Advice welcomed re increasingly dependent elderly relative

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STEINER

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Hi all. Just looking for comments/advice on elderly relative 76 who is in below average health, living alone in own house and refuses to consider going into residential care.

just some points....

2010 hospitalised for 8 months
2011 so far hospitalised for 3 months at different times, last month fell down stairs

health issues - spinal osteoporosis, emphysema, heart and renal issues, colostomy, long term depression. public nurse visits every single day and evening to give an injection.

mobility- never leaves house except for hospital, not on oxygen but breathing bad meaning post office/shops only 300m away are out of the question, can just about get out of bed and plonk in armchair all day, never goes out back or front gardens.

although living in house, doesnt clean, or cook proper meals. had meals on wheels, stopped it herself as she got fed up with it. refuses home help.

it is only because of her sons and daughters that she is able to live at home. instead of visiting your mother for tea and a chat, its a case of cleaning the kitchen, bathroom, hoovering etc 2 or 3 times a week. gardening for 2 hrs at a time during summer too.

frequently doesnt hang up telephone/cordless properly after a call, meaning family dont know is she ok or not, although she now has panic alarm around neck.

now the woman is not my mother so I can be a bit detached from the emotional point of view.

I and anyone that knows her can see that the woman's quality of life is very bad, can she be put into residential care without her consent? She can't manage on her own.

If she refuses home help, should the family just quit the hoovering/cleaning?

As she doesnt use the gardens, should the family quit maintaining them?

all the family are living at least 10 miles away from her in Dublin and will meet with hospital social worker to discuss case.
 
On the garden, is it possible to get someone to come on for a few hours a month and do the basics, eg cutting the grass and hedges.? I don't think you should quit maintaining them as if they get overgrown they'll only attract things like ferral cats (happened when my parents neighbour died and the house was left abandoned for almost a year).

Problem with putting her into care against her wishes, even if it is for the best intentions, if she goes downhill quickly afterwards, then the family will always blame themselves.

Is respite care an option?, if only for a couple of weeks to get her used to going into a residential home. Sell it to her on the basis that you need to get some things done around the house?
 
Mpsox said:
On the garden, is it possible to get someone to come on for a few hours a month and do the basics, eg cutting the grass and hedges.? I don't think you should quit maintaining them as if they get overgrown they'll only attract things like ferral cats (happened when my parents neighbour died and the house was left abandoned for almost a year).

Problem with putting her into care against her wishes, even if it is for the best intentions, if she goes downhill quickly afterwards, then the family will always blame themselves.

Is respite care an option?, if only for a couple of weeks to get her used to going into a residential home. Sell it to her on the basis that you need to get some things done around the house?
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she used to have a guy come around to cut the grass/hedges etc but she stopped that, we could always try him again.

she did a few weeks in respite after her long hospital stay and clearly benefitted from it, once she got back to the house however she dug her heels in and wouldnt go back even for a week or two every few months.

i think its only a matter of time before she enters care, every month or two there is some deteorioration
 
Hello Steiner,

It sounds like a sad situation for this older person and from what you explain, they don't seem to have very much quality of life. It must also be worrying for the family concerned when they live 10 miles away and this older person has refused home help, which would provide additional regular human contact, refusing meals-on-wheels, not cooking properly and so on.

I presume the family have spoken to the Public Health Nurse to seek their advice? I presume the family have also spoken to the family doctor?

A family friend of ours is 92 and continues to live alone with support (such as home help and regular visits from the public health nurse, etc). She also has some ongoing health conditions. She is a great advocate of the local day-care centre and it is an outlet for her to mix with others and where she is is often the life and soul of the place! Forgot to say, the local centre also provides access to other services, such a chiropody, clients can use the facilities to get assistance with bathing, help with information on rights and entitlements, and so on.

Not sure if this helps.

CMCR.
 
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I would consider reducing the amount of maintenance required by moving her to just the lower half of the house. Put her bedroom etc on the ground floor. This means she doesn't have to use the stairs, and the upstairs can be pretty much closed off. This may also reduce energy bills.

For the garden, consider creating a low maintenance garden. Put in slow growing plants, and get rid of any lawns.
 
It is a very sad situation.

I am an advocate of asking people to consider other's, as well as their own needs. It is all very well wanting to stay at home but it is a pointless and fruitless exercise if it only comes at enormous cost to everyone around you.

I've been through the geriatric phase with my own mother. As the (almost) primary carer, I am only too well aware of the constant anxiety of worrying "is she alright?". The only good aspect ( and I am joking!) is that it is a phenomenal weight loss program.

The very best advice I received from friends , who had been through the same/similar situation, was:

"In the event of an emergency, where she is on her own, is she:

a) Capable of contacting emergency services
b) Telling them the nature of the emergency and her address
and
c) Getting out of the house safely.

If the answer is no to more than two ( I would say to all three), it is past time to leave home.

My mother had advanced dementia and, in many ways, that made the final decision easy. There was no choice. But I have friends whose parents , while physically very frail and dependent, are compos mentis and determined to stay at home.

Mostly, what happens is the accident that everyone is waiting for, usually the broken hip. Followed by hospitalisation and the dawning realisation all round that going home is not an option.

Most people settle in to long term care - the biggest part being the lack of anxiety - for themselves and the knowledge that they won't be lying on the floor, in pain, should they have that fall.

In the OP's case ( and forgive me if this sounds hard) I would consider making ( or even threatening to make) the woman a Ward of Court.

mf
 
mf1 said:
frail and dependent, are compos mentis and determined to stay at home.

Mostly, what happens is the accident that everyone is waiting for, usually the broken hip. Followed by hospitalisation and the dawning realisation all round that going home is not an option.
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+1 seen this happen with a number of elderly relatives/neighbours.

Agree with CMCR re: day care centre - this could be a good option.
 
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