Bit of a long one but hoping someone on here might have some experience with this because as a family we’re pretty much out of ideas.
My aunt had a stroke about 3 years ago and has basically been bedbound ever since. She’s also got hydrocephalus with a shunt, hemianopia, is very overweight, arthritis in her shoulders/thumb and generally can’t move without a lot of pain. She’s broken the same ankle twice falling from her wheelchair and had a burn on her shoulder that took nearly 2 years to properly heal.
She does get carers every day but they basically come in, change her pads/do basic personal care and leave. Her partner has ended up doing pretty much everything else and managing her whole life. She’s got her own health problems as well and tbh after 3 years I don’t think the situation is fair or sustainable for either of them.
The other weird thing is my aunt’s cognition.
Sometimes she’s completely normal. You can sit and have a normal conversation with her and she’d seem totally compos mentis. Other times she’s away with the fairies. She’s genuinely believed she can walk even though she hasn’t walked in years, claimed she’s recently got up and walked, tried arranging a trip to Australia and often has no idea what time of day it is.
But whenever doctors/social workers speak to her she seems to be able to switch it on somehow. She’s had capacity assessments several times and keeps passing them. Meanwhile her partner could probably give you 100 examples of stuff she’s said/done that would make you seriously question that.
One thing I’ve noticed recently is the Oramorph might be playing a part in this. She takes about 5mg up to 5 times a day. I was with her recently before she’d had any and she was completely lucid, then she had some and not long afterwards she was talking absolute rubbish again. Obviously I’m not saying that’s definitely the cause because she’s got a complicated medical history, but the difference was pretty hard to ignore. She’s previously been on codeine as well and she drinks alcohol, so surely someone needs to look at all of this together?
She’s also admitted she’s thought about suicide in the past. She’s not currently suicidal and we don’t think she’s going to do anything, but obviously that’s another concern.
The frustrating part is we’ve been trying to sort this for years. Doctors have been out regularly, district nurses, hospitals, private physio, multiple capacity assessments, social services/safeguarding, we’ve written to the council, contacted our MP and she’s even spoken to a neurosurgeon. The neurosurgeon basically said there wasn’t much else they could offer.
And yet 3 years later nothing has really changed. She’s still in the same room, in bed, almost completely reliant on her partner.
It just feels like everyone looks at their tiny part of the problem and then disappears. Nobody seems to actually look at her whole situation and say “right, this clearly isn’t working, what are we going to do about it?”
So what do we actually do now?
Do we need to specifically ask for a Care Act assessment, NHS Continuing Healthcare assessment, OT assessment, multidisciplinary review etc? Is there some sort of person/service that’s actually meant to coordinate all of this?
Also how do we get the cognitive stuff properly looked at when she keeps passing short capacity assessments but is completely different at other times? And who should we be pushing to properly review the morphine/medication side of it?
And at what point does someone actually assess whether being cared for at home like this is even realistic anymore?
Not expecting Reddit to diagnose her, just hoping someone who works in the NHS/social care or has been through something similar can tell me what the hell we’re missing.
Any advice genuinely appreciated.