Advice / Opinions Needed

Discussion in 'ARCHIVE FORUM: Support discussions' started by Mike.M, May 8, 2008.

  1. Mike.M

    Mike.M Registered User

    May 8, 2008
    5
    Lincolnshire
    Hi all. I hope that some of you may be able to help with my problem. My mother was diagnosed with vascular dementia 18 months ago and has been deteriorating since then. She has the common list of other health problem such as angina, high blood pressure and diabeties. for which she has a variety of medication. She had a fall at Christmas last year which resulted in a broken leg and has been in hospital and respite care since then. She is now coming to the end of her stay in the care home and is very determined to come home, which is something I dread.
    The problem is that all the assesments she has had have all come to the conclusion that she is able to look after herself and I agree that on the face of things she would be able to do. Unfortunatly she is very stubbon and set in her ways and has constantly refused to take her medication, claiming it makes her worst. This was a direct cause of her recent fall and resulting fractured leg. She also doesn't eat properly, which means her diabeties is not controlled properly. She openly says she will continue to only eat what she wants, despite admitting that a balanced diet is even more important given her condition. I know that if she does return home within a few months we will be in the same situation or worst, as she was lucky that the fall at Christmas only resulted in a leg fracture as it could have been a lot worst.
    The medical professionals seem to agree with my concerns but say that they cannot do anything and that if she wants to go home then they have to let her.
     
  2. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    68,642
    Kent
    Hello Mike. :)

    I`m really sorry and can see how worried you are but the medical professionals are quite right. Your mother can only be forced into residential care if she were poorly enough to be sectioned.

    It`s really frustrating I know, but all I can suggest is you try to get her as much help and support as possible.

    The time will come when she might be prepared to seek residential accommodation. Meanwhile, it might help you if you were to inspect homes and shortlist the most suitable ones, in case of an emergency.

    Sorry I can`t be of more help.
     
  3. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,518
    They are correct. Unfortunately, many people with dementia are totally convinced there is nothing wrong with them, they have absolutely no insight into their cognitive failings - because of their cognitive failings! Beliefs, no matter how false, become fixed and no amount of reason, argument, or evidence to the contrary will shift those beliefs.

    Although it is very hard to do with a loved one, unfortunately, all you can do is your best. If your mum refuses to take medication or continues to eat what she pleases, then no-one can force her.

    The threat of "being taken into care if you can't look after yourself" may or may not be effective, because as you say, mum is convinced that there is nothing wrong with her and hence she can take care of herself. In her world, she can eat what she likes and she does not need her medication.

    I think, all you can do really, is to try to gain acceptance that you can't change this.

    All you can do is to try to cope with any crisis that may result.

    Eventually, things may come to a head, but until that happens, I don;t think there's much you can do...
     
  4. helen.tomlinson

    helen.tomlinson Registered User

    Mar 27, 2008
    541
    Hello Mike

    I can quite see why you are so worried. It doesn't make sense to me that someone who cannot be held responsible to take care of herself should be just left to it.

    I would need to get some things really clear. Like "who is responsible for your mum in that she clearly can't take responsibility for herself (re medication and diet)?" Are they saying that mum is responsible for herself even though she has a dementia and has demonstrated that she isn't reasonable regarding medication and diet?

    I can see that perhaps your mum is o.k. to be home but only with an adequate care package. What do Social Services say? Are they prepared to offer a home care package?

    Hope you get something sorted Mike.

    Best regards

    Helen
     
  5. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Hi Mike

    I understand why you are so worried, your mother is clearly not capable of acting in her own best interests.

    Unfortunately, the medics and earlier posters are correct, and your mum cannot be forced into care against her will.

    All you can do is contact social services and ask for a care package to be set up. I don't know if she had such a package before her fall, but she should certainly have one now.

    Social services should be able to provide someone to monitor her medication, and OT should assess her competence to look after herself, and provide any aids necessary.

    Having said that, there's not much you can do about her determination to eat what she wants. I have to confess, I have some sympathy with her here!

    I hope you manage to get something sorted out, let us know how you get on.
     
  6. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,518
    The only alternative is that someone becomes such a risk to themselves, or others, that they are sectioned. This is the extreme last resort and doctors are quite rightly very reluctant to use it.

    It should be remembered that, legally, any attempt to medicate someone against their expressed wish would be construed as abuse.

    When my father, years ago, became delirious in hospital after an operation the doctors there were very unhappy about any sort of sedation even after he managed to pull out the drips and get halfway down the corridor to phone my petrified mum at home to ask her to inform the police that he'd been abducted!
     
  7. Lynne

    Lynne Registered User

    Jun 3, 2005
    3,433
    Suffolk,England
    Hi Mike,
    I cannot really add much to the opinions already expressed, except that now, when your Mum is looking forward to going home, could be the best time to get her to accept such help as you can drum up for her "just for a few weeks", or whatever argument you may think will work. Don't forget to drop the phrase 'Duty of Care' into your conversations/negotiations with the Care Professionals (using the term ... well, hopefully).

    Best wishes
     
  8. Mike.M

    Mike.M Registered User

    May 8, 2008
    5
    Lincolnshire
    Thanks for all your replies. You're all saying what I know is right. My mother has had care packages put in place twice in the past but she has thrown the carers out after a couple of weeks on both occasions.
    My frustration is, as someone has said, that nothing can be done until it is shown that she cannot care for herself. But surely not taking her medication or controlling her diabeties with her diet is proof and the resulting fall shows that she cannot take care of herself! Actually the professionals seem to agree with this but still say that regardless of that she can still go home to look after herself if she wants to.
    I am really concerned about what has to happen before anything is done and that it will more than likely be too late then.
     
  9. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    #9 Margarita, May 8, 2008
    Last edited: May 8, 2008
    I hope you don't mind me asking , but I am wondering what type of assessment they done on your mother mental health to come up with the conclusion that she can look after herself . Did they do the New mental capability test on her that come into force last year , so they know if she can make decisions. on her own ?
     
  10. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    #10 Margarita, May 8, 2008
    Last edited: May 8, 2008
  11. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
  12. Mike.M

    Mike.M Registered User

    May 8, 2008
    5
    Lincolnshire
    They have done a couple of mental capability tests. Don't know if they were the new one's or not. She has also had some sort of test by an O.T at the hospital before going to the Care Home.
     
  13. Carolynlott

    Carolynlott Registered User

    Jan 1, 2007
    232
    Newcastle upon Tyne
    Quote: "Your mother can only be forced into residential care if she were poorly enough to be sectioned."

    I'm a bit confused here. My Dad went into respite care in December - we told him the truth, that it was to give my Mum a break because she was so tired looking after him, especially as he wouldn't let her sleep with his wanderings through the night. When we visited him he assumed we had come to take him home and we had to persuade him no, Mum wasn't well enough yet. When he first went to respite we had no idea he would never go home.

    However once in respite it was clear how far his AD had progressed, and how my Mum wasn't able to care for him any more. In conjunction with his SW, we transferred him to a permanent CH after 8 days - he never went home. He didn't have a say in it - we just took him. If anyone had asked him he would have said he wanted to go home - but no-one asked him. At first in the CH he still assumed he would be going home, hence his attempts to break out. Even now, after 5 months, I think if I told him he was going home, he would. To all intents and purposes my Dad is being held there against his will - albeit for his own safety - Mum has AD too and can now barely look after herself, let alone him too. However he has not been sectioned. If he had, he presumably wouldn't be having to pay for his care.

    Does any of this make sense?
    Carolyn
     
  14. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,418
    It makes perfect sense Carolyn. I think this is one example of the way in which the rules are "bent" when necessary. I think you'll find that very few dementia sufferers willingly enter a residential facility, but many of them are "managed" into it: "it's a temporary arrangement"; "you can come home when you're well" and all those other tarrididdiles that we tell. There's a stage, though, I think when they are still able to make "bad" decisions and they have to be allowed to make them. It's extremely worrisome for the people who care for them and you just have to hope that nothing really major happens during that time.
     
  15. Helena

    Helena Registered User

    May 24, 2006
    715
    "we just have to wait for a crisis " is the stock phrase from GPs and medics especially over anyone with Vascular Dementia which fluctuates quite wildly IMHE

    One minute they seem perfectly normal and the next they are in cloud cuckoo land

    Been there done that bought the T Shirt with my 90 yr old Mother

    She too refused to take her medication and in the end because she was simply tired of life she refused food
    The disease tends to progress in leaps and bounds and just when you despair of the situation something will overtake matters

    If your Mother is as stubborn as mine was you will simply have to step back and let it happen
     
  16. Carolynlott

    Carolynlott Registered User

    Jan 1, 2007
    232
    Newcastle upon Tyne
    Still don't really understand. You can't be "forced" but you can be "persuaded"? If you can be persuaded, under whatever premise - doesn't that suggest a degree of mental facility that isn't there if you have to be forced? Or have I got that the wrong way round?
     
  17. Mike.M

    Mike.M Registered User

    May 8, 2008
    5
    Lincolnshire
    Well there have been a couple of developments this week. The first is that Mother has suddenly started getting aggressive and abusive towards people both in the home where she is and on occasions when she has been out. I know this sudden deteriation is a normal progression of the disease. She was seen by an O.T from the mental health unit for an assesment on Tuesday. The result was that she was recommending 24hr care in a suitable care home with a Dementia unit. We have also been to see the consultant at the unit today and he is going to also recommend the same and is getting his report faxed to the Social Worker and asking for this to be treated as urgent.
    This is going to have to be done without her consent because she still refuses to accept that anything is wrong. Because of this I am a little confused as I expected that the consultant would be the one to section her so his recommendations could be carried out. But he hasn't done so and I got the impression that if sectioning was necessary the Social Workers would do it. Is this right?
     

Share This Page

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.