Elderly parent / mental health, your experiences?
Discussion
Both my parents are in their 70s. Mum has Parkinson’s and is weak / frail and can be slow to consider her speech but from a mental standpoint is as good as she’s ever been. She’s always been a dippy old bird but I find her very gentle in old age and easy to talk to, I’m probably on better terms with her now than ever.
Dad is physically healthier but I’m definitely seeing signs that he is starting to suffer mental degradation. Mainly it’s small things, but I’ve been staying with them this week (I live overseas) and have been witness to a nasty side to him that mum tells me is fairly recent but becoming more frequent. I can overlook him repeating things to me a million times or talking complete cod, I can’t ignore this.
He tells us both we mumble, but has the tv on loud with subtitles as well. I was in another room and heard him starting to raise his voice towards mum, saying she’s mumbling and to speak up. Literally moments later he’s shouting at the top of his voice at her, flailing arms around, telling her to shut the f
k up etc. another 2mins later he’s acting like nothing happened and making her supper.
Speaking to mum about this last night she started tearing up. She feels like she has to sit there and take it as she’s physically unable to get away from him and doesn’t want to escalate an already uncontrollable situation. She says it’s usually at night (I notice he drinks nightly) and does weird stuff like taking all the duvet and then shouting or even jumping out of bed if challenged. He’s currently sporting a broken wrist from a drunken fall that he won’t fully admit to.
Mum and I both think its down to mental degradation and that maybe he knows this himself and can’t face it, hence the drinking. She told me she is scared he might lose control sufficiently as to hit her, and is also scared that if it’s dementia she can’t look after him and he can’t look after her, and they have no plan in place for that. At present he does everything around the house and all the cooking. Mum can barely open the fridge on her own. The house itself is wholly unsuitable but selling it to move to an adapted bungalow is a battle I’m having with both of them,
Thing is, mum had a series of strokes not so long back and me and dad spent a week together whilst she was in hospital. I’d never seen my dad cry before then. He was out washing the windows in the rain, like staring into the abyss. I told him some home truths (the drink, the fact mum thinks he’s getting aggressive, the inevitable fact they need to sell their current home) and the result was my once invincible father crying and shuddering and telling me he’s sorry.
Didn’t mean to write so much, especially about something so personal. Just I don’t know what to do. I’m at the airport about to fly home and am tearing up as I type. I feel pretty wretched to be leaving right now tbh.
Is this a GP issue or do I need to find someone else? Over the past few years they’ve both been in and out of hospital and my general impression is that elderly healthcare is more about patching up than fixing. If meds will help then I want him to have them, but I also think some therapy aimed at accepting age and the inevitable, may help. I don’t need him to be the man he used to, I just need him to chill the fk out. Bizarrely he’s always had a sanguine attitude towards death himself it seems mums physical decline has triggered all this.
Can someone who’s been in this situation please give me some pointers or any idea where to start? Is there any hope of staving off further decline and ending the aggression, or do I have to plan on the basis it’ll only deteriorate from here on in?
NB I’ll probably be off the forum for the next day or two due to travel, so if I don’t reply it’s due to that.
Dad is physically healthier but I’m definitely seeing signs that he is starting to suffer mental degradation. Mainly it’s small things, but I’ve been staying with them this week (I live overseas) and have been witness to a nasty side to him that mum tells me is fairly recent but becoming more frequent. I can overlook him repeating things to me a million times or talking complete cod, I can’t ignore this.
He tells us both we mumble, but has the tv on loud with subtitles as well. I was in another room and heard him starting to raise his voice towards mum, saying she’s mumbling and to speak up. Literally moments later he’s shouting at the top of his voice at her, flailing arms around, telling her to shut the f
k up etc. another 2mins later he’s acting like nothing happened and making her supper. Speaking to mum about this last night she started tearing up. She feels like she has to sit there and take it as she’s physically unable to get away from him and doesn’t want to escalate an already uncontrollable situation. She says it’s usually at night (I notice he drinks nightly) and does weird stuff like taking all the duvet and then shouting or even jumping out of bed if challenged. He’s currently sporting a broken wrist from a drunken fall that he won’t fully admit to.
Mum and I both think its down to mental degradation and that maybe he knows this himself and can’t face it, hence the drinking. She told me she is scared he might lose control sufficiently as to hit her, and is also scared that if it’s dementia she can’t look after him and he can’t look after her, and they have no plan in place for that. At present he does everything around the house and all the cooking. Mum can barely open the fridge on her own. The house itself is wholly unsuitable but selling it to move to an adapted bungalow is a battle I’m having with both of them,
Thing is, mum had a series of strokes not so long back and me and dad spent a week together whilst she was in hospital. I’d never seen my dad cry before then. He was out washing the windows in the rain, like staring into the abyss. I told him some home truths (the drink, the fact mum thinks he’s getting aggressive, the inevitable fact they need to sell their current home) and the result was my once invincible father crying and shuddering and telling me he’s sorry.
Didn’t mean to write so much, especially about something so personal. Just I don’t know what to do. I’m at the airport about to fly home and am tearing up as I type. I feel pretty wretched to be leaving right now tbh.
Is this a GP issue or do I need to find someone else? Over the past few years they’ve both been in and out of hospital and my general impression is that elderly healthcare is more about patching up than fixing. If meds will help then I want him to have them, but I also think some therapy aimed at accepting age and the inevitable, may help. I don’t need him to be the man he used to, I just need him to chill the f
k out. Bizarrely he’s always had a sanguine attitude towards death himself it seems mums physical decline has triggered all this. Can someone who’s been in this situation please give me some pointers or any idea where to start? Is there any hope of staving off further decline and ending the aggression, or do I have to plan on the basis it’ll only deteriorate from here on in?
NB I’ll probably be off the forum for the next day or two due to travel, so if I don’t reply it’s due to that.
Hi,
Sorry to hear about the issues, both my parents had severe mental health issues albeit different variants and hence treatments differed.
I think you need to raise this to the GP, speak to them about it and highlight the issues. I just wonder if a care assessment needs to be done by the Local authority social services e.g: if you think your parents might benefit from carer visits 1/2/3 times per day then you need to go via GP first who will then refer to social services/elderly care team to start the assessment process.
Regarding the aggression, I'm not a medic but it might be the case that the GP can refer your dad for a mental health review and maybe they could treat it medically.
This may of already been done but that's my though process based on the issues I dealt with regarding my parents. Hope it helps.
Sorry to hear about the issues, both my parents had severe mental health issues albeit different variants and hence treatments differed.
I think you need to raise this to the GP, speak to them about it and highlight the issues. I just wonder if a care assessment needs to be done by the Local authority social services e.g: if you think your parents might benefit from carer visits 1/2/3 times per day then you need to go via GP first who will then refer to social services/elderly care team to start the assessment process.
Regarding the aggression, I'm not a medic but it might be the case that the GP can refer your dad for a mental health review and maybe they could treat it medically.
This may of already been done but that's my though process based on the issues I dealt with regarding my parents. Hope it helps.
stty situation, but it sounds like hearing aids wouldn't be a bad place to start. It's incredibly frustrating when you don't understand most of what's going on. But bear in mind that it can take a bit of perseverance and adaptation to get used to them, particularly (AIUI) as you get older.
(Not had the issue with parents, but I had to do without my hearing aids for a couple of days and it was bloody hard work.)
tty situation, but it sounds like hearing aids wouldn't be a bad place to start. It's incredibly frustrating when you don't understand most of what's going on. But bear in mind that it can take a bit of perseverance and adaptation to get used to them, particularly (AIUI) as you get older.(Not had the issue with parents, but I had to do without my hearing aids for a couple of days and it was bloody hard work.)
I haven't been through it with a parent but I have been through it twice with Grandmothers supporting my parents and have seen it first hand and had to watch my grandmothers deteriorate to nothing, you have my deepest sympathies.
From reading your post OP one thing that does occur to me from you talking about the TV volume and subtitles, does your father have hearing aids? If not it may be something that may help significantly, it sounds like he has hearing issues and I wonder if that is the cause of a lot of his frustration, which in turn links to the drinking and more frustration?
It may not solve all the issues but if he is making reference to mumbling and the TV issues It sounds like he may have hearing problems.
From reading your post OP one thing that does occur to me from you talking about the TV volume and subtitles, does your father have hearing aids? If not it may be something that may help significantly, it sounds like he has hearing issues and I wonder if that is the cause of a lot of his frustration, which in turn links to the drinking and more frustration?
It may not solve all the issues but if he is making reference to mumbling and the TV issues It sounds like he may have hearing problems.
It's very likely he has the start of dementia if this is long running. The symptoms you describe are common.
Went through it with my own father and my OH was a specialist in this area. She's at work so typing from memory.
First port of call is GP to get him in the system. He'll be referred for assessment and if he has it something aricept (what my father was on for vascular dementia) may slow the progress. It's not great though.
Go with them and make sure you get referred to the community mental health team and social services so there is a care plan for both parents.
If he has dementia, start looking at care homes now. Good ones have waiting lists, st ones don't. Start having that conversation with your mum. Putting your partner into care is one of the hardest things to do... You need to help her by absolving her of guilt / blame. I told my mother that it was happening.
Get power off attorney now whilst he has capacity.
Collect up any important documents, photos, things you don't want to lose. They get thrown out, hidden, destroyed.
File his details with police - my father went walkabout.
You have my sympathies if he does have it... It's a fking awful disease and heartbreaking for all involved.
A home full of dementia sufferers is a sight to behold.
Went through it with my own father and my OH was a specialist in this area. She's at work so typing from memory.
First port of call is GP to get him in the system. He'll be referred for assessment and if he has it something aricept (what my father was on for vascular dementia) may slow the progress. It's not great though.
Go with them and make sure you get referred to the community mental health team and social services so there is a care plan for both parents.
If he has dementia, start looking at care homes now. Good ones have waiting lists, s
t ones don't. Start having that conversation with your mum. Putting your partner into care is one of the hardest things to do... You need to help her by absolving her of guilt / blame. I told my mother that it was happening. Get power off attorney now whilst he has capacity.
Collect up any important documents, photos, things you don't want to lose. They get thrown out, hidden, destroyed.
File his details with police - my father went walkabout.
You have my sympathies if he does have it... It's a f
king awful disease and heartbreaking for all involved. A home full of dementia sufferers is a sight to behold.
OP, I feel for, I really do.
My wife and I dealt with this in 2017 when her Mum's "memory problems" were clearly Alzheimer's and she was primary carer for my FIL who had Parkinson's.
We'd tried the multiple times / day home visits by a nurse, but my MIL didn't like the nurse coming in and "stepping on her toes", although she clearly couldn't help herself or her husband.
As we live in another country, we had no choice, following a few incidents where my FIL fell and injured himself, but to put them both in residential care.
I'd ask their GP to make an assessment of them in a home visit, and to get Social Services involved first with nurse / home help. If that doesn't work out, then, well, you saw my comment above.... sorry.
My wife and I dealt with this in 2017 when her Mum's "memory problems" were clearly Alzheimer's and she was primary carer for my FIL who had Parkinson's.
We'd tried the multiple times / day home visits by a nurse, but my MIL didn't like the nurse coming in and "stepping on her toes", although she clearly couldn't help herself or her husband.
As we live in another country, we had no choice, following a few incidents where my FIL fell and injured himself, but to put them both in residential care.
I'd ask their GP to make an assessment of them in a home visit, and to get Social Services involved first with nurse / home help. If that doesn't work out, then, well, you saw my comment above.... sorry.
So much going on the list of possibilities is long - fortunately some are fixable. All depend on him playing ball
Everyone gets age related cognitive decline and can make people crotchety
Dementia.
Carer strain/relationship issues
Deafness
Alcohol - patients with brain damage (including dementia) are more susceptible to the effects of alcohol. Sometimes patients with early dementia have their one sherry or nightcap several times - innocent but still risky. TBF this is probably the biggest fixable risk.
Depression or other non dementia mental health problem. ALcohol can cause depression and most would advise stopping (not reducing) alcohol to see if mood picks up. Irritability is an under reported symptoms of depression and common in men.
Undiagnosed physical condition
Needs referral into secondary care. As suggested above he'll probably be triaged to the memory services. They tend to be a bit blinkered and if you only have a hammer everything is a nail.
I think he'd be better off being referred to a consultant psychiatrist for the elderly and supported by the multidisciplinary team. If the GP composes the referral and emphasises any other medical conditions he has; the complexity and doubt about diagnosis, this should steer it to the medics.
The deafness is an easy win and could be addressed outside the NHS. NHS audiology is a great service but overwhelmed in most places.
Parallel referral to social services referencing NHS referral (may work in same team depending on location) if not already on their books. They have statutory entitlement to assessment at the very least
Everyone gets age related cognitive decline and can make people crotchety
Dementia.
Carer strain/relationship issues
Deafness
Alcohol - patients with brain damage (including dementia) are more susceptible to the effects of alcohol. Sometimes patients with early dementia have their one sherry or nightcap several times - innocent but still risky. TBF this is probably the biggest fixable risk.
Depression or other non dementia mental health problem. ALcohol can cause depression and most would advise stopping (not reducing) alcohol to see if mood picks up. Irritability is an under reported symptoms of depression and common in men.
Undiagnosed physical condition
Needs referral into secondary care. As suggested above he'll probably be triaged to the memory services. They tend to be a bit blinkered and if you only have a hammer everything is a nail.
I think he'd be better off being referred to a consultant psychiatrist for the elderly and supported by the multidisciplinary team. If the GP composes the referral and emphasises any other medical conditions he has; the complexity and doubt about diagnosis, this should steer it to the medics.
The deafness is an easy win and could be addressed outside the NHS. NHS audiology is a great service but overwhelmed in most places.
Parallel referral to social services referencing NHS referral (may work in same team depending on location) if not already on their books. They have statutory entitlement to assessment at the very least
TGCOTF-dewey said:
It's very likely he has the start of dementia if this is long running. The symptoms you describe are common.
Went through it with my own father and my OH was a specialist in this area. She's at work so typing from memory.
First port of call is GP to get him in the system. He'll be referred for assessment and if he has it something aricept (what my father was on for vascular dementia) may slow the progress. It's not great though.
Go with them and make sure you get referred to the community mental health team and social services so there is a care plan for both parents.
If he has dementia, start looking at care homes now. Good ones have waiting lists, st ones don't. Start having that conversation with your mum. Putting your partner into care is one of the hardest things to do... You need to help her by absolving her of guilt / blame. I told my mother that it was happening.
Get power off attorney now whilst he has capacity.
Collect up any important documents, photos, things you don't want to lose. They get thrown out, hidden, destroyed.
File his details with police - my father went walkabout.
You have my sympathies if he does have it... It's a fking awful disease and heartbreaking for all involved.
A home full of dementia sufferers is a sight to behold.
I’d agree with the majority of this. Getting Social Services involved early is essential. They are under staffed and under strained so there may be some frustration and you might need to push things along but they do their best.Went through it with my own father and my OH was a specialist in this area. She's at work so typing from memory.
First port of call is GP to get him in the system. He'll be referred for assessment and if he has it something aricept (what my father was on for vascular dementia) may slow the progress. It's not great though.
Go with them and make sure you get referred to the community mental health team and social services so there is a care plan for both parents.
If he has dementia, start looking at care homes now. Good ones have waiting lists, s
t ones don't. Start having that conversation with your mum. Putting your partner into care is one of the hardest things to do... You need to help her by absolving her of guilt / blame. I told my mother that it was happening. Get power off attorney now whilst he has capacity.
Collect up any important documents, photos, things you don't want to lose. They get thrown out, hidden, destroyed.
File his details with police - my father went walkabout.
You have my sympathies if he does have it... It's a f
king awful disease and heartbreaking for all involved. A home full of dementia sufferers is a sight to behold.
My FIL developed dementia in his late 70s. In hindsight it had been coming on a while but latterly he would argue with MIL one minute then be fine the next. He’d retrograde back 40+ years and could actually drive and navigate to the places he grew up but would take a walk and get lost. Stopping him driving was the first thing and then we had a Vodafone tracker we’d slip into his pocket to monitor his movements. Latterly it rapidly advanced to the point he was sectioned under the mental health act for violence against my wife who was looking after both their needs. Then into a care home. He is a sad existence of his former self and the skills he had as a heavy plant and car engineer. Even now MIL cannot accept it and for a while wanted him back home but now accepts that is not possible.
It’s worse that he is in excellent physical health having kept fit into his 70s so could go on for years and I’m sure if he was of sound mind wouldn’t want that.
TGCOTF-dewey said:
It's very likely he has the start of dementia if this is long running. The symptoms you describe are common.
Went through it with my own father and my OH was a specialist in this area. She's at work so typing from memory.
First port of call is GP to get him in the system. He'll be referred for assessment and if he has it something aricept (what my father was on for vascular dementia) may slow the progress. It's not great though.
Go with them and make sure you get referred to the community mental health team and social services so there is a care plan for both parents.
If he has dementia, start looking at care homes now. Good ones have waiting lists, st ones don't. Start having that conversation with your mum. Putting your partner into care is one of the hardest things to do... You need to help her by absolving her of guilt / blame. I told my mother that it was happening.
Get power off attorney now whilst he has capacity.
Collect up any important documents, photos, things you don't want to lose. They get thrown out, hidden, destroyed.
File his details with police - my father went walkabout.
You have my sympathies if he does have it... It's a fking awful disease and heartbreaking for all involved.
A home full of dementia sufferers is a sight to behold.
Absolutely this.Went through it with my own father and my OH was a specialist in this area. She's at work so typing from memory.
First port of call is GP to get him in the system. He'll be referred for assessment and if he has it something aricept (what my father was on for vascular dementia) may slow the progress. It's not great though.
Go with them and make sure you get referred to the community mental health team and social services so there is a care plan for both parents.
If he has dementia, start looking at care homes now. Good ones have waiting lists, s
t ones don't. Start having that conversation with your mum. Putting your partner into care is one of the hardest things to do... You need to help her by absolving her of guilt / blame. I told my mother that it was happening. Get power off attorney now whilst he has capacity.
Collect up any important documents, photos, things you don't want to lose. They get thrown out, hidden, destroyed.
File his details with police - my father went walkabout.
You have my sympathies if he does have it... It's a f
king awful disease and heartbreaking for all involved. A home full of dementia sufferers is a sight to behold.
My dad went the same way. His was a known condition though (that caused dementia symptoms) that just got gradually worse. At the end, he spent 5 months in hospital then 2 months in a care home because mum couldn't pick him up when he kept falling over.
Text book stuff though, deafness, irritable, lethargic, poor mobility, mood swings, aggressive, forgetful, trouble finishing a sentence etc etc.
Power of attorney was sorted years ago but we never used it in the end. Mum would just use his bank card for anything that needed paying. His medical requirements were also out of my hands as the care home deemed him high risk and put measures in place (locked doors, sedatives etc) for his own safety. Not once were we asked who had POA over his health, they just cracked on and ran everything by mum (who didn't have POA but I guess spouse is just as relevant as POA).
Get things lined up now while you can.
Apart from the drinking, I could have been reading a description of my dad a few years ago
He was diagnosed with vascular dementia some time before that. He has been in a specialist care home for a couple of years now. It got to the point that it wasn't safe for him or mum for him to stay at home; it was starting to affect mum badly too. I had been unable to visit them for some time due to COVID restrictions, and I was shocked by his deterioration. Fortunately, my mum was and is still pretty independent, able to drive still (only short distances) at 82, and she has my brother nearby.
As others have said, please start to get the wheels in motion, including visit to the GP and power of attorney. For both your dad's and mum's sakes. Echo what TGCOTF-dewey says about care homes. My dad wasn't in a great one to start with and ended up in hospital and stayed there for quite some time until a place could be found in another one which could better meet his needs. They are like night and day. Fortunately, it was the psychiatrist and mental health nurse who said that dad needed to go into a home to give mum some respite care initially, then that they wouldn't feel comfortable for him to go home; this lessened the guilt somewhat.
Thinking of you.
He was diagnosed with vascular dementia some time before that. He has been in a specialist care home for a couple of years now. It got to the point that it wasn't safe for him or mum for him to stay at home; it was starting to affect mum badly too. I had been unable to visit them for some time due to COVID restrictions, and I was shocked by his deterioration. Fortunately, my mum was and is still pretty independent, able to drive still (only short distances) at 82, and she has my brother nearby.
As others have said, please start to get the wheels in motion, including visit to the GP and power of attorney. For both your dad's and mum's sakes. Echo what TGCOTF-dewey says about care homes. My dad wasn't in a great one to start with and ended up in hospital and stayed there for quite some time until a place could be found in another one which could better meet his needs. They are like night and day. Fortunately, it was the psychiatrist and mental health nurse who said that dad needed to go into a home to give mum some respite care initially, then that they wouldn't feel comfortable for him to go home; this lessened the guilt somewhat.
Thinking of you.
Edited by moorx on Friday 19th August 21:14
Sorry to read of your difficulty. It might be exacerbated by being aware of bigger jumps in decline if you live abroad and see your parents less frequently, and that can also make for being harder to bring up "difficult conversations" about critically important things like power of attorney and planning for how they would want to be cared for when they cannot communicate with you any more. Wait until it's too late and the Court of Protection will make the decisions for you.
On the other hand, initiating such conversations can be minefield, especially if you have siblings or another parent who disagrees - or who procrastinates because they can't accept this is happening. Organisations have tried to help come up with ways of asking sensitive questions like have you thought about how you would want us to look after you if you got to a point where you couldn't tell us any more. Think carefully how you will approach this topic but try to avoid ducking it completely.
As well as the advance planning, the advice to rescue items of no financial value like photos and other heirlooms is sensible so think about that before it's too late and you can no longer ask where things are - or risk finding out too late that they were thrown out in a house move. And things like videoing your parents talking about when they were younger can be a lovely thing to make for your children to help preserve their memory too.
No easy answers to a complex problem that many people face, just lots of sympathy from people who have already trod that path and learnt from it.
On the other hand, initiating such conversations can be minefield, especially if you have siblings or another parent who disagrees - or who procrastinates because they can't accept this is happening. Organisations have tried to help come up with ways of asking sensitive questions like have you thought about how you would want us to look after you if you got to a point where you couldn't tell us any more. Think carefully how you will approach this topic but try to avoid ducking it completely.
As well as the advance planning, the advice to rescue items of no financial value like photos and other heirlooms is sensible so think about that before it's too late and you can no longer ask where things are - or risk finding out too late that they were thrown out in a house move. And things like videoing your parents talking about when they were younger can be a lovely thing to make for your children to help preserve their memory too.
No easy answers to a complex problem that many people face, just lots of sympathy from people who have already trod that path and learnt from it.
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