Mum's refusal to visit doctor or have carers visit - what next?

Discussion in 'I care for a person with dementia' started by Stephg46, Jan 9, 2016.

  1. Stephg46

    Stephg46 Registered User

    Aug 5, 2014
    5
    My mum is nearly 88 and has some kind of dementia - we do not know what type as she has refused to visit the doctor or allow a home visit. There is no diagnosis. GP is persistently unhelpful anyway.

    Her self-care is non-existent; she will not wash herself or her clothes and insists on wearing the same T-shirt, cardigan and trousers every day. She says all the other clothes in her wardrobe are 'not hers' and refuses to wear them along with new clothes both me and my brother have bought for her. She will not eat anything except chocolate and cake.

    We asked SS for an assessment with both me and my brother present - they agreed she needed care. My husband works for an excellent care organisation (recommended by SS before the SW knew my husband worked for them). This was three weeks before Christmas - we organised a care package of twice daily visits, although she was quite difficult she was looking forward to the visits which began last week.

    First three days - visits worked like a dream, the relief was enormous. Mum has a highly unsuitable dog; carers were amazing with him, and even encouraged mum on little walks. Mum hugged carers and called them her 'new friends'. Fourth day - refused to let carers in, was rude and shouted at them saying they weren't coming in her house.

    I have looked after mum for many years - probably longer than I should have. My husband also helps me. Mum now seems to absolutely hate me - if I visit, something will set her off shouting and screaming at me. I dread the visits, and think it's not doing her any good as everything - everything is my fault; I started the 'horrible women' coming, I want her house, I want her dead.

    SS are trying to get the doctor to visit - they told me this was sorted, the GP surgery sent a healthcare assistant to do a blood test! Mum would not let them in.
    I have reached the point where I can no longer visit. The house is unlocked as she can't lock the doors, the dog isn't being fed except when my lovely, patient husband goes round. She cannot hear anything as she has refused to wear hearing aids for months having been reliant on them for 20 years.

    I have tried to explain she must allow the carers to look after her or she cannot stay in her house - my brother has also explained this. Mum is much calmer with my brother who visits very rarely as he lives 1.5 hours away and is often away for work.

    SS are helpful and the SW is sympathetic, and is trying to get doctor to visit so she can be referred to mental health services.

    Can someone advise what is likely to happen now? I cannot care for her, my husband can shop, clean and care for the dog, but cannot help with self-care. Mum has always been stubborn ('bloody-minded' according to my brother), but it's clear to me we cannot go on like this.

    At wits' end.
     
  2. cobden28

    cobden28 Registered User

    Jan 31, 2012
    442
    You can't honestly expect your husband to go round to your Mum's and feed the dog if she doesn't remember to herself, for much longer. Perhaps now is the time to think of getting the dog rehomed, as your Mum is obviously unable to care for it any lounger due to her dementia?
     
  3. V-DiL

    V-DiL Registered User

    Oct 10, 2015
    19
    Oh that sounds all very difficult and painful for you. I too have a 'non-compliance' situation (won't bore you with it). My only suggestion is can't the GP or Community Matron visit her in her home, maybe with someone she will accept in with her?
     
  4. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    I think that if you could get the carers back in you would be buying time. exactly the same as this, including dog, happened to a friends MiL - it was a temporary blip and 12 months on she is still in her own home with 4 carers a day so it is possible

    Just check - does she have a UTI - this might be difficult given your circumstances but worth having a word with GP to see if he would give her a course as there has been a rapid deterioration and her behaviour and confusion are causing such huge problems.

    Have you seen the compassionate communication sheet ? it is very helpful and can sometimes turn things around
    http://www.ocagingservicescollaborat...y-Impaired.pdf


    Can someone be there for a few days to let the carers in and insist that they she lets them help her? That is what friends family did and it took several days but established the routine back to where it had been. It may do nothing but is worth a try.

    Point out to her that she is making the dog really miserable - I think to take the dog away at this stage may be a big mistake - we all know dogs are members of the family and the bond broken would cause huge resentment - but to tell her that she needs some help for him to stay may be a key.

    Very tricky situation, take care of yourself x Keep posting, lots of support on here
     
  5. Beate

    Beate Registered User

    May 21, 2014
    11,499
    Female
    London
    I agree, first of all she should be checked for an infection. You could take a urine sample and take it to the doctor without her having to see him. But if this doesn't help, non-compliance to any care sooner or later will mean that the dog is not the only thing needing to be rehomed, I am afraid. I hope it will not have to come to that.

    One question though - if the door is unlocked, couldn't the carers or doctor let themselves in? Or you could install a keysafe?
     
  6. Stephg46

    Stephg46 Registered User

    Aug 5, 2014
    5
    Thank you for your replies

    Thank you - the dog is a huge issue, he is big, bouncy and hairy, but very affectionate. My brother wants the dog removed now. Trouble is, mum is absolutely obsessed with the dog and if he is not with her she panics, even though he is in the next room. Having said that she has let him out of the front door as she doesn't shut any doors. Worried about dog's wellbeing, but mum cannot see that at all.

    Appreciate suggestion about having someone there when carers visit - can't be me as that would make it worse. I have decided I will no longer visit on my own, but will only go with my husband as she behaves better for him.

    Don't think she has UTI - SW thought a series of mini-strokes more likely.

    I like the 'non-compliance' quote - sums mum up perfectly!
     
  7. BR_ANA

    BR_ANA Registered User

    Jun 27, 2012
    1,085
    Brazil
    I think you need some compassionate communication

    http://forum.alzheimers.org.uk/showpost.php?p=413710

    It will help with your mother fighting you.
     
  8. carol4444

    carol4444 Registered User

    Feb 5, 2014
    109
    I am reading this post with interest as I have just come to the same stage as you have. How are you feeling now that you have stopped visiting? Are you well yourself or have you felt unwell for some time? For the last three years, looking after Mum, it has felt like an abusive relationship and I couldn't take any more without becoming really unwell. Since deciding to stop visiting I have spent most afternoons in a deep sleep, unable to find the energy to press on. I am hoping that this will pass fairly soon and that it is a result of prolonged stress. I very much hope that you are able to resolve this and that you start to feel better soon. It is so difficult to think straight whilst you are under the onslaught of a hate campaign. The guilt is pretty bad and the phone calls are a constant reminder (I am not answering). I think our mothers are on a self destruct phase and they will get there any which way they can, with or without our assistance. I am in awe of the carers who can cope with such problems, they are angels. My wings have been packed away I'm afraid.......
     
  9. TooHard

    TooHard Registered User

    Sep 16, 2015
    109
    For a second I really thought you were talking about my mum though she's a good bit younger and her dog is a wee yappy, snappy poodle who bites anyone who gets too close to mum (and occasionally bites her). He must be made of stern stuff because his diet is now very erratic and mum can't be convinced that he needs a proper dog diet and also needs water. He is walked almost daily by someone else because mum struggles with more than a very short walk and only if the weather isn't too bad.

    My mum has consistently resisted formal diagnosis but a fantastic psychiatric nurse visited her at home to carry out an assessment. I was present so I'm now aware of the extent of mum's difficulties with long and short term memory, counting etc. A follow up appointment with a dementia specialist (for whom the charge nurse works) has been made but it's highly unlikely that I'll be able to persuade mum to attend. I'm hoping that the formal diagnosis can be made on the basis of the results of the assessment even if mum won't meet with the specialist.

    Mum refuses all offers of support and no longer takes her meds (blood pressure, cholesterol) but is deemed to have sufficient capacity to be entitled to say 'no' to help if she wishes. Her diet is totally inadequate as she can no longer use the cooker or the microwave but won't have 'meals on wheels' delivered.

    Basically we're waiting for a crisis and as PoA will probably have to go for guardianship once the crisis happens.

    I've spoken to her GP, to SS and to the dementia specialist and I've tried repeatedly to persuade mum to accept help. I live 100 miles away (and my siblings are further away) and am finding it increasing stressful worrying about her but not able to put help in place.

    Good luck to you - I sympathise.
     
  10. Delphie

    Delphie Registered User

    Dec 14, 2011
    1,244
    Our situation was very like yours. My mum wouldn't accept carers, though we tried all kinds of tactics. I had to give up on that score when she tried getting over her garden wall to escape them. She was also absolutely horrible to me most of the time, so there was only so much practical help I could give her. Sometimes I'd spend ages in traffic to get to her, only to have her start abusing me the moment I got there. So I'd leave again.

    The situation got so bad that her self-neglect was going to mean a section. The social worker and consultant, who were very good and tried to help, gave me a heads up and an opportunity to do something, so I literally conned her into coming to a care home with me. The story was that we were off travelling (which she loved) and going to stay in a fantastic hotel.

    By hook and by crook I got her there, then left.

    As bad as that sounds, the other option on the table was worse.

    It took her a while to settle but she did, and things are much better now. She is getting the care she needs and our relationship is much improved.

    I wish you luck because the phase you're going through can be extremely difficult. Hard to believe, I know, but things can get better.

    Also, maybe you'll find a solution that keeps your mum at home for a bit longer, but don't beat yourself if you don't. Dementia is a formidable enemy.
     
  11. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,740
    Hopefully the person who walks the dog also feeds him, no wonder he is neurotic, poodles are usually wonderful dogs to have, gentle kind and intelligent
     

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