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Trying to help when the person doesn't recognise the need - Carers UK Forum

Trying to help when the person doesn't recognise the need

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I am trying to help my aunt who was widowed in April. She is in her early 80s. She and my uncle lived hundreds of miles from us so we didn't see much of them growing up. They never had children, ran a little pet supplies shop, didn't really feature much in my daily life for decades. Then came the crisis of my uncle (mum's brother) dying and it wasn't until then that we (me, my brother and sister) realised how vulnerable she is. I feel guilty for not being more involved with her/them for years. She lives alone now. She is friendly with one particular neighbour who helps as much as she can (eg is still driving, whereas my aunt never learned) but who is also elderly. My problem is that my aunt thinks she is managing fine when I think she isn't. EG, she keeps losing keys and has broken into her house twice (smashed glass next to front door) to get back in. She thinks people are getting into the house when she's out and moving things around and stealing them. She is not taking important medication for recently-diagnosed diabetes. I persuaded her GP to refer her for an assessment and the local mental health team saw her at the end of May and said they would send her an outpatients appointment but nothing yet. I've told her surgery she isn't taking her tablets (when I ask my aunt if she has taken her tablets, she says 'I'm not on any tablets'. She was asked during the assessment where her tablets were and denied having any, then said she'd put them in a safe place, but couldn't find them). I'm worried that her lack of diabetes control will mean big health problems round the corner. BUT the current problem is FLEAS. She took in a stray cat which had to be put down recently. I stayed at her house for one night last week and am now COVERED in 100+ bites. I asked her if I could arrange for a company to come in and spray but she is adamant she doesn't want this and actually sounded quite annoyed - I don't know what to do. How to help someone who doesn't recognise they need help. I've got a horrible feeling of something bad about to happen to her. Have tried discussing money, but it's hard to march into someone's life like this and expect them to discuss really intimate stuff. I don't want to put her back up - but I also don't want to end up cursing myself for not doing more when I could. She has managed all these years. Oh dear..The only other family she has is a sister who has Parkinsons, and her sister's 2 boys who live in the US. Is there something I should have done but haven't?
Hi Helen
I'm sorry no one else has responded to you yet, sometimes posts can get missed. It's not really my area of expertise but I Think you need to contact adult social services of the area where she lives and ask (demand nicely!) for her to have an urgent needs assessment because she's vulnerable and a safeguarding risk. Then copy your concerns in writing to them and to her GP.

It may well be that she again refuses but at least you will have tried. There's many on here who despair of the stubborn elderly.

Good day, Helen. I agree with Mrs Average's advice, which I suggest you follow up, and I should like to add a few words of my own. Firstly, stop beating yourself up with guilt over the sparse contact you have had with your aunt in the past. It is common nowadays for families to spread far and wide in the fulfilment of their careers. My siblings are scattered around the country; I have nephews and nieces abroad; I have cousins that I haven't seen for goodness knows how many years but I know that I would be very welcome if circumstances should bring us to live nearby again.

You are clearly on good terms with your aunt and your main worry is, quite rightly, not to sour this relationship by appearing to be interfering.

So how do we go forward from here? You say that she lived (past tense) hundreds of miles from you. How far away does she live now? Does she live near any of your siblings?

If she is still at a distance you could suggest she move to a smaller house near to you. People often move to be nearer relatives after bereavement. This way you could visit here more regularly and discreetly observe any problems and help more. This would appear to be less interfering than coming from a distance and trying to change things.

Keep a certain distance, however. In this forum you will read of many cases of friction resulting from people moving in together with the best of intentions.

My biggest concern would be her failure to take her medication. She may not want to take up your helpful suggestions. But whatever happens, stop blaming yourself.
I would definitely agree that it would be sensible and prudent to write to her GP (I suggest writing, as a permanent record, rather than chatting, though you could do that as well), setting out your concerns, including specific things, definitely the not taking the tablets, her confusion as to whether she has, or is in them, and then the problem with the fleas.

Then, at least, the GP is 'fully informed' and can take what action they see fit - ie, you've passed the buck to the NHS, and if the GP then organises a health visitor/district nurse, or informs SS, etc, that is 'over to him/her'.

I would also see if you can chat freely with her neighbour. It's sadly very common, when there is no family 'next door' for a frail elderly person to become increasingly dependent on a neighbour. This happened to my MIL, who turned more and more to the lady in the flat next door, who was very nice and helpful, but was, in the end, only a 'stranger' - she would phone me sometimes (I was 400 miles away!) to say that my MIL was concerned about a particular letter that had arrived, or whatever. In the end, my MIL had to move out, as she just got more an more 'helpless'.

I don't know enough about whether untreated diabetes can 'confuse the mind', but that is one possibility - however, the most obvious 'suspiscion' is that your aunt is developing dementia. It creeps up quite slowly - my MIL I can now see in retrospect showed symptoms for quite some time, before I really 'twigged' that yes, she was developing dementia, and that she could not, sadly, live 'on her own' any longer, even if I moved her into a flat near me. She needed increasing help with 'everything'.

I think therefore it would be prudent to start thinking 'long term' in respect of your aunt, as if she is, indeed, facing a future where she CANNOT 'live alone' any longer, then things are going to get quite 'drastic'. My MIL either moved in with me (I could not cope with that at all - it 'took over' my life), or moves into residential care. She refused entry to any 'outside carers' coming in to check her, make her meals etc, and that, sadly, is very common again in dementia.

Finally, what is also quite common, as we read on this forum, is for the situation to 'limp on' for a few months, even a few years sometimes, with the person becoming increasingly frail, increasingly 'helpless', until a health crisis occurs (eg, they fall), and then they have to be taken into hospital, but then cannot be 'returned home' but have to go into supported living or residential care. It can take such a 'crisis' to 'resolve' the situation.
PS - Don't feel bad about not having visited much previously. You could not have prevented the current situation, dementia isn't 'caused' by external circumstnaces. My MIL was the LAST person I ever thought would get it - she was highly competent, highly indepdenent, highly self-sufficient - but she still got it (She's now in a care home, immobile, can't talk, totally helpless - a dreadful sight to see, and a horrible fate for her - the only mercy is that she does not know it....poor soul.)
Thank you all for your replies. Now we're one year on but no progress made.
Social services asked for the Enablement Team to assess my aunt; they produced an assessment that referred to the "lifeline that was tested on assessment" (she hasn't got a lifeline!) and then the report stopped using her name, and started referring to "Mrs Lawrence"! Looked like really sloppy cut and paste. We got the message that she was 'self-caring' and then her file was closed.
My aunt phones me sometimes 3 times a day. She feels lonely, she feels awful, have I got her key?, where is Ted? (my uncle who died last year), she's got no money, she's got no milk. She isn't taking her medication (for diabetes - and goodness knows what else - she gets dosette trays delivered by the pharmacy and just tips the contents of one tray into the other...). After we pleaded with the GP he re-referred her to the mental health team. They made a home visit and I happened to phone while they were there. I was told there was no food in the fridge and the washing machine was full of clothing that had black mould growing on it. They contacted social services and asked for her file to be re-opened. The basic problem is that every time we manage to get an assessment or a bit of help put in place she bats it away, saying she's managing fine, wants to stay in her own home, goes to table tennis on a Friday, goes to the very good butcher - all the usual lines get trotted out that described her life ten years ago maybe but simply aren't true any more. What on earth to do. I feel so frustrated - all agencies are saying that until she agrees she needs help there is nothing they can do. I'm THIS CLOSE to walking away from it all.
At least we have LPA for financial affairs in place now. Should we get the health and welfare LPA too? How would that help?? We still couldn't FORCE her to move into care.