"How does one get help or support?"

About: Hertfordshire and the South Midlands Northamptonshire Healthcare NHS Foundation Trust

(as a relative),

My mother-in-law is 92. Mentally, she is very alert, her memory is good. Considering her age, her health is good although she is getting rather frail. She can still walk and warm up her own food and make a cuppa. She's on some blood pressure meds but that's it. Pretty remarkable, I'd say.

At the beginning of 2014 she developed a tiny ulceration on her heel. This took 4 months to heal (District Nurses visiting twice and then once a week - who are marvellous by the way). No sooner had the heel healed (! ) than two of her toes became ulcerated. The District Nurses suggested more frequent podiatry appointments and the private podiatrist recommended NHS podiatry. I wrote to the GP. He refused saying it was available in exceptional circumstances only and my m-in-l's circumstances were not exceptional.

I insisted. She was assessed. She has very poor pulses in her left foot (the one that causes the problems) and very little sensation in the soles of her feet. The NHS podiatry department assessed her as qualifying for NHS podiatry. Her ulcers on her feet come and go and she also has one or two small ulcerations on her legs and the District Nurses (bless them all! ) are calling once a week again.

Nearly a month ago she began to have some bowel problems. We thought it might be one of the many viruses going around. It didn't clear after 3-5 days and she was distressed. I contacted the GP who advised there was nothing that could be done for another week or so when I should drop in a sample of her stools for testing. I did this and a week later the results were negative. My m-in-l, continued to be distressed as she was soiling herself. I telephoned the GP who again said there was nothing he could do. I have a friend who's a retired GP and a conversation with her helped a great deal.

The District Nurse called and did a 6 month health check. She was concerned by my m-in-l's weight loss. I'd say she's gone from a size 16 to a scant 12 during the course of this year. The DN said she would recommend and ask for a prescription for a food supplement (a Complan type product). I had already decided my m-in-l should have some multi-vitamins as she no longer wants to eat "proper" food. She eats a good breakfast (eggs or porridge with yoghurt) but only soup at lunchtime and a biscuit / cake mid-afternoon. No meat. She's perked up quite a bit in the last 10 days since she's had vitamins.

Just hear via the Chemist that Dr refused to prescribe food supplement saying that we can buy something like Complan if we like.

I have to say I am increasingly annoyed and somewhat upset. My m-in-l has been a tax payer all her adult life (and continues to pay tax). I'm intelligent, articulate and still working, but I could be 70 myself and might not be in good health.

I sense a battle ahead. I shall write to the GP and insist on a written reply so that I have something on record should I need it.

How do people manage who are not articulate? How does one get help / support? Clearly her health and general well-being is going to deteriorate. How do I find out what to expect? How do I make her final months/years dignified?

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