Posted by: Worried daughter | 2012-12-03

Aging parent management

My mom, 82 and currently still driving and living alone. To summarize a long complex story, 4 of her 5 children now live in Cape Town and 1 in Greece. She lives alone in Pretoria, drives and has a duet apartment with stairs. I have been the care giver over the past 30 years as the only child living near her, but through own personal trauma and loss (spouse to cancer) have relocated to be near my own children and gave a 10 months notice that I was going to do this to start a new life. We are now at the point that everybody knows, and can see, that mom has an increasing dementia problems (gets lost while out driving - just one example) and remembering to eat. Her 1 glass of wine a day is becoming 1 bottle of wine a day and she insists she only had her usual 1 glass. This leads to serious confrontations, in spite of trying to downplay. That aside - my question and serious concern is how do we take it to the next level of relocating her to the obvious of care 1km from a very involved child and 3 others not far away without destroying the relationship in total? What legal recourse or social system is available to assist us in handling this with the sensitivity it needs to retain her trust? Every phone call is perceived as being "  another attack"  in spite of using the utmost care in communicating without accusing and using the "  I care"  message. Nobody wants to control (benefit by) her finances (thus not our motivation) nor take away her dignity but responsibility should now prevail and I don''''t know where to start - she drives (licence expired), draws money at a bank in a high risk environment (forgets her pin often), doubt if she take medication as she should, etc. etc. etc. and attempts to get her to see a medical specialist for an independent evaluation provokes the biggest of anger attacks. Look forward to your reply. She has access to her medication, and threats of suicide have been mentioned.

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Our expert says:
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There are no easy answers here, as you know. One major issue has to be the realistic risks to herself and others - if she gets lost, she may not be safe ( for herself or other people ) to drive. Similarly the increasing alcohol intake, which will impair her health, physically and mentally, and her ability to care for herself - and to drive safely. Partly she may be becoming alcoholic, and partyl she may genuinely forget how much she has been drinking.
I suspect there can be a really tragic phase with dementia when the person's intellect and abilities are declinign and for a period, they can recognize that, and it must be terrifying. Drinking, so as to forget that, may be a choice, even if not a safe one.
The alcohol intake and the poor diet will add to the dementia and perhaps hasten the process and its impact.
Official systems are rarely responsive, efficient or sensitive, but there are mechanisms through the Mental Health Act, which a local psychiatrist could advise you about ( and maybe a good GO, especially if she has been seeing the GP ) for someone to be assessed for compulsory admission to a psychiatric facility for assessment and treatment. Once that is under way there are legal procedures, with the resultant psychiatric expert reports, by which someone may be declared legally unfit to manage their own affairs, and someone else can be appointed a legal guardian to do this for them.
Presumably steps could be taken legally, especially if her license has expired, to stop her driving, and that may be good for everyone's safety - but will trouble har as removing a source of her sense of independence.
A Guardian can enable her to spend her money any sensible way she wishes, but could do the actual money handling for her.
How does she have medication without medical access and without regular assessments in person, by a doctor, at least a GP ? Discuss this with the GP, who should stop all medication ( and existing supplies could potentially be removed ) pending a full new assessment which could be arranged in a non-threatening way but as a routine necessity for renewing her prescriptions. And if the meds are for physical reasons, the potential contribution of effects of the meds and side-effects, and of underlying other medical conditions, on her state of mind, need all to be assessed.

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Our users say:
Posted by: gd | 2012-12-04

thank you for the advice - will see how far we get!

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Posted by: Purple | 2012-12-04

AS I''m sure you''ve seen, there are days when she is more lucid than others. Try and catch her on these days to discuss matters with her.

We''ve recently been through this with my mom in law. Try to get her into good 24 hour care while she is still mostly lucid so its less frightening for her. Also, discuss her bank accounts with her - if you wait until she is no longer mentally able to handle her affairs, it is also too late for her to give power of attorney. It is a very costly process to go through the high court to gain power of her accounts to pay for her care. She may also fall prey to conmen and women during this time. We had our mother in law donating sums to some cult church, dishing out cash to two teenagers who followed her around the shops every day, her brother raided her account.

We did as CS describes - spoke to GP, saw a psychiatrist and at some point a nuerologist as well and with their help managed to get her into care and through the master of the high court were able to resolve some of her financial issues via an administration order. She has since passed away. We only wish we could have resolved these issues before her mind was completely lost. She suffered terribly under the care of her sister and brother and only when she was in failing physical care from their neglect could we get doctors and the hospital where they dumped her to help us to legally wrest care away from them. Its hard, but stand firm and do these things while she is still lucid on some days.

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