Care home against her will?

Discussion in 'I care for a person with dementia' started by Hamfox, Sep 15, 2015.

  1. Hamfox

    Hamfox Registered User

    Apr 6, 2015
    6
    Hi,

    Thank you in advance to anyone who is able to take the time to read my very long post!

    Does anyone have experience similar to mine with my mum? How do I get her to go into a home - as she can no longer live with my vulnerable stepdad - when she is completely unaware of her condition while strangely at the same time aggressively in denial and prone to massive outbursts?

    She is becoming more and more frequently verbally abusive, and has on a couple of occasions hit my stepdad and threatened to kill him, and says she wants to die. (He said he didn't think she would do anything.) She yells, swears and slams doors. In between things are apparently relatively stable but as time goes on, I get the impression these calmer patches are shorter, and fewer and farther between. In fact, when I dare to think about it, I think things are pretty bad most of the time now.

    I say 'impression' because I can hardly ever get to speak to my stepdad, it is incredibly frustrating. I live 1.5 hours away, have a young family and work every day, so I can only visit at the weekend. Up until my last visit I have always had an opportunity, albeit pretty brief, to have a quiet chat with my stepdad while my mum goes off to rummage or something. However, she never left our side last time, and when they came over to visit last weekend, she stayed with me the whole time. So my stepdad had to give an update to my partner. They get on ok, but it really ought to be me, as I fear he dilutes the seriousness of the situation for him. Communication by email is out of the question, he is not allowed near the computer which used to be her domain, doesn't own an iPad and only has an old-style mobile phone which is rarely on. She is always right there when I call - he has no way of getting away from her to make a private phone call. So he is trapped. He is physically more and more vulnerable, and can't move around very well.

    My mum can physically still look after herself, although she's getting very 'shuffly', doesn't wash her hair often and sometimes wears dirty trousers. She also remembers all the family's names including my partner and my two children. However, her short-term memory appears to be a mere few seconds long. In short, I imagine in her head it feels like she is literally losing her grip. Any suggestion of memory or health problems is at best dismissed, at worst aggressively denied. She was extremely rude to the community nurse from the mental health clinic who made a home visit, but her manner and dishevelled, manic appearance was all the nurse needed to witness to realise things are bad.

    Miraculously my mum does have a diagnosis - she has Alzheimers. The community nurse arranged for a CT scan. Thankfully the appointment letter went directly to my mum, (she would have laid into my stepdad - verbally - if it'd gone to him as her carer) and although it made her extremely angry and she hid it for 2 weeks, the letter re-appeared on the day of the appointment she suddenly decided she was going to go. The community nurse phoned to find out if they'd gone to the scan. My mum answered but refused to speak to 'that woman' (how can she even remember who this woman is, it is horribly spooky). She threw the phone at my stepdad when the nurse asked to speak to my him instead - as this just clearly proves that he is plotting against her. Surely all the nurse had to do was use her contacts to find out if my mum had had her scan? My stepdad said he had a 'bad day' after that phone call. Finally there was an ill-fated visit from a new doctor from the mental health clinic who (a) did not realise that the appointment had been cancelled (due to my mum saying she would refuse to speak to anyone) and (b) incredibly, suggested my mum have a scan, having no idea she’d had just had one. However, the doctor was then able to look up the results on her laptop/iPad/phone. Apparently there followed more memory tests (a pure waste of time in my opinion), she was asked if she could make meals, my mum turned on the charm and said she had 'this lovely man' to cook for her. Apparently she did not give any particular reaction when she was told she has Alzheimers. After the doctor left, she went into a rage, but I don't know exactly what happened.

    Basically, my stepdad has indicated that he "doesn't know what he's doing it for anymore". As he is usually fairly understated, I take this as "Please get me out of this situation as soon as possible." So, I need to get her into a home but I have no idea how or where to start looking, what their financial situation is (because my stepdad has previously been coy about this, and now I can't get to speak to him at all). And of course, the biggest problem of all, I have no idea how we'd ever get her over the threshold of a home.

    My brother lives 3.5 hours away and has not been (nor wanted to be) as involved, so it is mostly down to me. He and I looked at a couple of homes in my local area back in the spring, but he accepted that it was still too early for her to go into one (he wanted to get it done right away at that point). I think the situation is different now.

    There is a lot of information and advice on dementia out there, but not much of it covers the situation where the person thinks that any concern shown for their health is an evil plot against them...and in any case, would instantly forget any conversation about a diagnosis, the need to go into care, anything like that. My stepdad has already a power of attorney in place for each of them, but I am not really how it works - I need to find out about that.

    If you've got to the end of this post, thank you for sticking with it. I basically have one question - how do you get someone into a care home against their will?
     
  2. Beate

    Beate Registered User

    May 21, 2014
    11,713
    Female
    London
    Sorry, I admit to only skimreading your long post but if you want to put someone in a care home against their will, they must have lost capacity and you will need to reach a best interest decision with social services if they are the ones paying. It helps if someone has health and welfare POA. Even if she was self-funding (ie over £23,250 in capital or assets), they could help you with a list of care homes. You might try a care home for respite first to see how she gets on. Common love lies are that she is going to stay in a hotel for a while. This is actually a well-known problem on this board and I am sure you'll find lots of similar stories.
     
  3. Bod

    Bod Registered User

    Aug 30, 2013
    1,160
    Would it help if step-dad was moved out first?
    After all he could be described as a vulnerable person, who could be being abused.


    Bod
     
  4. dora

    dora Registered User

    Aug 1, 2007
    145
    England
    I could have written this post a few years ago. The only difference was, that the scan letter disappeared and we never got a diagnosis. We also had the rages, the suspicion, and not being able to speak to dad alone.
    One Christmas, she went into meltdown and we separated them. Dad said he couldn't cope any more. We went to the GP and the memory clinic came out to assess her, but as she wouldn't attend the scan, everything came to a halt. Dad was terrified of anyone official visiting, as she would blame him, and I also think he covered up for her because he was embarassed.
    In the end, Dad's health broke down, he went into hospital, Mum deteriorated very quickly. We managed to get the CPN involved and eventually she was sectioned and admitted to hospital, where she was given medication, and soon transferred to a care home.

    I suspect you may have to wait for a crisis, but you should make the GP aware of the situation either by letter or phone. You should also inform SS and emphasise that your stepdad is a "vulnerable adult" with an aggressive spouse.
    Also, you did right to start looking at care homes. If local authority funded, you should be aware it may be difficult to place her in a home in a different county to where she currently lives.

    I do remember so well the desperation of wanting to do something to improve the situation, but not being able to. I hope you soon find some help.

    best wishes
    dora
     
  5. MissDiane

    MissDiane Registered User

    Oct 18, 2013
    73
    Things I did in a similar situation to you that may wish to consider:

    Inform their GP in writing of your concerns
    Report all physical attacks to Adult Social Services and keep you own record
    Get LPA in place either you or your dad as attorney
    Get a as much help as you can for them
    Contact Age UK, Alzheimers Society and ask what is available
    Age UK have leaflets explaining about care home funding
    My parents were reluctant to accept help but I went ahead and arranged for carers to come in to prepare meals/help with bathing/dressing/washing etc
    Alzheimers society took mum out for regular trips to give my parents a break from each other
    Ask for an allocated social worker - keep records of all discussions
    If mum still has capacity then unless you report the abuse no one can force her.
    If capacity is to be decided, if found this to be extremely tricky as it depends on many things and no professional wanted to commit either way
    Start building up a case of evidence
    Be ahead of the game and pick out the best homes a put her name down, you can always say she's not ready yet if a place comes up and its not the right time. I found the best homes have waiting lists.
    Hope some of this is of some help. it was easier for me as I had LPA for mum. Although nothing was done by SS until the 3rd crisis situation. I basically made the decision in the end as I had LPA. Don't assume its too late to get this done. Having LPA makes everything so much easier.
     
  6. Katrine

    Katrine Registered User

    Jan 20, 2011
    2,850
    England
    It strikes me that your stepdad has become an abused spouse. His fear of your mum kicking off, or punishing him, is a major impediment to any help they could receive. I imagine that she would not accept any carer help for HIM (physically infirm)? This could potentially be a means of getting support but I think she would resent it and could be violent to the carer. :(

    If it was me I would plan a visit with either brother or OH as a team. Plan to get mum distracted by one person while the other talks to stepdad. Is there anything you could do that would make her leave his side, e.g. OH or brother could say they are going to bleed the radiators to make sure they are warm now the heating needs to go back on. Would this make her hover and supervise well away from stepdad, or perhaps it could work the other way round with it being a boring man job that wouldn't interest her, so stepdad could come and 'help' in another room. Meanwhile you could keep her busy in the kitchen or go to the shops with her? I am assuming you are female. If not, then reverse suggested roles as appropriate!

    The talk with stepdad would need to be short and to the point. It is essentially a domestic violence intervention.
    Do you want to come home with us today so that you can have a break?
    Do you want to go on living in this house if Mum wasn't living here any more?
    If Mum's behaviour could be controlled by medication, would you want to go on living with her, with visiting carer support?
     
  7. janey106

    janey106 Registered User

    Dec 10, 2013
    139
    Hi Hamfox

    I could so relate to your post (and Dora's) - just about every line - except it is Mum and Dad in our case. Whilst Mum's GP is, and was, defensive and pretty useless (that's another thread), we persevered in demanding a specialist consultation and this eventually lead to the Consultant doing an 'unannounced home visit' and Mum was admitted to a local 'mood ward' for a few days. If she had not gone voluntarily (and actually it was a really lovely ward with tremendous staff) he was ready to section her. Mum was only in a few days but his review and amendment of medication has certainly taken some of the aggression and fight away although the paranoia I regret remains but not as severe. Mum continues to think and say, whenever we talk about getting help etc, that we just want her in a mental institution .... no amount of talking or evidence to the contrary is shifting this. The Consultant has remained involved with accompanying support staff and this has been a major help in keeping Mum at home but we are moving towards respite or care as we speak.

    I really think this sounds like you need to be pushing for more frequent support - Step-Dad sounds pretty vulnerable. Maybe just say it is because he is unwell and needs it?
    Sorry I can't be more helpful but I can really empathise with you - good luck.
     
  8. Hamfox

    Hamfox Registered User

    Apr 6, 2015
    6
    Thank you so, so much for all these ideas, it's an incredible help to get some insights from someone who 'gets it'. A few (not all) of the ideas have been buzzing around in my head but I just didn't know where to start. I managed to squeeze in a call today to the clinic to ask for an update (have to wait for a call back), and have made a telephone appointment to speak to my mum's GP early next week.
    It did occur to me that it wasn't obvious if I am mum's son or daughter - I'm her daughter :)
     

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.