General Medical issues thread

[Seat0B]

Stuff always happens when it is least expected

Which is exactly why I am suggesting that we all accept that at a certain point (aged related, or capabilities declining or whatever) it is not actually unexpected that one is only one fall, one stroke, one flirtation with pneumonia, one medical issue away from needing much more care than can be provided in the home.

it is unreasonable to expect healthy supplicants to be spending some time in a box, just to be ready.

And why I am not suggesting pre-emptive moving to residential care long before it is needed. That's not good for anyone. But sticking your head in the sand and pretending that things are fine when they are not is also not good for anyone. That's why I now feel that it is a good idea to get an ACAT assessment (or whatever they are called now) that covers both care in the home and residential care (factoring in the 12 week wait for the assessment and the 9 month wait for the package to be activated) before it becomes an emergency.

And having done that, to visit a few residential facilities and make your own choices of places you would find acceptable if it were needed and put your name on their waiting list(s). If a place comes up and you don't want it , no problem, just decline. Trust me, there are enough desperate families like we were that will snap it up in a heartbeat. You will remain at the top of the list for the next place until you finally need to accept one. This is confirmed by the placement coordinators, so not just made up - there are many people wanting each vacancy, and you do not go to the bottom of the list if you decline a spot.

I will be following my own advice when the time comes, and I hope I do not waver in the moment. There are some very nice, modern facilities around as well as some of the older, more traditional ones most of us think about. My family's willingness to stick their collective heads in the sand almost had us at the seriously sub-optimal position of choosing between a dark, dingy shoebox 45 -60 minutes drive from home or abandoning mum at the emergency department, because they were the only choices we had. Those are the very real and very unpalatable alternatives we faced when the reality of her physical condition did not match her lifestyle wishes. It sucks, but then so many parts of life are not unalloyed joy, aren't they.

Also, I accept a bit of blame here for being too helpful when mum was still "managing" at home on her Support at home Package. She was not in fact coping and was only "managing" because my sister and I perpetuated that illusion by visiting her every day, cooking and cleaning up after almost all her meals, doing her shopping, her washing, taking her to her medical appointments, cleaning up after quite a few "accidents", going round at all hours of the day and night to pick her up after falls, and many other tasks too numerous to mention. With the best will in the world, we all facilitated her thinking she was coping for far too long and that only made it harder for her in the end. Although I was the first to call it - after an absence of 4 weeks at Seat Son's wedding, her decline was very obvious on my return - the rest of the family would just not countenance any action or discussion, not even the bland one of putting her name down. Had that been done in April, August wold have been much less stressful for us all, including mum.

And now there is my 95 year old father in law, who lives alone on the Gold Coast in an area poorly serviced by public transport and 30 mins drive from his family. He told an ACAT assessor about 12 months ago that he did not want any help, so he is not on any package at all . Except that his two daughters are doing his shopping, washing his sheets and towels, doing his gardening, mowing his lawn, doing his cleaning and cooking for him a few times a week.....After my mum's tale of woe, they had put him down for a new assessment a couple of weeks ago and the wait there is "at least 13 weeks" and then the usual 9-12 month wait for activation.

Today, after months of treatment for macular degeneration, the opthalmologist has bitten the bullet and said that FIL's best corrected vision is now only 6/36 and will not improve. This means he does not meet the vision requirements for holding a driving licence - he is currently refusing to accept this and is planning to keep driving until next renewal in March 2027 which requires an eye test. He got through the last one by doctor shopping until someone signed the form. Yes we know this is illegal and dangerous and irresponsible, and invalidates his insurance, but hey he's an adult and he wants to drive, so we must all accept it, right?

This level of vision impairment also significantly increases his risk of falls and impacts his ability to see well enough to do most daily tasks like cooking, cleaning (oh wait, he isn't really doing these things) and reading, using a phone or TV remote etc etc etc. He suddenly needs more support at a time when both his daughters have less time to give due to health issues with their husbands (one has had a stroke, the other just got an alzheimer's diagnosis at age 72). And because of his earlier intransigence, he won't get it for 12 months or more from now. When he will be 96 years old. Arghhhhhhhhh. My year of discombobulation continues.

And finally, as a general comment by me and not directed specifically to you @tgh, it's all very well to say let older people make their own decisions, even when they are bad decisions. Sure, they are an adult, I get it.

But sometimes those decisions impact others and are dangerous or irresponsible like driving when you can't see, FIL. I use the roads too, so do you, and our children and grandchildren. Or they have tough consequences or choices for the people who have to support the older person - it's my sleep that is disturbed, and my risk of injury when I have to come and pick you up Mum when you call me after you fall over going to the loo at 3 am because you want to live at home, when you are not actually capable of that any more. Or when I have to come the next morning and clean up the mess because you decided not to risk a fall at 3 am when you needed the loo.

I understand that this is a sensitive and diffcult topic for us all, and I recognise that most older people seem to think they are more capable than they actually are, probably enabled by well-meaning family. And no one wants to be trucked off against their will, and I certainly didn't want to push mum off against her will, so luckily she accepted it in the final hour before it came to that. I definitely don't have all the answers, not even some of them, and everyone's situation is different, but I think it is rather selfish to foist all this onto adult children because of an inability to face or accept reality. YMMV.

 

[Quickstatus]

get an ACAT assessment (or whatever they are called now)

SAS = Single Assessment System

hey he's an adult and he wants to drive, so we must all accept it, right?

You got it right.
My dad who is 89 soon and whom after a minor fall with no injury and after mum was admitted to NH, got himself into the same NH - that is a miracle for us. I told him he did not need to but he was adamant.
However, he is still driving (even while in residential aged care) and recently had a accident running up the back of a bus with his car in good weather and middle of day.
Airbags+++
No injury
The problem is he thinks he can still drive
I went as far as reporting it using an Unfit for Driving report (NSW)
I took it to Service NSW and lodged it. Someone then called me back and discussed the issue. They did not seem too concerned and I should get dad to see his GP even though I said it is not a medical issue but a cognitive one.
when i went to retrieve his personal belongings from the car, I found 11 pairs of shoes - yes it is a cognitive issue.
His recurrent test is next year.
In any case, if anything catastrophic happens like a third party gets killed, legal discovery will show that I did notify the authorities.

I even showed his the Uber app. But he thinks it is too expensive...........

let older people make their own decisions

That often ends in tears and significant cost for everyone and society in the long run.
There is no easy way unfortunately but to sensitively and empathetically bring up the issue from time to time.

Living alone just to avoid a residential Aged care is extremely sad. People think it is the end of the road, but in many cases like @Seat0B's mother,, it can be a new chapter in one's journey through life.

 

[drron]

Well I know my time is getting closer as my neuropathy is progressing. I am registered with my aged care and have had an ACAT assessment.
Family is the problem is with our son wanting placement in Sydney and Mrsdrron’ totally opposed to that idea.
Hopefully at least a. Couple of years away yet.

 

[tgh]

A long time ago , I came across my father driving along in pouring rain.
I followed him, he was just crawling along up and down some back streets through at least one red light and I decided he was lost.
I rounded him up, invited him to follow me to his home where I summarily removed his keys and grounded him.
I went back next day , took the car and sold it .. tough love but necessary.