FIL with Dementia - What help should MIL get?

moggylover

My (ex) FIL has severe Dementia to the extent that he doesn't know anyone around him or where he is, has become quite violent, and cannot be left alone for a moment. My MIL is really struggling to cope, and so far has had to manage more or less on her own (with some help from the family) except for brief respite breaks where he has been taken into hospital in Aberystwyth.

He has just come back from the first longer one, two weeks, and she is being told that they will not have him back as he wanders around the place too much and is dirty (doesn't bother with the loo anymore I am afraid:o ) and that she will get no more respite breaks:eek: .

Does anyone have experience of this, and is there any specific care that a LHA is supposed to have in place for people who have reached this point in their dementia as he really is too much for my MIL to cope with as she is over 70 and not in particularly good health herself. He apparently kicked her in the knee last night and she can hardly walk today and he is very angry and aggitated all the time, but she has been advised he cannot have sedatives due to his severe asthma.

I am having difficulty getting all the information from my MIL as her first language is Welsh, and she struggles a bit with English these days:o , but surely there must be care facilities for people in these latter stages of dementia?

Iguana

Has your mum in law had a carers assessment?
Has your FIL had an assessment from Social Services?

purple12

You can ask the GP to refer to Mental Health Services - they may be a lot more helpful than social services too. I work in a specialist mental health team for older people where we have a lot of experience of these kinds of situations and not least, can offer respite which has a lot more scope than that which social services can offer.

As well as that contact social services too, although if you are getting respite I'd imagine you are already involved.

Asking the GP for a specialist referral would, I think, be best in this situation.

Penry

Hi, not sure of how it is in Wales, but it sounds as if the respite was organised by health. Social Services would use nursing homes for a respite, not a hospital. Has your FIL been assessed by Social Services? Are health and Social work speaking to each other to assist your MIL? As mentioned she is entitiled to a Carer's Assessment, and she would need to emphasise that she is reaching the end of her ability to continue caring for FIL. Nursing homes and hospitals should both be able to manage to care for people with advanced dementia and continence issues. Perhaps there is a need for a review meeting involving all professionals, your MIL and someone to interpret/ensure everyone understands what is planned?

Good luck

Savvy_Sue

No moggylover it's not the wrong board, but give us a chance to get in from work, put the kettle on, and have something to eat! :rotfl:

To add to what Iguana said: your MIL is entitled to a Carer's Assessment for HERSELF from Social Services. They have a statutory duty to come and see her, find out what she is up against, and work out what SHE needs in order to carry on caring for FIL. Actually, the answer may be that NOTHING will make this situation workable, and if she feels that way then she needs to make that clear. Assuming she is in Wales there shouldn't be any problem with her getting this assessment done by a Welsh speaker, although she'd need to say this when she asked for it.

Perhaps she should ask what they will do with FIL when she needs hospital care for some injury he has inflicted on her? do encourage her NOT to put a brave face on it or pretend it's better than it actually is.

Presumably your FIL wasn't taken into hospital for medical needs, but for the respite, but I don't see how your mother can be refused respite care just because one setting couldn't (or didn't want to) cope with him.

PS good advice from purple and Penry too, make sure her own GP knows that the situation is beyond her. Even though her GP cannot discuss her health with you, you could phone and alert them to how bad things are if you suspect she won't.

bex2002

Sounds like your father in law needs social services involved and needs a nursing needs assessment (What is now called DST) for care - an EMI placement sound most appropriate but difficult to assess without knowing all the details although a nursing home may cater for him. In an acute hospital he would require one to one specialist care.

moggylover

Many thanks to you all for getting back. Sorry I was impatient earlier, I admit I was panicking a bit because MIL is a good lady (even though she is really my ex MIL) and sounds at the very end of her tether!

I believe that Social Services are the people that have been arranging respite care (this is only the second occasion that she has had a break) but I will have to try to sit her down (not easy since he wanders about so much) and get her to go through who is what and who she has spoken to for me so that I know who to talk to for her next. She is not very good with arguing with people "in authority", so to speak, so suspect that she will get very little help if I do not try to help her.

I think he really does need to be in care of some sort if he is getting violent, otherwise they need to look to giving him some kind of medication to quiet him down, because he doesn't seem to sleep for more than the odd hour and is very aggitated and angry when awake so life is getting very bad for her, despite the fact that her son lives there as well: he does have to work and so the bulk of FIL's care falls to her.

I admit to finding it hard to grasp as he has gone from being a bit forgetful three years ago to completely not in this World now and it has all happened so very quickly.

Thanks for getting back to me. The information you have given will be very helpful, and I will see what I can find out tomorrow.

Thank you again.

Edinburghlass_2

If he is ex services there could be help there for respite for MIL or if he had been a Lodge member perhaps?

Mojisola

moggylover wrote: »

My (ex) FIL has severe Dementia to the extent that he doesn't know anyone around him or where he is, has become quite violent, and cannot be left alone for a moment.

Once someone has deteriorated to this level they should be in care. It is impossible for one person to provide continuous 24-hour care without it impacting on their own health.

margaretclare

Mojisola wrote: »

Once someone has deteriorated to this level they should be in care. It is impossible for one person to provide continuous 24-hour care without it impacting on their own health.

Yes, absolutely. And especially with the violence. Doesn't the Mental Health Act kick in: 'a danger to himself and others...' He certainly sounds as if he's a danger to his poor wife!

purple12

Yes, that's why I suggested contacting the GP for a referral to a specialist Mental Health Team.

Just to emphasise, this is exactly the job I do at the moment - namely, assess older people under the Mental Health Act if necessary. Social Services aren't always equipped to do so and we receive all our referrals from GPs (even if it is the social worker contacting the GP).