I apologise for this lengthy post but I need some advise. Wow! what a visit I had with my Mum over the Bank Holiday! I decided to visit her rather than bringing her to me for her usual 'holiday' as it was taking her a couple of weeks to settle back into her home. I arrived and she was delighted to see me. I noticed that her clothes were dirty (Mum has a Colostomy and has had this for the last 13 years) when I lifted her top I saw that she had no bag over her stoma!!! I took her into the bathroom and asked her where her bags were - she replied "I don't have any" I knew she did so went and got some for her. When I looked at her stoma it had a huge swelling above the stoma site (looked like she had swallowed an orange!). I was really concerned and wanted to take Mum to A&E but wanted to check with the carer who showered Mum on Friday (it was Sunday by now) that it was not like this (I had a feeling it wasn't as my gut told me she would have contacted me). The carer arrived a little earlier and popped in. When she saw it, she said it was a little swollen but nothing like it was. She asked my Mum why she didn't have a bag over her stoma to which my Mum repeated that she didn't have any. The carer said to my Mum "why didn't you ask" I was close to saying that my Mum shouldn't have to ask and that she should check but I kept my thoughts to myself as my primary concern as my Mum. I took Mum to A&E and they decided to keep her overnight after standing my ground (she has perforated her bowel twice and nearly died on both occasions the last kept her in ICU for 3 days in an induced coma so I don't take chances with her.) They kept her in for observation and I stayed with her until 4am as she was understandably frightened so I just sat with her and we chatted until she was settled. They discharged her the following day saying that she had a Hernia. When I got home with her I was putting her clothes away and found dirty clothes and underwear in with all her clean clothes, the coffee mugs and plates (that Mum had washed) all dirty, Choc Ices in the refrigerator, bathroom and kitchen sink very dirty, shower cubicle not cleaned and the shower head left on the floor, kitchen floor sticky and a very, very dirty tablecloth on the table! I have raised these concerns with the carer before and had asked her to keep an eye so I was totally dismayed when I saw these things (I know the dirty clothes where folded very neatly in the drawer but that is no excuse I managed to see them). My Mum says that when the carer visits she doesn't do anything she just does the jigsaw puzzle with her and they sit outside on the wall and chat. I have to be very careful as to what I say due to Mum's AZ but on this occasion I could see it with my own eyes. When I was in the hospital with my Mum I was shocked to see how much weight she had lost. She has a cooked meal (served hot) (not meals on wheels) delivered to her each day by a different lady. The meal is very, very, good. However, during our conversations in the hospital Mum was telling me that if she has something on her plate she doesn't like she flushes it down the toilet (although the lady has said that if there is anything she doesn't like then Mum is to tell her). I told her that she should put it in the bin as it may block the toilet!! I thought that way if she isn't eating all her lunch the carer will be aware as she should see it in the rubbish bin. So I don't know if she has lost weight due to not eating all her meal or there is something more going on. I had a couple of telephone calls from my Mum around 17:00 saying she is hungry so I have now arranged for the lady who does Mums lunch to leave a sandwich for her which my Mum has at 18:00. She leaves a lovely Tupperware type box (Mum and I call it her 'Picnic Tea') it contains a filled roll or sandwich some savoury biscuits and piece of fruit and a yoghurt. When I visited I didn't cancel the carer so as to keep Mum's routine the same. The carer returned in the afternoon (she has an hour 3x a week to help with household chores etc.) but all she did was sat and chatted to my Mum and emptied the bins (she didn't even wash them out I ended up doing that). The carer had put a bottle of milk in the freezer! When I asked her why it was there she said it was a back-up but I don't think she appreciates that things like that confuse my Mum. Added to that, Mum wouldn't wait until it defrosts plus I think she would start leaving her fresh milk out which would then go off. Upon my departure I removed the milk from the freezer and explained my reasons in a note to the carer. I am not too sure if any of the carers from the agency are trained to deal with AZ and Dementia clients. I think the lines have become VERY blurred. My Mum sees the carer more of a friend and thinks she is coming in because she likes her, but in the next breath Mum moans because the carer doesn't do anything (except the jigsaw and chats about the other people she visits). I feel lucky my Mum has a good relationship with her carer, however, I feel the carer is taking advantage of my Mum's kind nature. Am I right to have these concerns or am I being silly?