tell them everything that’s going on and what your worries are etc. If she doesn’t have one / hasn’t had one for a while etc, explain to the person taking the call you are seriously concerned your MIL is not coping and that your FIL may well be at an immediate, serious risk of abuse.
That sounds quite harsh I know but ultimately he is at risk and she clearly isn’t managing so someone needs to visit them both at home and carry out a full assessment.
Once all these things are flagged up, the confidentiality issue moves to a different level and both your MIL and FIL will be given the right type and level of support they need.
