Hi,
I have just joined the forum after visiting for many years!
Sorry in advance for my long message.
I am based in the UK and help care for my 88 y/o Gran.
She just had a week in hospital after a mild bout of pneumonia and a UTI.
We got her home last night but she didn’t seem to recognise her flat and also was expecting me to do everything, take her to the toilet, pull her trousers down, undress her for bed (although she was quite able to work the TV and check the messages on her phone?)
Prior to going into hospital she was doing these things for herself, but does have carers in two times a day to do meals for her, laundry and give her a shower etc.
This does sound awful but she has, for at least the last 20 years, been a very lazy person. My Grandfather did pretty much everything for her until he developed dementia 10 years ago (he died in 2016).
I lived with my Grandparents from age 11 to 19 after my mother died, hence I am more involved in capacity of a Daughter than Granddaughter.
Obviously being in the hospital she got used to the nurses doing everything for her, but she was only in a week, seems a short time for her to completely forget how her life was before hand?
She does not live in the home she shared with Grandad, she moved to a managed flat when he went into care although there are not staff there all the time. There are pull cords etc. in case she falls.
My Dad (65) also helps care for her, he takes her to appointments, deals with her finances. My involvement I mainly do food shopping, a bit of cleaning but really up until now I have only visited once a week to do these things but will mainly spend a few hours just as company for her, chatting.
There is a communal area in her building and she used to go down there herself to meet with the neighbours for coffee etc. but when the pandemic struck it closed for two years and when they reopened it this year she decided she wasn’t able to do that any more so spends all day at home. I think she is still able but just lost confidence. But try as I might I can’t convince her, even if I offer to walk down with her (she has a walker too which she can use well).
My view is that if she wants to continue living independently in the way she has been then she will need to start doing things for herself again as neither my Dad or I or her carers can be there 24 hours a day.
Maybe she will bounce back again, just wondered is this a normal thing after a stay in hospital or is this usually when the conversation about a nursing/care home needs to start?
I personally think she would enjoy a care home but has a mental block about it as my Grandad’s was a specialist unit for dementia and it was upsetting for her when we would visit.
Sorry for long message, just be nice to be able to chat to folks going through the same thing, as I don’t think people who aren’t currently in it appreciate how stressful it is and how much mental space it takes up for us.
Thank you,
Jennifer
Yes, it is common for some confusion after a hospital stay, especially for the elderly. It only takes 1 day of laying in bed for them to lose all stamina, she probably feels weak and wobbly.
Giving her prompts to do what needs done and helping when she runs into trouble will show if this is temporary and she has the physical ability to recover.
However, at 88 changes happen quickly and this could be her new normal.
Wow after 1 day really I did not appreciate that!
I do hope she can bounce back being more independent as she was doing quite well before (although needy in the way many old folks are!).
However she does every now and then (maybe every few months) wakes up in the night and think she’s in the wrong house and will call my Dad to ask where she is.
He can usually talk her down from this state.
They told us that could be to do with very concentrated urine or also sundowning(? If that’s the right term).
I would prefer it if she was in a full time care place but feel selfish for that as that is not what she wants.
but worrying about her all the time is making me ill.
My Dad will say as long as we are doing our best for her then there is no use in worrying. Easier said than done!
So be patient with her, and know that it's the delirium and not her.
I pray she will find her bearings again at home but will watch closely for the next few weeks.
Have the carers been started again?
Carers have started again but at the moment they were only really there for meal times but think we have the option to increase it to include more personal care like helping dressing etc.
seems to be all fully funded by the local authority which is a welcome surprise!
Gran has started using the toilet herself again which is a small but good step in the right direction.
She is not getting herself dressed yet and still seems a bit disorientated, when she wakes up particularly and is more keen to stay in bed whereas before she would always get dressed straight away and head to the living room.
I can totally understand it must be so confusing as time can lose all meaning when you’re in hospital.
Thanks again!
If so, get on board with the concept as well as you can. You have up to six weeks' service, which goes quicker than you'd believe, and there should be a folder or something like that in her house which will contain the support plan and the workers' daily notes.
Reablement as it should be done can be difficult to deliver because local authorities, although they're required to offer the service, can't afford and are not funded to pay for the time it takes. If you have 45 minutes to get somebody started off in the morning it's a lot quicker to do things for her than to help her do it herself and the temptation can be too much.
So the more positive you can be in encouraging your mother to use the service as it's intended to be used, the more likely she is to achieve the best possible outcome.
You can find out anything you want to know about how it's supposed to work from the Social Care Institute for Excellence - https://www.scie.org.uk/reablement/what-is/carers-family
Thanks so much for the education on benefits in the UK. I'm tucking the info away because you never know when it might just come in handy!
Hold off on all premature diagnoses, neurological evaluations and jumping to conclusions until gran has been home at least a month or two. If she's still not back to her old self, then you can start worrying.
Good luck.
I just don’t want her to give up all her independence yet. That is probably just selfish of me!
Both are very frequent causes of delerium in older people.
Hopefully as the infections clear, she will bounce back to herself.
Gran will be a much bigger falls risk if confused/disorientated, so more supervision from family or carers popping in (if possible) will be a good thing as well. Hopefully her set-up is quite suitable? Habbit of wearing sturdy shoes, good bathroom lighting, no rugs to trip on.
She does have a pretty good set up and was good about wearing shoes in the house (after a few falls in the last few years she realised they helped steady her).
My Dad and I have been popping in more often since she got home but also want to encourage her to remember she is living alone again (which is her preference) so has to take a little bit of responsibility for herself.
Unless she wants to sit in her nightgown til the carers come to help her, which is fine if she’s happy to do that but she has been complaining that no one has helped her to dress which was something she did comfortably herself pre hospital stay.
So, say your grandmother can manage to wash and dress her top half but struggles with getting socks on or her trousers over her feet - it's *fine* for her to get halfway and then just keep her dressing gown or pj bottoms on until they arrive. The workers should also be looking for and recommending tips or adjustments or gadgets that will help her manage more easily, too.
We have started the ball rolling with the reablement, the manager of the care company we use is coming to assess her so we’ll see.
Thank you so much for your help and advice!
Absolutely...with each hospitalization it's almost a setback for the elderly. For every day they are admitted it takes them so much longer to get back on their feet. Oftentimes you have to find out what their "baseline" is after a safe discharge.
Be patient, loving and kind as it is an ordeal for the elderly to be out of their environment, mostly with everyone wearing facemasks, they can't shower and there is constant noise and interruptions with blood draws. The Pandemic did a number on the elderly.
The fact that you are writing in you love your Grandmother. Hold their hand, tell them you love them and that they have a family who cares for them and there is nothing to worry about.
Amen...
I am envious of some of the "fully funded" services and re-enablement provisions described. Those would be very helpful.
I can only add my "vote" for giving Gran a little more time while tapering off some of the assistance she may need. If she cannot regain safe independence after a few weeks, it would be time to re-assess her living situation or amount of care needed.
You say she is a very lazy person for the last 20 years and your grandfather enabled her laziness until he became ill himself.
She is very likely looking to you to become her next enabler. Don't do it. Remind her that she is not an infant and you will not treat her as one.
I was an in-home caregiver mostly to elderly clients for almost 25 years. I will tell you that sometimes with the elderly they need a bit of tough love from their families and caregivers. You love and care about your grandmother. Do not enable her to become a useless invalid that has to have her pants pulled down to go to the bathroom and has to be put to bed and tucked in at night like a baby. You must refuse to do these things if she can still do them for herself. If she can no longer do for herself, she will need a higher level of care.
Elderly people have to hold on tight to whatever level of independence they still possess. Doing for themselves whenever possible must be strongly encouraged by family and caregivers and even demanded.
I've worked for too many families at the end of their ropes who just did everything for their elders because it was faster and easier than the elder doing for themselves when possible. These people turned their elderly loved ones into invalids then were upset because they were invalids. Your grandmother must be forced to do for herself where she is able to. It's the best thing for her and for her own good. Any level of independence is positive. Good luck.
It will get better!
Have her drink cranberry juice daily if she likes it. It is a natural UTI preventive. There should perhaps be a follow-up urinalysis to make sure the UTI has been eradicated. Getting an oximeter (cheap on Amazon) to check her oxygen blood levels as her lungs heal would be good.
Pneumonia is VERY depleting. I have had it 4 times so know what I am talking about! Encourage movement around the home. The fatigue can last weeks to months.
The next time she has bloodwork ask them to check her B12 levels as low B12 is common in elderly people.
You are correct that if she wants to continue living in her current level of care, she will need to resume certain tasks for herself. That may help to motivate her. But she may not be ABLE to do so. Give 4-6 weeks to see if things improve. Then have an impartial carer assess. Together you may have to make a decision to move her to a higher level of care.
Good luck
I would say monitor your gran and see if she really can't do things- which would prompt more care- or if she just won't. It may take a bit of encouragement on your end to see what she can still do.