Caring from a distance

Can I offer a big cheer for the NHS?

This afternoon I have got the results of mum's recent blood tests through, spoken to her G.P. and arranged for mum to be admitted to hospital - all from a distance. Every person I've spoken to - nurses, G.P.'s, receptionists and secretaries has been caring, efficient and most importantly they really listened to me and accepted that I know what I'm talking about and responded accordingly. I know there are often genuine grounds for complaint, but today I'm celebrating our fantastic NHS.

They are for you for coping

Great to hear some praise for the NHS. I was going to say that with 3 sisters you could have different roles. I'm afraid I had to be 'bad cop' and say the things my sister couldn't say to Mum. She had most day to day care although I was pretty involved too despite Mum not being pleased with me. I was also the one who liaised with NHS as required. The different roles worked ok as I didn't mind being the unpopular one! That's life.

I was closely involved in my Dad's care even though I am 100 miles away - different members of the family took on different responsibilities. My sister, who was on the spot did the bulk of the visiting; my brother dealt with the finances; and I was organising the care plan - I used to be a SW, so I was bound to get that job! It was, I have to admit, a bit of a nightmare, as those of you who followed the dreadful saga a couple of years ago, (when I had another username!).

My OH said it was like living in a SSD office - we had calls night and day with carers who simply vanished and did a bunk, agencies who refused to provide care in his area etc.

Eventually he went into a home, where he was happy till he died there. I too was the one who found myself dealing with the contentious stuff - my siblings and I had realised that care at home was falling down and could not continue; and I was the one who had to broach the subject of a care home with him - and, having been determined to stay at home, he jumped at it, as he was so unhappy with the lack of continuity and the chaotic situation at home.

It was really tough, but worked because my sister and brother and I got on well and could share the load.

Luckygirl - hello old friend. [waves at the screen]
Like yours, one of my sisters on the spot is doing most of the visiting and offering a great deal of practical help, but anything that involves people in a position of authority is dealt with by me. My sister in the USA contributes financially and another brother and sister provide me with a chauffeur service to get to and around Manchester.
I was wondering, did you have Power of Attorney for your dad? I've hesitated to go down this road, but I think that even if mum recovers from her current problems she's going to go downhill pretty fast. She's a bit confused right now, but is generally compos mentis - well enough legally to know what she's doing if she signs a POA. At the moment I am involved in all her health care and the hospital and her G.P. have a written authority from my mum confirming that I am her carer and she's given permission for medical confidentiality to be waived so that her care can be discussed with me.

Go for POA anyway!

Hi GA, it's a problem being part of the sandwich generation, isn't it! And, isn't it strange how siblings all slot into their allotted role?

Will you need/want to go to see your Mum now she has been readmitted?

We have POA in place for Mum but haven't activated it yet. I have been able to operate Mum's bank accounts for years (in fact it's all down to me now!) and we have never had any problem, in practice, as far as health decisions go. So, it's probably wise to have it but probably not vital.

I hope your mum gets better soon.

Yes kitty I'm off to Manchester first thing in the morning. I've already phoned to introduce myself to the ward staff and requested a referral to the dietician as a first step to getting a psychological assessment done. My mother has not yet been officially diagnosed with an eating disorder, but she certainly has one - she's gone from a size 16 to about a size four and now weighs less than six stones.
Because it's the weekend there's little I can do to with regards to her medical care, but I plan to sort out hot meal deliveries for her and my sister has already engaged a cleaner to 'do' for her when she gets home; I'm also going to visit some nursing homes as a Plan B.

An 'eating disorder' might be pushing it a bit. A lot of older people seem to experience a change in appetite. Both my mum and MIL just seemed to lose interest in eating. Things like Fortisip or similar helped to maintain levels of nourishment without hassling them to eat when they didn't want to. I remember long ago there were special diets for convalescents. Great lengths were gone to to tempt people to eat. I don't think a psychologist would get involved I'm afraid. Discuss with experienced care of the elderly nurses.

We had organised P of A for my parents long before they became unwell, and we were always glad that we had done so. My Dad organised it through a solicitor and it was not cheap, but when my OH and I did the same thing I did it myself. Not difficult as all the directions are clear online - you just have to be methodical and make sure everything is done in the correct order - I drew a flow diagram!

My Dad also opened a joint bank account with my brother and put £10k into it. It was such a boon as my brother could sign cheques when Dad was ill for bills that needed paying; and it was of course very useful for paying for his funeral when he eventually died.

My Nan was vanishingly small and weighed near nothing when she was in her final illness. You do need to get on top of this and make sure that she has proper preventive measures in place against pressure sores. My Nan eventually died of a huge infected pressure sore that extended across her whole back - it was indescribable and I would not want anyone else to go through that.

There are food supplements and substitute protein high drinks - my OH has these.

It is also very important that the staff make sure she is able to reach and eat her meals. She may need a lot of encouragement and help to get a meal down her, and this is something that there is often no time to be done properly by the nurses.

Jane10 I won't go into details on here, but it really is an eating disorder without a doubt - last time she was in hospital a dietician was involved and said that was the case, but there was very little follow up and I discovered no diagnosis was noted in her records. Mum has all the classic signs of anorexia nervosa - which is very common in elderly people, but often under-diagnosed, especially when there are several other medical conditions present, as in my mum's case. When I spoke to the nurse who looks after her she said staff had already spotted it as a major contributory factor to mum's current problems, which was very encouraging. Mum has been on Fortisip for a long time, but it's basically all she has and that's one of the reasons why she's ended up in hospital.

Luckygirl I've been assured that mum's food intake is being monitored and someone will sit with her when food is served so that they can see what happens to it. (Mum is not happy with this arrangement!) She's refused all food today, but has had two Fortisips. You're right about pressure sores - my mum moans about it like billy-o, but staff insist that she has to have an air mattress to prevent them. She has no 'padding' on her bones now. They've put her in Bed 13 and she's so superstitious that she's threatening to leave (she can't actually walk at the moment) if they don't move her! #drivingeverybodybonkers

Pressure sores are diabolically painful. Nurses used to be mortified if a patient developed them. Nice new ripple beds help though the motor could be quite noisy (according to MIL)

Good luck with all this Ga - it is so difficult and I hope she will be well cared-for. She is lucky to have you rooting for her.

I'm still in Manchester and mum is still in hospital. When I'm not visiting I'm spending each day with my sister cleaning and sorting in mum's house. I've called out people to do several repairs that have been outstanding for some time and ordered new carpets for most rooms. When I've explained I need things done quickly, before mum comes home from hospital, everyone has been very responsive, so there will only be one repair outstanding when she comes home and all the new carpets will be down.
The hospital staff have been brilliant. Mum now has an official diagnosis of anorexia, has been referred to the mental health team, dietician, OT, physiotherapist and social worker. She is also on an appetite stimulant and staff monitor her food intake - consequently she's putting on weight (she weighed 5st 3lb on admission). Mum hates the hospital food so my younger sister is cooking meals for her twice a day and mum still complains.
The bonus to being here is that I get to spend some time with my lovely nieces and relieve my youngest sister of the daily responsibility of looking after mum.
Today we're going shopping for a recliner chair and some new clothes for mum - she's been wearing her size 16 clothes that haven't fit her for two years!

I recognise this description and it could be my mum whom you are describing regarding eating issues,I always thought of mums issue with eating as something that had gone on for years tied in with her many anxieties and depressions and the result of remembering choking on a sweet as a child. As a young woman she would mash any food given to her and after her mother died developed an agrophobia and eating disorder living on baby food ...earning her the name nanny Gerber from my kids.she also had issues with her weight which was a normal one for her height and in her 70s became obsessed with being fat and would just live on a tin of creamed rice or custard or maybe a choc chip cookie,we thought that this was a way of control in her life where she felt unhappy it was soon after my daughter had died in suspicious circumstances and I was torn between mum and looking after my then 4yr old GD my own health and dealing with 3 separate court cases,mum had broken her hip she seemed to go downhill from there on and this anorexic type behaviour became more apparent.A difficult time trying to tempt this type of disorder in the elderly we did think mum was just giving up..GA

I finally arrived home yesterday evening - having spent far longer with my mother than I had anticipated I would need. She has discharged herself from hospital against medical advice and is scathing about the care that she received - I think she was confusing being in hospital with staying in a 5* hotel!! Honestly the staff were patience personified and my mother was horribly rude and cantankerous to everyone. She threatened to call the local newspaper and tell them it's the worst hospital in the world!
Another of my sisters has taken over looking after her for the next few days, but mum has completely stopped eating again and lost another 4lbs before leaving hospital, so I don't think my sister will have an easy time of it.
The highlight of being in Manchester for so long was that I managed a (far too) brief meet up with whenim64 in the hospital cafe. [Waves to when] My poor brother (who has a great many health problems of his own and rarely complains) had to spend an hour on his own with mum whilst I did so and needed copious amounts of coffee and cake to recover from the trauma! Apparently my mother spent an hour complaining that I was in Manchester to see her and not to gallivant with friends!!
Anyway I'm home again now and very happy to be here, but have my in-laws moving in on Friday so there's barely enough time to thoroughly clean my own house before then. The Wonderful Man has been busy working on the roof of the house so housework has been rather neglected for the past ten days.
I'm flying off to New Zealand next week. I'm dreading the journey, but so looking forward to meeting my granddaughter at last. [Yippee!]

Blimey its not boring in your life anyway!

I had this problem in some respect with my parents refusing all suggestions of meals on wheels in the end all I could do was to send in waitrose on line ready meals which they both would eat .My mother would not /could not Cook.

Just thought I'd post an update as two days ago mum was re-admitted to hospital for the fourth time since I last posted about the situation. Mum is still refusing to eat and is living on Fortisips exclusively. Her GP and the community nurse are very attentive to her and amazingly caring and compassionate - especially as she isn't always very nice.
Each time the ambulance is called and she's dashed into hospital we think she won't recover and prepare ourselves for the end and then she rallies - after treatment she returns home significantly frailer than before. When she's in hospital it's a full time job getting her to stay there and not discharge herself as soon as she feels slightly better.
This time my lovely youngest sister has forbidden me to make the journey north again and insists that she will do whatever is necessary, but I am constantly on alert and each time there's a text or phone call I'm on edge. I was due to attend a conference on Wednesday, but have cancelled because I feel I can't risk not being available if I'm needed. My sister is due to come over from America for Christmas, but she's on standby to come immediately if mum's condition deteriorates.
Being the sandwich generation is not easy.