Relative with cognitive impairement not eating properly - home help/care?

BrianD3

My elderly mother is having problems with memory and looking after herself - she has not been diagnosed with Alzheimer's or any other neurological condition and is quite good in some ways but I am pretty sure that there is an issue there. She refuses to go to her GP, obviously I can't force her. She has always been arrogant and stubborn, unsociable, intolerant and critical of others yet gets very defensive at the slightest hint of criticism.

I visit her everyday and often stay overnight too but when I am at work during the day I am worried about what she is doing. My main concern is eating. She has lost weight and is eating less than she used to. When I ask her what she has eaten during the day I don't trust the answers. I think it is a combination of
-she has become less aware of the importance of nutrition
-she forgets to eat
-she forgets what she has eaten when I ask her or else lies about what she has eaten

She does not drive a car anymore and lives in an isolated location so is basically dependent on me for shopping. There is always plenty of food in the house. She has no friends (the small number that she had are all dead) and no family (all either dead or living far away) apart from me. She does come with me to shop and I usually wait in the car so that she can do something for herself. She does get the shopping done but every time complains afterwards that she found it hard to find anything as Tesco keep reorganising the shop. Now I know that while Tesco do reorganise their shops and move things around, it doesn't happen every single week. She is in complete denial that the problem is her own memory, not Tesco.

Has anyone any advice on how I go about improving the situation for her and myself especially re: the eating. Home care or home help from the HSE or private? If someone were to come in for half an hour a day for a chat and verify that she is getting one decent meal per day I think that would be a major help.

sullivlo

BrianD3 wrote: »

My elderly mother is having problems with memory and looking after herself - she has not been diagnosed with Alzheimer's or any other neurological condition and is quite good in some ways but I am pretty sure that there is an issue there. She refuses to go to her GP, obviously I can't force her. She has always been arrogant and stubborn, unsociable, intolerant and critical of others yet gets very defensive at the slightest hint of criticism.

I visit her everyday and often stay overnight too but when I am at work during the day I am worried about what she is doing. My main concern is eating. She has lost weight and is eating less than she used to. When I ask her what she has eaten during the day I don't trust the answers. I think it is a combination of
-she has become less aware of the importance of nutrition
-she forgets to eat
-she forgets what she has eaten when I ask her or else lies about what she has eaten

She does not drive a car anymore and lives in an isolated location so is basically dependent on me for shopping. There is always plenty of food in the house. She has no friends (the small number that she had are all dead) and no family (all either dead or living far away) apart from me. She does come with me to shop and I usually wait in the car so that she can do something for herself. She does get the shopping done but every time complains afterwards that she found it hard to find anything as Tesco keep reorganising the shop. Now I know that while Tesco do reorganise their shops and move things around, it doesn't happen every single week. She is in complete denial that the problem is her own memory, not Tesco.

Has anyone any advice on how I go about improving the situation for her and myself especially re: the eating. Home care or home help from the HSE or private? If someone were to come in for half an hour a day for a chat and verify that she is getting one decent meal per day I think that would be a major help.

We had a very similar issue with my great aunt. I'll tell you our situation and then hopefully it might give you some ideas.

She is diabetic with kidney trouble. She was really sick in January so I brought her to the doctor and explained our concerns. He referred her to the geriatric clinic in Smithfield for assessment. They did memory tests and some scans and stuff.

They referred her to the geriatric psychiatry team for diagnosis, and she was diagnosed as having cognitive impairment. Like you and your mum, she relies on me for food and often lies about what she has eaten.

We got a referral for the district nurse from the geriatrician, however a GP can also refer. The district nurse will do a home visit and ask your mum some questions. Ultimately, she has to be willing to let the people into her home though so maybe start broaching the subject now.

The DN decided my aunt needed companionship only, 2 half hour slots a day. She also suggested meals on wheels.

So we get the home care team in twice a day, 7 days a week and that's covered by the HSE. The meals on wheels is 4 days a week and costs €8. But there are probably other options that your district nurse could advise you on.

First step is a visit to the GP. You can go with your mum and explain your concerns to her GP in her presence and your GP can decide. You just need to focus on the weight loss, the confusion and the loss in appetite.

Good luck. And if you have any questions let me know.

BrianD3

sullivlo wrote: »

We had a very similar issue with my great aunt. I'll tell you our situation and then hopefully it might give you some ideas.

She is diabetic with kidney trouble. She was really sick in January so I brought her to the doctor and explained our concerns. He referred her to the geriatric clinic in Smithfield for assessment. They did memory tests and some scans and stuff.

They referred her to the geriatric psychiatry team for diagnosis, and she was diagnosed as having cognitive impairment. Like you and your mum, she relies on me for food and often lies about what she has eaten.

We got a referral for the district nurse from the geriatrician, however a GP can also refer. The district nurse will do a home visit and ask your mum some questions. Ultimately, she has to be willing to let the people into her home though so maybe start broaching the subject now.

The DN decided my aunt needed companionship only, 2 half hour slots a day. She also suggested meals on wheels.

So we get the home care team in twice a day, 7 days a week and that's covered by the HSE. The meals on wheels is 4 days a week and costs €8. But there are probably other options that your district nurse could advise you on.

First step is a visit to the GP. You can go with your mum and explain your concerns to her GP in her presence and your GP can decide. You just need to focus on the weight loss, the confusion and the loss in appetite.

Good luck. And if you have any questions let me know.

Very good advice, thank you so much for sharing. Food wise, today was a better day - looking at a few things I'm pretty sure that a reasonable amount of protein carbs and calories were consumed. E.g. last night I counted the number of slices of bread in the bread bin without her seeing me. This evening there are four slices less which tallies with what she said she ate for breakfast.

Still, even if there are good days I believe that the overall trend is one of decline, at least now I know where to start and the role of the district nurse.

It will be hard to get her to a GP. She has a couple of minor ailments and regularly attends specialists for them (I drive her to the appointments which she books herself) but there is no way she will want to go to a GP to be assessed for memory problems or for a home care referral. My thinking is I might encourage her to go to the GP "to get cholesterol and blood pressure checked" but pre warn the GP that the real purpose of the visit is to try to see how she is neurologically and mentally.

sullivlo

BrianD3 wrote: »

Very good advice, thank you so much for sharing. Food wise, today was a better day - looking at a few things I'm pretty sure that a reasonable amount of protein carbs and calories were consumed. E.g. last night I counted the number of slices of bread in the bread bin without her seeing me. This evening there are four slices less which tallies with what she said she ate for breakfast.

Still, even if there are good days I believe that the overall trend is one of decline, at least now I know where to start and the role of the district nurse.

It will be hard to get her to a GP. She has a couple of minor ailments and regularly attends specialists for them (I drive her to the appointments which she books herself) but there is no way she will want to go to a GP to be assessed for memory problems or for a home care referral. My thinking is I might encourage her to go to the GP "to get cholesterol and blood pressure checked" but pre warn the GP that the real purpose of the visit is to try to see how she is neurologically and mentally.

Maybe just say it's for a check up and when you're there mention the weight loss. There's no harm in phoning ahead to speak to the doctor, but they may tell your mother you called.

You don't need memory assessment for referral to the DN either. You could ring your local health centre and ask them what are the general grounds for referral?

I don't envy you by the way. It's a tough position for you to be in.

Skyfarm

bear in mind that your mother is a person in her own right,and if she refuses to go to doctor then that's her right,i was in a similar situation a few years ago with my mother,a very kind social worker called me aside and reminded me that its elder abuse by doing something against her wishes or behind her back..

in saying that my friend went to her GP and told him about her mother who was getting stressed by the mention of help,he didn't like it but he understood and invited her in for a chat and while she was there asked would she mind blood tests etc

its a bit of a journey but the above post/poster has written it well.