discussing problem openly

[fluff]

Hi
I'm new to this forum and have joined because I've been increasingly worried about my mother-in-law, who has some memory problems which she is aware of and open about to a point. She and my father-in-law are both elderly and in failing health but so far care for and support each other. My worry is that she is really no longer able to care for or help him and needs more help herself than he should have to give her, given his own health. The burden that causes and the extent of her problem is not acknowledged in the family. Really I would like some advise on whether and how to broach the subject with them.

My reasons for believing she has some form of dementia go back several years - lots of little incidents of odd behaviour, forgetfulness, and 'misremembering' (sort of making up stories to fill in gaps, if that makes sense?). Last time we visited I noticed that she was frequently rude to her husband, which is uncharacteristic and that he was humoring her. He hasn't openly said there is a problem, but he said he has to make plans for both of them and give her warning of any activity and he now does all the cooking because he feels it unsafe for her to do it - she used to be a proud housewife but she hardly seems to notice this. I do not know if she has recently seen anyone about this or has a diagnosis. Some years ago a GP told her forgetfulness was normal ageing.

My in-laws live in a different part of the country, I think this may mean that when we see them we are more aware of the problem than family who live locally and make more regular but short visits. Even if they were fully aware, my sister-in-law, who does live locally, also has serious health concerns at the moment, so it would be unreasonable to expect that her family could take on the burden of care. This means that, because of the distance, my husband and I feel unable to give useful support and the situation has been allowed to drift.

My husband agrees that his mother is 'losing the plot' a bit. When his father had a recent spell in hospital he persauded him to go to social services to seek help on the grounds of their general health needs and an assesment of needs was made. They were then offerred some help to make things easier for them, including such things as meals on wheels. This package, which to us sounded a good start, was turned down by my in-laws because they said they were not offerred anything they would find useful.

My husband has discussed the general problem of aging parents who want to remain independant with his family- without having reached a solution - but won't specifically open the isssue of his mother's mental health. When I've said things to other family members they've said things like 'O she's always been like that' and I haven't liked to force the issue. I'm not sure if it would be of help if I did?

I'm reasonably certain my father-in-law knows exactly the problem but does not feel willing to discuss it. My husband is similar and I guess just hopes it won't get any worse and I suspect that nobody in the family is ready to confront the problem. If you were me would you continue to let the problem drift until something happens to one of my in-laws, or is there more we could do now to be of practical help if I try to insist the family discuss this openly?

Thank you for any insight, if you've been in a similar position.

 

[jenniferpa]

You know, I hate this line that GP's trot out "forgetfullness is a normal part of aging". It may be statistically normal (that is it may happen to a large percentage of people) but everything I've read tells me that it isn't "normal" in the sense that it is inevitable. There is always an organic cause. It may not be fixable, it may not be practically diagnosable, but there is a reason. I had this line from my mother's GP. Subsequently, it turned out she had had a stroke, but we didn't discover that until she had had 2 more. Even if there was nothing that could be done (medically) this "this is normal" attitude meant that we (or rather I) didn't put in place the one thing that might have minimized her risk of subsequent ones - ensuring that she took her medication. With forgetfullness, it's difficult to remember whther you've taken your meds, although a simple dosette box would have helped. Sadly, the GP spent more time on reassurance than practical problem solving, and frankly, for that I shall never forgive her.

Anyway - I think the most important thing you can do is encourage your MIL to go for aa check-up. It may do no good (see above) but perhaps the GP will detect something out of the ordinary. How you broach it depends on your family dynamics. Personally, I would have little success getting my DH to get my MIL to the doctors, but fortunately, I can tell her directly. Obviously, though, this sort of thing is normally more effective coming from the child.

jennifer

 

[fluff]

Thanks for the reply Jennifer - it sounds silly given your suggestion, but it hadn't occurred to me to discuss it with her and perhaps I could. I don't want to frighten or upset her by raising this but she might be happy to talk about what she thinks is going on.

One thing I know though - she doesn't want a dispenser, she is on a number of medications for different problems and has refused a dispenser in the past as she thinks they will be too difficult to use. Instead she writes a list and ticks things off and I know that is not very reliable.

fluff

 

[May]

Hi
Welcome to TP
One thing struck me when reading your post ,about MIL's meds. I believe you can get the pharmacist to make up the doses she requires in a sort of 'bubble pack'. Usually used when carers are coming in to supervise meds taken. Would that maybe help your MIL accept this rather than a dosette box as it would come direct from the pharmacy? It would be one less thing to worry about.....
As to family not acknowledging possible problems, that's a difficult one...only you know if an approach will cause too much hassle, but I would say better to tackle things early than get into an emergency situation...would they accept an approach to MIL and FIL's GP, just setting out the family's 'concerns' and asking if the GP could call for a visit under the pretext of proactive routine check ups on elderly patients in the practice? Just a thought. What ever route you take come back to TP it's a tremedous lifeline to us all coping with this d....d disease. Take care.

 

[fluff]

Thanks for the suggestion about the bubble pack - I will investigate that.

Would the GP have to respond to a letter about family concerns? I know that my husband approached a practice nurse on one occasion (he'd taken one of his parents to the surgery) and was told that any intervention from the practice could only happen as a result of a request for help from my in-laws, not from family. Is that wrong?

Thank you for your welcome.

 

[fluff]

Another question, prompted by reading other posts - can/should we suggest my f-i-l sets things up so that one of their children can take poa for her/them?

My f-i-l is perfectly capable of managing their finances now, but I'd guess we'd be in a financial nightmare if my m-i-l had to look after herself. Can this be sorted out by my f-i-l now, on behalf of both of them, or would it need m-i-ls consent if it was applied to her? That might take some persausion!

Thank you

 

[Meldrew]

power of attorney (POA/ enduring power of attorney(EPA)

POA and EPA an only be made by an individual for themself. That is to say someone cannot give POA or EPA on behalf of someone else. Check out the Society information sheet for EPA http://www.alzheimers.org.uk/After_diagnosis/Sorting_out_your_money/info_epa.htm

 

[fluff]

Thanks for the link, Meldrew. I don't think it is worth talking about with her, she wouldn't accept the suggestion that she might ever not be able to manage her own money and it would probably make her very suspicious of our intentions.

The more I read about this illness, the more difficult the future for the whole family appears. Perhaps they are right to refuse to acknowledge it at all, for as long as is possible

 

[jenniferpa]

Fluff, don't forget though, that although the easiest and least hassle route (although that is, of course relative) is for a person to get an EPA made for themselves before losing mental capacity, it is possible to get a recievership for a person who has lost mental capacity. It's not particularly easy or cheap but it is doable. I would encourage your FIL to get an EPA made for himself, even if your MIL won't participate in the whole thing (although she might if he's making one as well).

Jennfer

 

[Nell]

Thanks for the link, Meldrew. I don't think it is worth talking about with her, she wouldn't accept the suggestion that she might ever not be able to manage her own money and it would probably make her very suspicious of our intentions.

The more I read about this illness, the more difficult the future for the whole family appears. Perhaps they are right to refuse to acknowledge it at all, for as long as is possible

I live in Australia where the systems are different but, for what it's worth it, this is what we did in this situation.

My Dad and I held joint POA for my Mum, and my Mum and I held joint POA for my Dad. Dad didn't need anyone for POA really, but Mum does as she has AZ. Dad has since died, so there is no longer a need for POA for him (except that I'm completing the probate docs. etc.).

IF you can arrange something like this, it is very IMPORTANT that the joint POA is for EITHER / OR to operate - in other words you can operate the POA without the other person if necessary.

By getting both of them to do it together, and both to act for each other as POA (as well as having me - daughter) we avoided the need to point out that it was necessary for Mum.

I have only invoked the POA as necessary - our system (Australian) seems less complicated and more straightforward than what I read on TP about the English system. Here we have a POA drawn up at the local court house by a clerk of the court (no charge) and once it is in place you can use it (or not) as desired. There is no requirement to register it etc. as seems to be the case in UK. At present I use it to act for Mum in paying bills, etc. but involve her as much as possible in decision making (well, to be honest, I tell her what I think should be done and ask "Is that OK with you MUM?" and she usually agrees!).

However we are fast getting to the point where I will need to take over completely for her financially as she is getting less and less capable of understanding what is happening.

I hope you can find a way to make the UK system work for you. I think (in this instance in particular) I'm lucky to be under the Austn. system.
Nell

 

[fluff]

Nell
Thank you for that suggestion - joint POAs do seem feasible to suggest to them, if they'd accept the idea that could really help If not, then probably means we can't do much unless receivership that jennfer mentioned ever becomes necessary.

I'll tell my husband about the options, he can raise it with them if he thinks it a good idea. Much better coming from him, they'd be quite entitled to tell me to keep out of their business

 

[Helena]

I have a joint EPA with my sister

Either of us can sign although in practice its easier for me to handle everything otherwise theres too much running around and paperwork

You can have as many attorneys as you like on an EPA and you can have it either to sign or all

You can place stipulations on it too