Overwhelmed, so many issues

Downnotout

Registered User
For some background, my partner of 4 years and I relocated to be close to his mum (86) after his dad passed away. Due to lockdowns he had not had much contact previous to this for a couple of years. I did not know them before.
It was clear to me that his mum had early dementia- having been through all this with my mother 10 years ago. It took a while for my partner to accept this as he wanted to put it down to grief from the loss of his dad. I will call Mother in law ‘mum’ from now on for ease of writing.
We are very rural and mum was living in a huge old house that had become unmanageable. It was unclean, packed to the rafters because of hoarding, in disrepair, and she was isolated because the GP had said she was no longer safe to drive.
It took a while to get a diagnosis, she has mixed Alzheimer’s and Vascular, we were able to put LPA in place and have now moved her into a small cottage in the village so that she can walk to the GP, go to the shops and still have some independence. We thought this would make life easier and having a clean, clutter free home would be safer and more manageable.
It has just thrown up more problems though. She wasn’t washing/showering. Didn’t change her clothes. Wasn’t taking her meds. Couldn’t work the oven/hob (previously had an aga that was just on all the time). Getting dehydrated, which made her ill, because she doesn’t remember to drink…etc
Already we have in place a carer once a day, a cleaner once a week, memory nurse once a week and we are also going in most days and do/take her shopping, out for walks, to cafes. Despite living here for 30 years she doesn’t know anyone, has no friends or social circle, no other family around and because it’s a little village in rural Cumbria there is nothing locally like groups, day care,( there is a volunteer meal delivery once a week.) We struggled to find the carer that she currently has. We both work Full time. It’s exhausting.
We battle every day because she is hoarding again. Tissues, plastic bags, empty food containers, boxes, envelopes you name it. She won’t throw anything away. Food is a huge issue. Half eaten meals hidden in strange places. Refuses to store food correctly, things that should be kept in the fridge in various cupboards or just left out. We are throwing so much away because we don’t know how long things have been there. Despite the carer going in and making lunch and only taking a meal out of the freezer one at a time, by the time I/we get there everything like butter, cheese, yoghurts, meats, coleslaw, quiche etc is out of the fridge again. It’s the same when the carer arrives.
Because mum can now walk to the shops, she goes and buys the same things over and over. So much fruit, that she doesn’t eat, hides, then we find it rotting in a cupboard. Eggs, boxes and boxes, all hoarded away and not eaten. By the time we found them they were out of date. You get the gist. Mum used to run a B&B and had food hygiene qualifications. She has forgotten all this.
We are trying to monitor her water intake. We’ve tried refillable water bottles, she hides them. A jug and glass in front of her. It’s still there untouched when we go back. Disposable mineral water bottles. Short of standing over her and insisting she drinks we think she doesn’t drink anything until the next visit when we remind her again.
She has become childlike when prompted to do anything, eating, drinking, washing. She either lies that she’s “just” done it or laughs like she’s been caught out.
Mum also has 2 cats. They are all she lives for. She is fixated on them. So much so she now shuts them in rooms to keep them safe. Unfortunately she doesn’t grasp that they need food or water and access to a litter tray. We have put automatic food and water dispensers in but when she closes doors the cats can’t get to them. We try to encourage her to let them out into her totally secure garden. She is so scared of losing them that she cries and says she’ll never see them again. As soon as we leave she has them shut in a room again. (We’ve gone back in 5 minutes later to check) This is getting to be a real concern. It’s unfair on the cats, even cruel and I can’t let this go on much longer.
Having been through this with my own mother I thought I was prepared but this is different circumstances and she presents differently. We are desperate to keep her living semi independently as long as possible but she has deteriorated so quickly since moving into the cottage- she just doesn’t have capacity to manage even basic self care. Although if you met her and had a conversation you would think she was extremely capable.
I’m sorry this has been so long. I don’t know what I’m asking- tips about food, drinking, maybe. I think she needs more care visits each day but we can’t get anymore at the moment as the carer doesn’t have space. This was the only carer who had any space at all so we are stuck.
Lastly, I feel ashamed to say this has such an impact on me and my partner. We are only 4 years in, and only moved here last year. I’m finding it hard as it brings back so much of what I went through with my mum- which was just terrible. But it isn’t my mum, I barely know her and didn’t know her before as she was. I want to help and she has been nothing but lovely to me but this feels like a huge weight. We have space here in our house but I don’t want to go down that route. I work from home and from my point of view it would be too much. I would effectively become her 24 hour carer. I just want her to be safe and know that I’ve done the best I can to make this as easy as it can be on all of us.
If you managed to get this far, thank you.
 

2ndAlto

Registered User
Oh my goodness @Downnotout there are so many issues there. However you look at it your MiL is not coping, in fact she isn't really safe where she is. I know this won't be easy to accomplish but she would be so much better in some sort of care home where she would have regular meals / hygiene carers for showers etc / supervised medication etc and company. But not the cats... so I'm not sure how that issue will be addressed. But it seems that something will have to be done - something other than you being her 24 hour carer.
 

Violet Jane

Registered User
I think that it's time for a care home or, alternatively, a live-in carer (the LA will almost never fund the latter if she needs to be LA funded). You've tried to maintain her independence but it's not working and her health and dignity are being put at risk.

Don't move her in with you. You correctly say that you will become her 24 hour carer. This will affect every aspect of your life including your physical home - she is likely to hoard in your home as well.

People go into homes before they are absolutely decrepit, when they can still walk and talk, recognise people and feed themselves. Many are still continent. What people at this stage need is constant supervision, which can't be provided at home if the person lives alone or the resident carer has reached carer breakdown. Most people don't stay at home until the end of their lives. Some do but they are the compliant ones, often with several family members helping and / or a large package of care. Others are taken by another medical event or illness before the end of their dementia journey. So, don't feel guilty about a care home.
 

Downnotout

Registered User
Thank you both for taking the time to reply. Care homes around here are very few, there are none locally, so would probably be quite a distance away. This is something my partner worries about and it isn’t my decision. I’m trying to be supportive whilst prompting him but I always feel that I am pushing him beyond what he is ready to accept. No one likes to see this happen to their parents but I’ve been through this before and have detachment whilst he is still somewhat in denial. I feel guilty when I flag up issues but if I hadn’t done he wouldn’t have LPA and mum would still be living in a house that was falling down around her. It’s so difficult.
 

Violet Jane

Registered User
Yes, your husband does need to come to terms with what is happening and what his mother needs but be careful that you're not taking on more and more whilst he does, particularly as you work from home and might be seen as able to pop round at the drop of a hat. It will have to be handled sensitively but you do need to have a frank discussion about what the limits are otherwise your lives will be consumed by your MIL.
 

Jools1402

Registered User
I would also say that the time has come for a care home. It would be a good idea to ask social services to carry out a care needs assessment. They should do this whether your MiL is self funding or not. Perhaps your partner would accept their conclusions. Unless there is a safeguarding concern they cannot force your MiL into a home against her will even if they recommend it. They may also be able to help finding carers - but don't hold your breath. Does anyone have POA?
 

Downnotout

Registered User
We had the Social Services assessment a couple of weeks ago. They were happy with what we had in place and said her case would be closed for now although we were always able to get back in touch when things changed. I think it’s a case of the limitations of what is available in our area. It’s a low bar.
 

sue31

Registered User
For some background, my partner of 4 years and I relocated to be close to his mum (86) after his dad passed away. Due to lockdowns he had not had much contact previous to this for a couple of years. I did not know them before.
It was clear to me that his mum had early dementia- having been through all this with my mother 10 years ago. It took a while for my partner to accept this as he wanted to put it down to grief from the loss of his dad. I will call Mother in law ‘mum’ from now on for ease of writing.
We are very rural and mum was living in a huge old house that had become unmanageable. It was unclean, packed to the rafters because of hoarding, in disrepair, and she was isolated because the GP had said she was no longer safe to drive.
It took a while to get a diagnosis, she has mixed Alzheimer’s and Vascular, we were able to put LPA in place and have now moved her into a small cottage in the village so that she can walk to the GP, go to the shops and still have some independence. We thought this would make life easier and having a clean, clutter free home would be safer and more manageable.
It has just thrown up more problems though. She wasn’t washing/showering. Didn’t change her clothes. Wasn’t taking her meds. Couldn’t work the oven/hob (previously had an aga that was just on all the time). Getting dehydrated, which made her ill, because she doesn’t remember to drink…etc
Already we have in place a carer once a day, a cleaner once a week, memory nurse once a week and we are also going in most days and do/take her shopping, out for walks, to cafes. Despite living here for 30 years she doesn’t know anyone, has no friends or social circle, no other family around and because it’s a little village in rural Cumbria there is nothing locally like groups, day care,( there is a volunteer meal delivery once a week.) We struggled to find the carer that she currently has. We both work Full time. It’s exhausting.
We battle every day because she is hoarding again. Tissues, plastic bags, empty food containers, boxes, envelopes you name it. She won’t throw anything away. Food is a huge issue. Half eaten meals hidden in strange places. Refuses to store food correctly, things that should be kept in the fridge in various cupboards or just left out. We are throwing so much away because we don’t know how long things have been there. Despite the carer going in and making lunch and only taking a meal out of the freezer one at a time, by the time I/we get there everything like butter, cheese, yoghurts, meats, coleslaw, quiche etc is out of the fridge again. It’s the same when the carer arrives.
Because mum can now walk to the shops, she goes and buys the same things over and over. So much fruit, that she doesn’t eat, hides, then we find it rotting in a cupboard. Eggs, boxes and boxes, all hoarded away and not eaten. By the time we found them they were out of date. You get the gist. Mum used to run a B&B and had food hygiene qualifications. She has forgotten all this.
We are trying to monitor her water intake. We’ve tried refillable water bottles, she hides them. A jug and glass in front of her. It’s still there untouched when we go back. Disposable mineral water bottles. Short of standing over her and insisting she drinks we think she doesn’t drink anything until the next visit when we remind her again.
She has become childlike when prompted to do anything, eating, drinking, washing. She either lies that she’s “just” done it or laughs like she’s been caught out.
Mum also has 2 cats. They are all she lives for. She is fixated on them. So much so she now shuts them in rooms to keep them safe. Unfortunately she doesn’t grasp that they need food or water and access to a litter tray. We have put automatic food and water dispensers in but when she closes doors the cats can’t get to them. We try to encourage her to let them out into her totally secure garden. She is so scared of losing them that she cries and says she’ll never see them again. As soon as we leave she has them shut in a room again. (We’ve gone back in 5 minutes later to check) This is getting to be a real concern. It’s unfair on the cats, even cruel and I can’t let this go on much longer.
Having been through this with my own mother I thought I was prepared but this is different circumstances and she presents differently. We are desperate to keep her living semi independently as long as possible but she has deteriorated so quickly since moving into the cottage- she just doesn’t have capacity to manage even basic self care. Although if you met her and had a conversation you would think she was extremely capable.
I’m sorry this has been so long. I don’t know what I’m asking- tips about food, drinking, maybe. I think she needs more care visits each day but we can’t get anymore at the moment as the carer doesn’t have space. This was the only carer who had any space at all so we are stuck.
Lastly, I feel ashamed to say this has such an impact on me and my partner. We are only 4 years in, and only moved here last year. I’m finding it hard as it brings back so much of what I went through with my mum- which was just terrible. But it isn’t my mum, I barely know her and didn’t know her before as she was. I want to help and she has been nothing but lovely to me but this feels like a huge weight. We have space here in our house but I don’t want to go down that route. I work from home and from my point of view it would be too much. I would effectively become her 24 hour carer. I just want her to be safe and know that I’ve done the best I can to make this as easy as it can be on all of us.
If you managed to get this far, thank you.
It’s so hard to do the best for them. Mum went down a similar route, totally delussional, denial when odd things pointed out to her. Same situation as you on the food & hygiene issues. Nothing we said or did improved it. Carers twice a day - she flatly refused to do anything other than take her tablets when they were there. She shadowed us every weekend so we’re unable to do much at all - if we did she’d kick off & more or less throw us out unless we just sat in the lounge. 🤷‍♀️
Memory people & SS both discharged her due to lack of compliance (still find that difficult to understand) she had dementia. Obviously she’s not going to comply. 🤯🤯

As others have posted many times it takes a ‘crisis’ of some sort & hospital admission to actually get anywhere with this particular strain it seems.

Our crisis came mid December - she wasn’t allowed back home. Sent to a care home after 3 weeks for care level assessment which was as disgustingly useless as the hospital here. Mum deteriorated rapidly, after 3 weeks there I got her referred to the local to me hospice.
Her last 2 weeks there were amazing. The staff amazing supporting her & us. Her dementia strangely seemed to almost disappear but physically she could take no more she was just too weak.
I totally understand your OH reluctance on every aspect. Is there any chance of respite care close by? Maybe if she tried a day or two she might like it - that said mine wouldn’t even leave the house for the last year incase she was whisked away to a “home”.
Sorry I can’t actually offer any constructive advice, you can’t force them to do anything against their will.
 

Jools1402

Registered User
As @sue31 says - it often takes a crisis for action to be taken. Not much you can do about this, due to non compliance and denial, but let it happen and hope that it's not too bad. With my Mum - just like with your MiL - she wasn't eating properly, taking meds properly, wasn't washing properly and wasn't drinking. It ended up with her being admitted to hospital with severe dehydration. From there she was formally diagnosed with atypical Alzeimer's and discharged to a thoroughly disgusting care home. We found a nicer one for her and moved her there where she has been settled ever since. Wishing you luck on your journey.
 

SAP

Registered User
This is a tough time for you all. Society Services will always back off if they see family prepared to give care. I do feel that something is going to give soon though, either your partner’s mum will have an accident or get ill, you will reach breaking point or your relationship will. You need to have a cards on the table talk with your partner if you can and be clear about what you can and can’t do. I really do feel for you both and I can see how the locations makes this so much harder but everyone would be safer and healthier if residential care was looked into ( or 24 hr home care if she can afford it.) Maybe you could up the care package?
 

Violet Jane

Registered User
You can force a PWD to go into a home against his/her will if s/he has lost capacity and is at risk of harm. However, if there is a family member propping up a grossly unsatisfactory situation then SS won't act as the PWD is not at risk.
 

sue31

Registered User
We had the Social Services assessment a couple of weeks ago. They were happy with what we had in place and said her case would be closed for now although we were always able to get back in touch when things changed. I think it’s a case of the limitations of what is available in our area. It’s a low bar.
Same as! Mum masked so well in the assessments they said no further action. Refused to take note of anything I said, despite when they visited her she was in month old clothes covered in food/drink stains - clearly not able to take care of herself or her home.
I stupidly thought they were there to help in these situations, the ones in mums area couldn’t have been more useless if they’d tried. It was so frustrating.
 
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