Help please

[Webbkaz]

hi all
I’m hoping for some urgent advice please. My dad has had 4 admissions to hospital in the last 4 months this last admission has lasted so far, 6 weeks.
Each admission has been due to a chest infection and confused state. My dad has vascular dementia which was diagnosed some 18 months ago. While he has been in hospital he has become quite confused, scared even, he has been aggressive hitting out at staff. He has been held down by security guards, his arms have been covered in bruises.
He had been given haloperidol to help with the agitation but it seems to have made things worse. I would like to point out that he has never been aggressive at home. His infection is clearing but he will be on long term antibiotics.
My mum is 75 and missing dad very much, they have been married 55 years and never been apart, he rings her from hospitalvevery night at 7 pm to tell her it’s breaking his heart not being with her and he just wants to go home. When I have rangcthe hospital to see how dad is they tell me he’s doing well and helping the staff and that he is a lovely man. He has a Dols on him at present and social services are saying he won’t be allowed to go home without 24 hr care provided for by the family, they say both Mam and Dad are vulnerable but mum is insistent on him coming home, social services have said if we retry to take him home they will go to the court if protection. My mum and I have been appointed by Dad to be his power of attorneys and we are just awaiting finalisations from the OPG. Would this mean officially and acting on dads best interest we could take him home? Dad has capacity, he has been playing cards and dominoes with the staff, he has been pleasant and helpful. Social services are adamant he needs to be in an EMI but the family insist he isn’t ready for that yet. We are desperate and time is ofcthe essence any advice would be much appreciated, thanks in advance x

 

[love.dad.but..]

Others will be along with their thoughts or advice this is a difficult situation for you all. My understanding is that the health poa has to be validated by the OPG and so can only be used once it has been sent back to you so even if it is in the system you do not have authority...I understand that in exceptional circumstances the finance poa can be fast tracked if you speak to them but not sure if this also applies to health. However...even with authority as his legal attorney for health and welfare the medical profession and SS with advice sought from medics can over ride an attorneys wishes if they deem it not to be in your dad's best interests as they have a duty of care to a vulnerable adult. Many relatives can only get care visits because care home funding is last resort from SS so this is obviously a case where they see an immediate and urgent need.You feel your dad has capacity and the health poa cannot be used until he is shown to lack capacity. The DOLS in place in hospital which is pretty standard perhaps points to others feeling that he doesn't although capacity can fluctuate and they must have concerns if they will refer him to the COP. If your mum is considered vulnerable because of her own health needs unless you can show a plan will be in place to provide 24 hr support for your dad to meet his needs it will be difficult to get him home in the short term I fear. Perhaps you can work with SS to suggest a couple of weeks respite in EMI in the hope that his aggression which understandable...my dad was always very frightened in hospital I stayed with him to help calm him but it was difficult...May settle and whilst his dementia will decline his other medical problems also settle and take it from there. I can however understand your sadness at the situation.

 

[Webbkaz]

Others will be along with their thoughts or advice this is a difficult situation for you all. My understanding is that the health poa has to be validated by the OPG and so can only be used once it has been sent back to you so even if it is in the system you do not have authority...I understand that in exceptional circumstances the finance poa can be fast tracked if you speak to them but not sure if this also applies to health. However...even with authority as his legal attorney for health and welfare the medical profession and SS with advice sought from medics can over ride an attorneys wishes if they deem it not to be in your dad's best interests as they have a duty of care to a vulnerable adult. Many relatives can only get care visits because care home funding is last resort from SS so this is obviously a case where they see an immediate and urgent need.You feel your dad has capacity and the health poa cannot be used until he is shown to lack capacity. The DOLS in place in hospital which is pretty standard perhaps points to others feeling that he doesn't although capacity can fluctuate and they must have concerns if they will refer him to the COP. If your mum is considered vulnerable because of her own health needs unless you can show a plan will be in place to provide 24 hr support for your dad to meet his needs it will be difficult to get him home in the short term I fear. Perhaps you can work with SS to suggest a couple of weeks respite in EMI in the hope that his aggression which understandable...my dad was always very frightened in hospital I stayed with him to help calm him but it was difficult...May settle and whilst his dementia will decline his other medical problems also settle and take it from there. I can however understand your sadness at the situation.

Others will be along with their thoughts or advice this is a difficult situation for you all. My understanding is that the health poa has to be validated by the OPG and so can only be used once it has been sent back to you so even if it is in the system you do not have authority...I understand that in exceptional circumstances the finance poa can be fast tracked if you speak to them but not sure if this also applies to health. However...even with authority as his legal attorney for health and welfare the medical profession and SS with advice sought from medics can over ride an attorneys wishes if they deem it not to be in your dad's best interests as they have a duty of care to a vulnerable adult. Many relatives can only get care visits because care home funding is last resort from SS so this is obviously a case where they see an immediate and urgent need.You feel your dad has capacity and the health poa cannot be used until he is shown to lack capacity. The DOLS in place in hospital which is pretty standard perhaps points to others feeling that he doesn't although capacity can fluctuate and they must have concerns if they will refer him to the COP. If your mum is considered vulnerable because of her own health needs unless you can show a plan will be in place to provide 24 hr support for your dad to meet his needs it will be difficult to get him home in the short term I fear. Perhaps you can work with SS to suggest a couple of weeks respite in EMI in the hope that his aggression which understandable...my dad was always very frightened in hospital I stayed with him to help calm him but it was difficult...May settle and whilst his dementia will decline his other medical problems also settle and take it from there. I can however understand your sadness at the situation.

Thanks for your advice x

 

[Tin]

If you can organise and guarantee 24/7 is in place at home, other than your mother, her health and caring ability is paramount too, then this will be taken in to consideration. Have you considered that the reason you are now getting good reports from the hospital is because there is staff around all the time.

No doubt you are in a very difficult and emotional place, especially your mother and I can understand that you want to do your very best to keep them together, really hope you can find a way.

 

[Hazara8]

Others will be along with their thoughts or advice this is a difficult situation for you all. My understanding is that the health poa has to be validated by the OPG and so can only be used once it has been sent back to you so even if it is in the system you do not have authority...I understand that in exceptional circumstances the finance poa can be fast tracked if you speak to them but not sure if this also applies to health. However...even with authority as his legal attorney for health and welfare the medical profession and SS with advice sought from medics can over ride an attorneys wishes if they deem it not to be in your dad's best interests as they have a duty of care to a vulnerable adult. Many relatives can only get care visits because care home funding is last resort from SS so this is obviously a case where they see an immediate and urgent need.You feel your dad has capacity and the health poa cannot be used until he is shown to lack capacity. The DOLS in place in hospital which is pretty standard perhaps points to others feeling that he doesn't although capacity can fluctuate and they must have concerns if they will refer him to the COP. If your mum is considered vulnerable because of her own health needs unless you can show a plan will be in place to provide 24 hr support for your dad to meet his needs it will be difficult to get him home in the short term I fear. Perhaps you can work with SS to suggest a couple of weeks respite in EMI in the hope that his aggression which understandable...my dad was always very frightened in hospital I stayed with him to help calm him but it was difficult...May settle and whilst his dementia will decline his other medical problems also settle and take it from there. I can however understand your sadness at the situation.

A very helpful post. I would certainly underline that important element regarding being able to stay with someone whilst in hospital, which is not always easy, but can most certainly ease the potential harm which can alas come about during a long stay, 'harm' meaning the way in which dementia proves so vulnerable in these circumstances. And of course 'best interests' assessed by SS and the medical team, with family included in that decision, has to be seen as both prudent and wise, albeit never an easy decision.

 

[Webbkaz]

Dad was assessed by as as having capacity some 6 weeks ago but not at present. We disagree, we know Dad has capacity and has done for about a week the nurses tell us he is brilliant but his main problem when he gets confused is when he wakes up, he won’t sleep in the bed he sleeps on a chair with a footstool when I have asked why he doesn’t get into bed he says cis mams not there, this is sole tormenting. I have just read about intermediate care and reablement and not sure why Dad hasn’t been offered this, he shaves and washes himself