can my mum be forced into a care home even though I DO NOT WANT THIS

[monday]

After almost 3 yrs my mum was diagnosed with alzheimer's. Mum's PA gets 17.5 hours per week, through direct payment. I have been asking for more hours for many months now without success. Mum recently had 3 falls in two days so was taken to hospital, she has been in for 1 week, doctors advised that her pottasium was very low and could contribute to her 'dropping like a stone'.

Mum still knows myself and all her family and friends and continuously asks to come home. Social services have been involved from the begining due to her care package.

Social services have now said that mum will go to a 'transitional bed' (to free up hospital bed as they are being fined £100 everyday mum stays). This was supposed to be for a two week period, (to get an adequite care package together) however, now they say under the 'Mental Capacity Act' they can keep her there permenantly.

I know mum needs lots of support, she can no longer feed, bathe, use the toilet without assistance but I want her at home for as long as its possible.

Can I fight their decision? I am looking to take her to her own home so she will not go to a transitional bed, as I am terrified that they will take her away for good.... please help

[jenniferpa]

Hi and welcome to Talking Point

It's really going to come down to safety. You say she can "she can no longer feed, bathe, use the toilet without assistance". Is she living alone? Because if so, I have to believe that she is unsafe if this is the situation. On the other hand if she is living with you it might be possible.

[Saffie]

You can try, but the medics can be very persuasive. I tried to have my husband home - obviously living with me - but was told that the care given in a nursing home would be better than that which I could give him. Also, what settled it for me was that if he came home and it didn't work out, it would be far more traumatic for him to then have to go into a nursing home than if he went into one without coming home first. Then i realised I was being a bit selfish in trying to insist he came home.

It does sound as though your mother will need a lot of help and with so many falls, could be in danger in her own home even though I understand the reason you want her to remain in familiar surroundings. As Jennifer has said, in your home, it might be a different story.

[caravaner]

I agree with Jennifer & Saffie - unless she has got someone living with her 24/7 it isnt safe for her to be at home.

I have recently had to put my mother in a c.h although it was the last thing I really wanted to do but caring for her 24/7 was too much for me as I work.

In all honesty she is better off now in the c.h. as she has company all the time and is well cared for. They love her to bits there

[Margaret W]

Hi Monday

17.5 hours per week is a lot of help, I don't know any LAs who would offer that much, let alone any more. I am not saying it is enought, but if you feel more is needed, and they can't give it, then maybe it is time to consider permanent care.

I don't think your mum can be forced into care, but if the professionals agree that they cannot provide care in the home sufficient to meet her needs safely, they may be within their rights to refuse to give the care they already do on the grounds of safety. That is only my view, I have no evidence to back it up.

As said, if she is living with you, and you are able to provide supervision for other 150 hours a week (I deliberately used that figure to portray what 24-hour care means), you might manage it.

Other possibilities if you or mum have the space and money, is to consider a live-in carer, but even that would not amount to more than about 40 hours a week.

Think about the care home possibility, Monday, it might be inevitable.

Love

Margaret

[Mariondb]

My MIL was deemed to be too vulnerable in her flat despite the fact that she was immobile and therefore unlikely to fall. A care package had been set up at the maximum level of 2 carers 4 times a day but they simply could not cope with the medical problems and monitoring she needed and it didn't even get off the ground.

They simply were not geared up to provide the kind of medical care she needed.

She was going back and forth to hospital sometimes within hours of discharge and spent more time in ambulances than in her own flat!hat just going on and on to her detriment.

We were told she was too vulnerable and we realised that keeping her in her flat was simply no longer an option. Even 24 hour carers would simply not be able to provide the level of medical care required.

So we placed her in a NH and that was the best decision for her we could have made - the improvement in her has been amazing. From someone who believed she was dying 6months ago and mentally very confused to someone who is content, happy, stimulated and most importantly safe.

Sometimes we need to look at the bigger picture and sometimes whatever we may want or feel is best simply isn't. I would step back from what you want or what you feel she wants and look at the options objectively - you may find a NH is actually not only the only option but actually the best one for everyone.

[NeverGiveUp]

The hospital social workers may appoint an advocate to represent your mum, you put your case to them and they make the descision, I think that the Mental Capacity Act says that they should be appointed when a person doesn't have anyone to speak for them, in practice it may be when the relatives have challenged the social worker. 'Best interests' is the phrase used, should be for the person's best interests.

I agree with the othes in that it might not be a good idea for her to go to her own home if only she lives there. Things to think about are, if she is discharged and it doesn't work out, will it be more difficult to get her into a home? From memory, I think the rules are different for those in nhs care and those who are at home.

I have an idea of what you are facing, my thoughts are with you.

[FifiMo]

Hiya Monday,

You might find that this becomes a legal issue (it certainly would be classed as one in Scotland). If your mum has been assessed by a psychiatrist who diagnoses her as no longer having the capacity to manage her own affairs, then someone has to take permanent legal responsibility for her. The Local Authorities have a duty of care towards your mum and they will discharge that responsibility by ensuring that she is in a place that protects her and attends to her needs, due to her lack of capacity to manage these things for herself.

Due to the current funding issues within Local Authorities, there is no one who is going to take making such a decision lightly. No Local Authority would be placing anyone in a care home unless it was necessary for the health and welfare of that individual. If you read the threads on here, you will find that they are trying every trick in the book to re-assess people as having less health problems that previously assessed with as they can save a few £££. So, from a starting point, I would be listening to any diagnosis with regards to your mum and take on board what they are saying about her needs.

I can understand as a family you want her to stay at home for as long as possible. No one in an ideal world wants anyone to end up in a care home. The reality though is that some people need a higher level of care than can be given at home and without this care could be a danger to themselves. You say that your mum has started having falls. How will you feel if the next fall she has breaks her hip and leaves her in great pain for many months? What if she has a fall that kills her? What if something happens to her during the 150.5 hours a week that she is on her own? Will you be going after the Local Authority tellling them its their fault because she only had 17.5 hours a week worth of care? Ultimately this is what the Local Authority is avoid happening. I think that you are lucky that she is getting 17.5 hours worth of care a week already. On that basis, I don't know of anyone who is receiving more care than that at home and can understand why the local authorities haven't agreed to increase the hours.

As to care homes, I am not sure why you are so against your mum being placed in one. Would it not be better for her family to know that she is no longer at risk of something happening to her whilst at home? Won't you feel better knowing that the care home will help her deal with all the challenges that she faces eg feeding, bathing, using the toilet and helping her get around without falling. If she is in a place where someone else can help her with these things, then the family can focus on all the things that will keep her happy and content.

Now, here is the point that I am trying to get your to consider. Please DO NOT isolate yourselves form those in authority who are trying to help your mum. They DO have the authority to place her in a transitional home and to decide that she needs to be placed in a care home for her own good. Having decided this, and particularly if they feel that you are not in agreement with them, they DO have the authority to go to the courts and gain approval to take control of all facets of your mum's affairs. If you work with them then you can be the one who goes and finds an appropriate care home for her. You can make sure it is the kind of place that you think your mum would like. You can make sure that the staff are all nice people and that everyone in the home looks contented and well looked after. You can make sure that the home of your choice has nice rooms and facilities. You can make sure that it has things going on that you think your mum would enjoy being involved in. You can make sure she is not in a home miles away from anyone so that you and her friends can hardly visit her very often. These are all the things that the Local Authorities are happy for you to go and decide on. If however you are disagreeing with everything then you will be denied this opportunity and they will just send her to a home that they feel is ok. This could, feasibly end up being one at the other end of the county from you and they might just choose that one because, say, it is cheaper or maybe it has beds free so she can move immediately, who knows. This is not the end of your relationship with your mum. If anything she needs you even more now as she is relying on you to make the right decisions for her as to which care home is best for her. So please don't end up being marginalised by the authorities to the point you no longer have a say because the Local Authorities have gone to court and obtained the rights to do all this themselves.

Hope you find a solution that works for all of you, most of all your mum.

Fiona

[nita]

I have been reading this thread with interest and I am grateful to Fiona and others who have written here for setting out the implications of this situation.

Mine is slightly different but I too am concerned that my mother won't be allowed to return home. She is in respite at the moment; went into care because she was extremely agitated and I couldn't cope. They say she is "fine" in the CH and she acts differently, occasionally getting upset but nothing like she was at home where it was continuous.

She is to be assessed next week and I think they will find that she doesn't have capacity. I am hoping that she will be treated for the dementia (perhaps Ebixa as I think she has reached the moderate stage) and for her agitation. However, if they assess her as she appears with outsiders, I fear she will not get this treatment. Will they take into account the underlying anxiety she is feeling which she displays with me?

I am afraid they will think it is in her best interests to remain in care. The SW and GP both are already suggesting this. Will my views/concerns about treatment be taken notice of? Is it possible they won't treat her with medication?

[min88cat]

My MIL was agitated when she lived at home alone.

She was constantly asking to 'go home', looking for her parents, upset about the neighbours cats that came into her garden as she thought they were hers and was worried she couldn't look after them. Programmes on the TV used to upset her as she thought they were talking about her. She thought the neighbours were talking about her. She couldn't find her own way to her toilet (she had lived in the same house for 20 years)

Each time we visited, she begged us not to leave her, but we struggled on with the maximum care that SS could provide, as hubbie had promised her that we would keep her in her home as long as possible.

Looking back on it now, living at home alone, during the last year or so must have been absolute torture for her, and if she could understand, we would apologise unreservedly for what we put her through.

It was fortunate (if you could put it that way) that after 3 falls at home (resulting in 3 hospital visits), she was deemed unsafe to be at home and a place was found for her at a local NH. The decision would have been taken out of our hands if we had disagreed. Luckily we did agree.

She is not on medication, but is now calm and not agitated. We think it's because she has people around 24/7, feels safe and secure and is well fed. As despite the care visits and meals on wheels, it was becoming apparent that she was not eating much at all.

Sorry Mum, so glad that you are now happy and safe..............

[nita]

Min88cat - I am glad your MIL is in safe hands at last. Hers really was a case where she needed to be looked after 24/7. You did what you thought was best at the time, as your husband was trying to carry out her wishes. This is the conflict we all face.

My mother would be at home with me if she were to come out of respite care. She isn't paranoid (yet), doesn't wander and so far has had no falls. She is not at risk in any of these ways. The agitation is only emotional in that she becomes upset and wants to know what is wrong with her, but this type of upset can go on and on if unchecked. I think it is the dawning realisation that she has memory loss - she says she is muddled. I feel I could cope with this if there was some way of calming her down/distracting her. Sometimes she just falls asleep or will watch TV if I put it on. i think she might also pick up on my own anxiety, so I have to work on this to appear unconcerned by her behaviour.

At the moment, she cries and gets upset when I visit, wanting to come home, which is understandable. The trouble is, she could also get like this back at home.

I am more worried about her state of mind. If she is calmer in the CH, would it be cruel to bring her home where she seems to get so emotional?

[nita]

Monday, just re-read your post and saw the bit about your mother's potassium levels dropping low. This happened to my Mum once when she went into hospital and had got very dehydrated from having a water infection and being very sick. It made her very confused, symptoms like dementia. I remember they gave her treatment in liquid form and she got better. (This was before she got Alzheimer's and they thought then that she might be going into dementia. However, that started years later.) They should not assess your mother till her potassium levels rise and she is back to normal.