My grandma is 88 and shows a lot of signs of possible dementia. She lives alone (my grandpa died 5 years ago). Her house is packed full of piles of things-- you can hardly get around. That is, if you can get in her house at all. She rarely answers the phone or doorbell. My dad and uncle have noticed that she smells like urine or isn't wearing clean clothes often. My aunt says she isn't eating well. To make a long story short, there are a lot of concerns we have for her.

The way I see it, we need to have a doctor evaluate her. Problem is, she refuses to see a doctor and no one even knows when the last time was that she ever went to the doctor.

Any ideas on getting a medical opinion of whether she has depression, dementia, Alzheimer's, etc?

Do doctors ever make house calls these days? Ugh. Where to start........ Please help!

Been a little preoccupied lately here in Israel so I've missed recent postings. I agree that this may be a blessing in disguise to have her hospitalized. Try to get as much evaluation done as possible. This isn't going to be easy, because doctors don't like you to tell them what to do. But stand up for your rights. This is also an ideal time to get a social worker involved in addressing all the household problems. Regarding trying to convince your grandmother to see a doctor: when I was faced with a similar problem with my mother I used a bit of a "guilt trip" on her and asked her how she would feel if I didn't take care of my health and refused to see a doctor (in our case it was actually a test that my mother needed to diagnose her condition). This did the trick! I hope you get to the bottom of the problem and find some satisfactory solutions.

quote:

Originally posted by granddaughter Mary:
Update:

Today when my dad stopped by on his weekly visit to take Grandma shopping she didn't answer the door and he went inside to find her lying on the kitchen floor. She didn't remember how long she'd been there but she was hungry and thirsty and needed to go to the bathroom. He and his brother (who he called to come help) got her immediate needs taken care of and then called an ambulence. The EMTs checked her heart and it was irregular. They convinced her to go to the hospital (thank goodness!).

I just got back from a quick visit there. They are keeping her at least overnight, if not longer. They've done an EKG and CT scan so far because the top 2 portions of hear heart aren't beating right-- just quivering. They're checking for clots, etc, and she's on a blood thinner for now.

She kept forgetting that she was going to be staying at the hospital overnight and wasn't happy to hear it whenever it came up and she was reminded. My dad and uncle are going to be switching off staying with her for now, so that should help her.

At any rate, I reminded my dad, and he talked to the doctor, and they're going to evaluate her for Alzheimer's, make sure she won't fall and will remember to take her medication (as well as fully evaluate this heart problem) before she can go home by herself.

So, long story short, it did take something 'bad' to get her to see a doctor but at least she didn't break anything and wasn't laying there longer, etc. Now, hopefully, we'll be able to find out what all issues she's facing and can make sure she does as well as possible from here on out.

Thanks everyone for your input and advice! I thought a follow-up to let you know what's happened might be helpful for others in a similar situation...

granddaughter Mary - I hate to say this, but it's good news your grandmother made it to the hospital! Hopefully they will be able to help.

Bobcat, thanks for your response. You are correct, her kids are all several hundred miles away, which makes it even harder to tell what's really going on. Unfortunately, we've tried the meals on wheels and housekeeper route, and it wasn't successful. She "interviewed" three housekeepers we had come talk to her, and she didn't like any of them and refused to have any of them in her home. Then, she managed to fire meals on wheels! We were so frustrated about that. One of the volunteers has recommended a yard man to her because she wasn't taking care of her yard any more (she has a HUGE yard, over 1 acre, so most of us can't keep that going at 40 - nothing to be ashamed of!) and she got really offended about it. Anyway, the volunteer told the director about it when she got back to the office, so she called Mom, and that's when Mom told them not to come back anymore. We were so disappointed about that - I think that was really helping her some. Even thought they just dropped by to leave the meal for her, it was at least one activity a day at the same time that made her interact with others.

We finally found a yard man that she likes, so he's been with her for almost 2 years now. She is letting him do her grocery shopping, and in the 6 months since she agreed to let him do that and help with light housekeeping, she's let him vacuum once, so I am hoping that maybe in a year she'll let him at least run a load of laundry. Fortunately she has quit driving, so she lets him take her to the bank and go to the post office for her, so we aren't worried about that any longer. I've taken control of all of her bills and set up automatic pay for all of that. She hasn't even noticed they aren't coming to her and she's not writing checks for them any longer.

Sadly, she has started telling some really odd stories, claiming that some lawyers came to see her about some scam that supposedly went on in her town and she's worrying about having to testify. All of her details are sketchy at best. The one thing she clearly claimed was that she got a letter that said someone else had a claim on her property, but we called every property office in the county and triple checked; she owns her home and land outright, and no one else has anything to do with it. We've dug around about any trials going on where she lives, and there's nothing going on like she has described whatsoever, so we're really concerned about her mental state now. Unfortunately, I almost think that may be a good thing as we could get some intervention on our behalf if that does happen.

I am very frustrated with her at the moment. We found a lot of services in the community where she lives that she qualified for, but she refuses to have any of them. Three of us kids live in Florida (my sister and I who are dealing with her mostly now are both here), and my house has a complete apartment attached, which I thought was a huge plus when I bought the place so she would have the option of living with me in her own space and would have her privacy. She has refused to leave her home, and tells us she doesn't like Florida, so she won't come here. So unfortunately, at this point, we are hoping that we can get her to tell one of her "off" storied to a social worker so we can get guardianship and make her come live with us.

Thanks for listening to the long-winded rant! While I hate for any of us to be in this boat, it has been a relief to find this board.

If you can, make certain that they keep her there for three days minimum. Otherwise, no matter her condition, medicare won't pay for in-patient rehab at a skilled nursing facility.

That isn't to say that she'll necessarily need to go, but it's good to preserve your options, you know?

Update:

Today when my dad stopped by on his weekly visit to take Grandma shopping she didn't answer the door and he went inside to find her lying on the kitchen floor. She didn't remember how long she'd been there but she was hungry and thirsty and needed to go to the bathroom. He and his brother (who he called to come help) got her immediate needs taken care of and then called an ambulence. The EMTs checked her heart and it was irregular. They convinced her to go to the hospital (thank goodness!).

I just got back from a quick visit there. They are keeping her at least overnight, if not longer. They've done an EKG and CT scan so far because the top 2 portions of hear heart aren't beating right-- just quivering. They're checking for clots, etc, and she's on a blood thinner for now.

She kept forgetting that she was going to be staying at the hospital overnight and wasn't happy to hear it whenever it came up and she was reminded. My dad and uncle are going to be switching off staying with her for now, so that should help her.

At any rate, I reminded my dad, and he talked to the doctor, and they're going to evaluate her for Alzheimer's, make sure she won't fall and will remember to take her medication (as well as fully evaluate this heart problem) before she can go home by herself.

So, long story short, it did take something 'bad' to get her to see a doctor but at least she didn't break anything and wasn't laying there longer, etc. Now, hopefully, we'll be able to find out what all issues she's facing and can make sure she does as well as possible from here on out.

Thanks everyone for your input and advice! I thought a follow-up to let you know what's happened might be helpful for others in a similar situation...

TCH, welcome to ECO. What you are facing with your mother is very difficult. Modern standards of "clean and neat" are often not a true measure of health and hygiene. Many of them hate a doctor (for that matter, uh, well, ) anyway, unless they are judged to be a danger to themselves or others, they have rights to refuse assistence (or interference, as the case may be). Sometimes there is nothing that can be done until they get in trouble of some sort.

Frightening, yeah. Sometimes they don't want to bother anyone, sometimes they are depressed and no longer care, sometimes a type of dementia is beginning and they really can't see what is bothering you, sometimes we are jumping the gun a bit and imposing our standards.

To start with, you might look into meals on wheels in her town. (I take it you and your sister live long distance?) You can offer.

Does she drive? Will she allow you to hire her a house keeper to come in? Maybe make it a birthday present? What help do you think she needs? What do you envision as being a good outcome for her?

Re read Mae's post just below yours.

This message has been edited. Last edited by: Bobcat,

This sounds so much like my mother. She absolutely refuses to see a doctor ever again, and cannot keep her house or herself clean at all any longer. She was running out of food in the home, but finally begrudgingly agreed to let her yard man do grocery shopping for her.

My sister called the elder services department in the state she lives in to see what our options were for some sort of guardianship for her, where we were told unless she was shown to be mentally incompetent, there was nothing that we could legally do. She has started telling us stories now that seem to me that she's a little "off," so I am just hoping now that we can convince elder services to come evaluate her, and that she'll tell one of her wild stories that will show them she's not quite rational all the time.

wE HAVE TO STOP SEEING THINGS WE DO AS DECEPTIVE?When we make decisions for the welling being of someone, we see it as just that.
Many times we have to be honest and tell them the consequences of what can happening if they fail to find answers to their health problems.
I would have her bathed and cleaned up.I also would, little by little get the house clean and healthy for her to reside.When we see these conditions we see they are no longer abloe to decide right or wrong.Use homor to get her bathed.Get her some thing fresh and pretty to put on.The house could be a fire and health hazzard for all .Believe me, she will get past any feelings she has.Many times we have tobe assertive just as our parents were to us.The roles reveres .Take what she told you when growing up and introduce it to what you have to do for her/You cannot allow her to be intimidating.Do what is right and not worry about being popular

Sweetie it makes perfect sense
The suggestion Dochka gave yes its deceptive but its something we do all the time with this disease its called Therapeutic lying
Now heres an idea how about dad calling her PCP (primary care physician) tell him/her you are trying to get her in to be seen but make it look as if your dad has the appt and he would like her to accompany him to said appt.
Its either that or have dad call and ask if they could come out for a home visit they could send the office LVN in to check her out and assess her for the doc

(APS= Adult Protective Services.Usually a state agency that has social workers and resouces like meals on wheels, etc. to help the elderly)

I'm glad your dad and your aunt are trying to help her.

It's just one step at a time, I guess.

Otherwise it is very overwhelming!

Hi Bunnys_grl,

Yes, this is my dad's mom. The problem is that my grandma's always been a bit more anti-social, esp. compared to my grandpa. Its def. been lots worse since he died (5 1/2 years ago). Her memory has gotten lots worse, she's become even more reclusive, the house is virtually impassable.

She let my dad start cleaning up the kitchen but it became totally overwhelming for him, it was so bad. She also let him sort through paper piles in the living room once but I think the same thing happened. Its really bad... She does seem to trust my dad quite a lot but its really more than my dad can handle by himself.

They've (he and his sibs) have come up with a plan to have dad and aunt approach grdma this weekend and suggest a clean up plan to her. We'll see how that works out. It would be a step but I'm even more concerned with getting a diagnosis and finding out what the actual problem(s) is, you know?

I liked your thoughts on how to treat her as an adult still, etc. My dad is super sensitive about respecting her and not forcing her into anything if at all possible for as long as possible. He has PoA for her... The problem is not only that she's stubborn (about the doctor, etc) but also that she'd def. forget that she ever agreed to going to the dr., even if he can get her to agree to it. Does that make sense?

What is APS? Any other ideas would be appreciated....

Thanks, Mary

DOCHKA,

Thanks for your reply! I'm actually not in any kind of a panic, so that's good. My grandma's issues have been around for over 4 years now and are just getting worse. She displays many symptoms of some kind of dementia (from what I've read on WebMD, etc) and besides that, has had quite a few falls, has bad circulation, and seems to have an incontinance (sp?) problem. These are all besides the fact that her short term memory seems to be very shot. She asks you the same thing over and over again. Its very difficult to find a pathway through all the clutter in her house. She has zero contact with people except my dad and my uncle both go over to see her one day a week (one Friday and one Saturday). Sometimes they can get her to come to the door, other times they can't. We can't get her to answer the phone. She doesn't go to church anymore, ever, and she used to go ALL the time. She won't come to any family functions and hasn't for years. I could go on and on......

My dad has mentioned that it may well take a serious medical emergency to get her to the doctor... If someone made an appointment for her with a doctor and then just took her-- are you suggesting not telling her where they are taking her? That seems deceptive-- I think we'd rather be more above board than that. If we made the appointment and told her that is where we were going, no, she absolutely wouldn't go. She refused to go to the doctor even when my grandpa was alive and he thought she should go. (Even though he wouldn't go either and she sometimes thought he should-- go figure.)

I think I'll make some calls to a few local doctors and ask about a home visit possibility. Has anyone ever heard of that these days?

--Mary

Welcome in Mary
Im guessing this is your Dads mom?
By the way it sounds AD is my first guess depression definitely how long has this been going on?
Has anyone tried to take her to a doctor? Clean her up? Assist in cleaning the home up?
What was her response to it?
Is there anyone she trusts?
Friend relative clergy?
Maybe they can intervene.
Whether or not she wants to do something I would first start by visiting her regularly many folks we take care of dont like outside help at first but they start to let their guard down eventually, they usually adjust fairly well to care given.
One thing you must always be cognizant of is that as we age we lose more and more LO's in our life till a time when you can only count a few...depression sets in quick, my mom before she died went through something very similar after losing a few friends within months of each other, then a neighbor got sick and put into a NH. My mom lost what little she had when that happened, she cried like a baby at this loss, I was never more heartsick at seeing this from her, it was frightening to watch but it made me realize how devastated our precious elders can become with all that loss.
They need to feel loved and important in our lives, not an afterthought and unfortunately thats how they end up feeling when loss comes around.
Try to approach her with the same demeanor as when she was younger and healthy. Do not say things like mom you need to take a shower or this house is a mess treat her as you would want to be treated in this situation.
Always remember she is an adult even if she doesnt always act like it.
She is afraid and needs to know there are still people out there that love and cherish her
If this doesnt work a last resort would be to call APS to do a welfare check on her and they can decide how best to approach this situation.
Hope this helps

quote:

Where to start........ Please help!

First, take a deep breath and try to stay calm.

Next, realize that people don't die from being unclean.

Okay, now that you are not in a panic, let me tell you how great it is that you want to help.
I am also glad you reached out to us to talk about your problem.

It is difficult to get older people to see a doctor because, just like my parents, they never went unless they felt "deathly ill".

When someone loses a spouse it is likely depression can bring on these symptoms: lack of self care, seclusion, etc. My dad died 5 years ago and I still feel the pain deeply, imagine a spouse.

Does she show any other medical problems?

I had to just make an appointment and not tell my parents until the day it came and just took them to the doctors.
Do you think this might work?