95 year old carer needing respite - please help

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ciano6

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I live in Cork City Centre in a former corporation housing estate of 6 houses. My next door neighbour Mary is 95 and is the most gentle and kind person. Her sister died in childbirth and she raised her son as if he was her own. He is now in his late 70s and has serious dementia at this stage.
She is the only person who looks after him and spends all day looking after him, but is now finding it very difficult to help him up the stairs, wash etc. He is also incontinent and she has to get up in the middle of the night to change the beds etc.
She has to pay a nurse to call every Saturday morning for half an hour and that is the extent of help from an health services, except for respite which had been more frequent but is now not due until the end of June again. My heart is broken after being in there again tonight as she has pleaded with me to find help for her. I cannot empasise how terrible the situtation is. For example, three weeks ago, two people called to her and pretended they were from the Health Board. She gave them somewhere between €1600 and €4000 cash to get help for her. She has not seen them since. For another example, On Saturday afternoon, she had to call me because he was stuck in the couch and neither she nor he could lift himself out of the seat and he needed to go to the bathroom.
She only has a non-contributory pension and he is the same I imagine. But surely the state has some obligation. She is a 95 year old woman pleading for help in looking after her nephew who has dementia. Where do I start? They have no real family, as all of her siblings are long dead (she was the youngest) and the same for him. And neither of them married. They do have a cousin's daughter who calls every so often.
I know that community nurse is based in Ballyphehane and that maybe I could call her? But does anyone know what the hell I can do? It is terribly sad.
 
I'm stunned.
For starters, can you contact the local Gardai and tell them about the fraudsters. That's outrageous.

Here is a link to the Carers Association. If you look up the care centre or give them a call they maybe able to guide you in the right direction.
Also contact Age Action Ireland, they can help with [broken link removed].

If anyone else on the board has any practical advice or experience, please share.

Lets know how you get on.
 
Thanks so far.
I did go to the guards about the fraudsters. In fairness to them, they were very concerned, but there was little that they could do due to the lack of details eg. no car reg number, vague description etc. They did tell me that it was far from an isolated incident!
I'll definitely get on to the carers today.
 
I would contact her GP, he would know roughly about her circumstances - she needs better services. Failing this I would go to the local press as this is where the HSE are abandonong care.

A bit severe I know but I am currently reeling from a friend whose mum is terminal becuase last november her consultant didn't pass on the results of a test test indicating cancer to my friends mum's GP...
 
Her GP should be able to put her in contact with the District Nurse, who is the key person who can arrange carer assistance (in our experience). The problem will be budgets, but she should be able to get some extra help. For example, our situation involves a younger carer (64) but she gets someone in once a day to help with showers/washing and also gets an extra 2 hours a week respite at home. The district nurse can also advise on respite hospitals nearby - there's usually a waiting list but perhaps she can get priority so that her son can go in e.g. for a week a month and give her a bit of a break. It's really an appalling story.

Another option is that there are voluntary groups around the country that either will take someone out for the day, or transport them to respite care, or will just come in to mind someone. Again, the GP or district nurse can direct your neighbour.
 
Unfortunately in these situations the health service won't react until its a crisis.

It appears to me that the 70 yo is in need of permanent long term care.
The only way to access this is through the hospital.

So, its drastic but probably effective.
I would call an ambulance and bring him to the local emergency room.
I would tell her to tell them she cannot cope and he needs medical care and walk out.

They will take care of him and will look after him.
But if she stays they will try and convince her to take him home.

Once he is in hospital they will check out his dementia etc and general state of health and as long as she refuses to take him home, they will organise long term care for him too.

She can visit him but just don't be swayed about taking him home.

Regarding the money...I would see if she can claim it on her house insurance. Its very very dangerous that people realise that she might have that amount of cash in the house.
 
How come the local priest/vicar/gardai didn't step in to help. They are in a position to know the relevent organisations. Do this family live in a village, town or the country?
 
It would make sense to get the local GP and the District Nurse involved.

The GP could refer the son to a Care of the Elderly Specialist for assessment with a view to long term care. The social worker on the medical team would then be involved, and could help organise help in the house/subvension for a long term nursing home.
There is often a waiting list of many months to get seen however.
It doesn't sound like this situation is sustainable for many months.

The District nurse would also be able to help out getting assistance into the house, and needs to be aware of the situation anyway. The district nurses are an excellent resource (or at least have been, recent cuts may affect this)

I think Momah's advise is excellent however, and would force a solution.
It's a dreadful situation,

Nicola
 
Hi Cian,
I know of a Woman in Dublin in a similar situation but not as serious as your Neighbour, she requested an appointment with a Geriatric Consultant in St. James Hospital after her Sister being on a waiting list for a placement in Cherry Orchard for over 10 years initially for her disability as she had been disbled as a Child and then as a Geriatric Patient, the Consultant was very concerned about their predicament and somehow the wheels were greased after that appointment and her Sister received the bed within about 6 months. I think the Health Service find it easy to turn a blind eye to situations such as these where the Carer copes regardless of the toll it may take on them personally and doesn't complain or have a lot of demands but the State and our Health Service have a legal obligation to care for him at this stage, I'd recommend you advise her to speak to her GP if this hasn't already happened and get a referral to see a Geriatric Consultant for her Nephew.
Best of luck
 
update from OP

Thanks all,
Just to answer a few things and update you.
His GP is not Mary's GP or my GP and 6 months ago, he would not talk to either myself or Mary about "his patient".
On the idea of bringing him to A and E and leaving him there, I know that I couldn't do it Mary. She would be too sad. He really is like a son to him. Even when he was in respite in March for the week, she visited him everyday.
Anyway, today there has been some development in that I rang St. Patricks hospital where he went for respite the last time. The girl there was very helpful and refered me to the correct Public Health Nurse in Ballyphehane. She is not working today but will get back to me tomorrow.
We will need to make an application for more respite, she said.
Then she also said that we need to have him referred to a Geriatrician who will try to make him "banded for continuing care" which would make him entitled to a public bed. Mary did pay €200 for a geriatrician appointment before Christmas, but we are still waiting to hear back on it. At least there has been some progress today, and we have been pointed in the right direction.
I will try the Alzheimers Society later.
 
Write a letter detailing this situation to the local Director of Community Care and copy it to all the local TDs. Mark it URGENT. If there is no response, contact the media. Action needs to be taken immediately here.
 
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WHat a terrible situation, am not remotely surprised at the lack of help, have experienced similar in my time.

Mommah has the right idea and it is something that my own family had to resort to in the past, except instead of calling an ambulance we brought relevant family member to A&E and left her there, explained her carer had been admitted to hospital and someone needed to care for her. She was admitted that night as a 'social' case. They then started proceedings to get her into long term care as her carer was not capable.

However, if the 95 year old lady in this case will not go ahead with that action then you need to look at getting more services into the home.

The Public Health Nurse is the best place to start, I would also advise getting onto a local politician and as other posters have said, give the local parish priest a shout. Tell Vincent de Paul the situation also, they used to send someone to my family member now and again allowing the carer an hours time to themselves.

Considering the age of both parties, is there no way they can both go into residential care - together (would Mary consider that?)? At least that way theyd be looked after together and not parted - thats something to ask the Public Health Nurse about also if Mary is on for it.

WHat is Marys ideal to come out of this situation? In the case of my family member the carer was not capable but the HSE kept returning the person to their care - because the person being cared for kept insisting on it. So we had crisis after crisis because the person being cared for was not making decisions in her own best interests. Be aware that that may be an issue for this situation also.

Oh another person to put a call into is a social worker in the local public hospital (the Public Health Nurse may be able to arrange this also), a social worker can help assess the situation and talk to those involved (Mary) and try to figure out the best way forward that will not be distressing for those involved.
 
I really think you need to bypass the public health nurse in this case and go straight to her boss. The public service recruitment embargo will mean that the public health nurse won't be able to apply for more home care hours although these are badly needed. My mother has dementia and I have very recent experience of caring for her and dealing with the system. Go straight to the top. Ring your HSE office and get the name of the Director of Public Health Nursing. Deal directly with them. It's the only way this case will get the attention it deserves and this elderly lady and her nephew will get appropriate care. Best of luck.
 
Threadser said:
I really think you need to bypass the public health nurse in this case and go straight to her boss. The public service recruitment embargo will mean that the public health nurse won't be able to apply for more home care hours although these are badly needed. My mother has dementia and I have very recent experience of caring for her and dealing with the system. Go straight to the top. Ring your HSE office and get the name of the Director of Public Health Nursing. Deal directly with them. It's the only way this case will get the attention it deserves and this elderly lady and her nephew will get appropriate care. Best of luck.
Click to expand...

And get a politician to lean on them to make sure they listen to you.
 
Hello -
I'm a medical social worker and registered to reply to this to see if I could help. However, new to it and managed to lose what I was posting! Here goes again!

In summary,
Talk to Medical Social Worker (local big hospital) and Public Health Nurse (Maybe you've done this by now). The nephew can be listed for long term care while still at home, but takes longer to get a bed. Regular respite is best option in meantime (short of bringing him to hospital and leaving him, as someone else suggested, which in awful reality is the quickest way).
HSE Home Care Grants exist to help pay for care at home, but funding has more or less dried up - Social Worker and Public Health Nurse will know if any available.

ALSO - NB - this lady should apply for Carer's Allowance. It's payable at half rate (120 euro p.w.) in addition to her pension, and there's an annual payment of 1,700 euro as well, PAYABLE ONLY ON 1 JUNE, so she should apply now. Could help to pay for some care at home. Not enough, but something. Social Worker or Social Welfare have details.

Some indictment of our society that we're not beating down the door to help this lady. Well done, Ciano6, and good luck.

Best wishes,
Kate'o
 
Cian,
Not sure if you've seen my message yet but one final point - every HSE area has/should have Manager and Director of Services for the Elderly. Can be contacted through your local HSE HQ. If Social Worker/PHN can't sort it for you, try them.

Best wishes,
Kate'o
 
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