My mum has dementia. She’s 90. She’s had it for a few years now, but the past year has seen marked deterioration. She no longer walks but can manage some fairly unsafe shuffling on a frame, just a few steps. She only eats if food is put in front of her, and wouldn’t drink at all if she could get away with it.  She veers between the present day and anytime between about 1950 and 1990. She thinks her parents are still alive or have recently died and no-one has told her. She wonders who is ‘that old man who’s always in the house?’ – it’s her husband of 65 years. She is argumentative and objectionable with every member of the immediate family. Verbally aggressive and cruel.

My dad is 92. He is my mum’s carer. He has a leaking (repaired) aortic aneurysm, hypertension and suffers from chronic anxiety and depression. He can no longer deal with my mum. She shouts at him, she gets very agitated and he can’t manage her. He says he is going to kill her.

My sister has been doing as much as she can – more and more – over the past year. She spends most the day there and my dad now calls her at night too when mum goes awry – almost every night. She is constantly verbally abused by my mum. They are both exhausted.

My mum has been assessed a few times. She knows the date when asked. She can answer questions very reasonably. She is polite and accommodating. When asked – yes she can walk. No, she doesn’t need help, she has everything she needs from my dad.Yes, she can get around the house. No, there is nothing wrong with her. Yes, she looks after her 92 year old husband. On the strength of this she is deemed to be fine to be at home. She refuses to have a care package – she doesn’t need one. Last time one was arranged she contacted the GP and cancelled it.  My dad’s views, my sister’s descriptions of her behaviour seem to count for nothing. I live 100 miles away, work full-time and offer moral support as much as I can. I have the easy part.

My mum’s in hospital today. For twenty four hours previously she was agitated, confused and abusive. Constantly arguing and questioning. She couldn’t walk at all this morning, had slurred speech and increased confusion. My sister, at the end of her tether and sleepless for 24 hours called an ambulance and mum was taken to hospital. This evening mum was improved. My dad refused to go to hospital with her. He’s at home, watching tv and relaxing for the first time in two years. He say’s he won’t have her home, he can’t cope. He’s right. My sister is guilt-laden and exhausted. She cannot manage them both anymore. The fragile care from the family has broken down irretrievably. We know my mum will play holy hell if anyone so much as mentions ‘care’. I suspect that tomorrow someone will decide that she doesn’t need to be in hospital. What happens next?