Thought I was doing to right thing

honeybears

Registered User
Oct 18, 2014
41
0
Hampshire
Dad has late stage Vascular Dementia and is almost 80 years of age - he has declined considerably in the past 6 months and a few weeks back suffered a major dip whereby his actions could not be explained and since then we are having sometimes daily incidences where something has clearly happened, but he is not able to explain in words or sentences that make any sense what happened, but it is something concerning enough that he has either phoned me or pressed the alarm button on the system we installed as an extra precaution.

I therefore decided that rather than waiting for something more serious to happen, I would contact Adult Services to ask if Dad could be assessed with a view to possible respite care/short term stay in a care home as a starting point to his long term care. I thought respite or short term care to see how he adapted before any decision was made was a good starting point and presumed this was something I had to go through Adult Services for, because of his condition. We would be self funding, so it wasn't as if I was expecting his care to be paid for by the local authority.

I thought that was the right thing to do for his own safety and my piece of mind that he would be monitored 24/7, even if it was for just a couple of weeks, but apparently until such time as Dad agrees (which I can't see that ever happening as he won't accept any outside 'interference' as he calls it) we either have to continue as are, with Dad living at home on his own, with all the additional support measures I can put in place, or wait for a 'crisis' to occur whereby the need for his consent may no longer be applicable.

I don't think my Dad does not know what is best for him anymore - if he did then I wouldn't have to do half the things I do for him - he just follows the same daily routine whether it is a good day or a bad one but that doesn't detract from the fact I am not taking away any respect for him as a human being, all I am trying to do is what is best for his safety with the condition that he has so with the increasing day to day concerns that seem to be occurring, why is my request to keep him safer, deemed to be the wrong request to make as his carer??
 

kindred

Registered User
Apr 8, 2018
2,935
0
Dad has late stage Vascular Dementia and is almost 80 years of age - he has declined considerably in the past 6 months and a few weeks back suffered a major dip whereby his actions could not be explained and since then we are having sometimes daily incidences where something has clearly happened, but he is not able to explain in words or sentences that make any sense what happened, but it is something concerning enough that he has either phoned me or pressed the alarm button on the system we installed as an extra precaution.

I therefore decided that rather than waiting for something more serious to happen, I would contact Adult Services to ask if Dad could be assessed with a view to possible respite care/short term stay in a care home as a starting point to his long term care. I thought respite or short term care to see how he adapted before any decision was made was a good starting point and presumed this was something I had to go through Adult Services for, because of his condition. We would be self funding, so it wasn't as if I was expecting his care to be paid for by the local authority.

I thought that was the right thing to do for his own safety and my piece of mind that he would be monitored 24/7, even if it was for just a couple of weeks, but apparently until such time as Dad agrees (which I can't see that ever happening as he won't accept any outside 'interference' as he calls it) we either have to continue as are, with Dad living at home on his own, with all the additional support measures I can put in place, or wait for a 'crisis' to occur whereby the need for his consent may no longer be applicable.

I don't think my Dad does not know what is best for him anymore - if he did then I wouldn't have to do half the things I do for him - he just follows the same daily routine whether it is a good day or a bad one but that doesn't detract from the fact I am not taking away any respect for him as a human being, all I am trying to do is what is best for his safety with the condition that he has so with the increasing day to day concerns that seem to be occurring, why is my request to keep him safer, deemed to be the wrong request to make as his carer??
Oh my heart goes out to you. Your dad obviously has capacity and if so, he can say where he wants to be. I know, I know. Adult Services are the advocate of the PWD because they cannot advocate for themselves, whereas we without dementia can. It is designed to protect the weakest members of society but the broad brush philosophy is difficult for us and we don't want to wait for the crisis. It may be sensible to put your concerns on paper or e mail, stressing that capacity or not he is a vulnerable adult and you can foresee accidents ...I am sorry. Warmest, Kindred.
 

Amethyst59

Registered User
Jul 3, 2017
5,776
0
Kent
This is a problem which I am sure I have read on this forum had been dealt with in different ways. Find a home that you like and present it to your dad as a ‘holiday’, or use some other ‘love lie’. Maybe you could say that you need a break, or are going away, and that you need to know he is safe while you are away. It is a good idea to get him properly assessed, but obviously you might need to use a little subterfuge to arrange it.
Another route you might choose to take is to employ carers to live in with your dad and get them to make a set of observations of his needs. (I mention this, as it was done for my husband, under different circumstances, but we ended up with a full set of professional notes for me to give to a care home, so they had an idea of his needs).
 

Beate

Registered User
May 21, 2014
12,179
0
London
First of all, if you're not sure about your Dad's capacity you can find independent assessors. If it is then deemed that your Dad has lost capacity to decide where he lives, a best interest decision should be made by Social Services, however, I am not convinced that you need to involve them if he is self-funding. Have you got LPA?
 

Kevinl

Registered User
Aug 24, 2013
5,937
0
Salford
I didn’t find that Soc Sers were very interested once they found out we were self funding.
Social Services aren't that interested when they are doing the funding either.
The first thing they have to consider is the "least restrictive option" so they won't go down the care home route until all other options have been tried and proved not to work. Self funding means you get to choose when the time is right not a social worker.
If you want a care home or respite SS will give you a list of places and tell you to go and find the one they like self funding or LA funding so no difference there, you have to do it all yourself the social workers won't visit the home and aren't allowed to recommend one either.
The myth that getting LA funding means you get loads of help from SS is exactly that a myth, has anyone LA funded ever come on here and said how Helpful social services were?
They do offer help to people who are alone in this world with no family or friends available to help but if there is family and friends then it's over to you, all they do is pick up the bill, minus of course the top ups.
Self funders have a choice of homes, LA funded the choice is this home, take it or leave it or get your hand in your pocket and pay a top up and I mean your pocket as the PWD's money can't be used to pay what can be several hundreds of pounds a month.
Social Services only help people where there is no other option so self funders aren't missing out on anything, no one gets help unless it's absolutely necessary.
Getting the LA to fund means the social worker has to be happy it's the only option, they often appoint an Independent Mental Capacity Advisor who has to agree it's the best option then you have to apply to the panel for funding as well as finding a home, it's way harder to get someone LA funded into care it's a "crisis only" system and SS will do everything and anything they can to keep people out of care.
K
 

Witzend

Registered User
Aug 29, 2007
4,283
0
SW London
My (self funded) mother would never in a million years have agreed to go into a care home, so given that it was by then an urgent necessity, I am very glad that we didn't involve social services at all. Quite apart from anything else, we didn't need anyone who didn't know her assessing her needs, since these had been glaringly obvious to family carers for quite some time.
 

honeybears

Registered User
Oct 18, 2014
41
0
Hampshire
Can I ask - if she didn't give her consent how did you get around that?
I do agree that it is those closest that know what is best for their relative rather than someone carrying out an assessment having never met or known the person before
 

Witzend

Registered User
Aug 29, 2007
4,283
0
SW London
Can I ask - if she didn't give her consent how did you get around that?
I do agree that it is those closest that know what is best for their relative rather than someone carrying out an assessment having never met or known the person before

It was quite a while ago now, so details are a mite vague. However we found the care home with no input from SS, since we had never involved them at all. By then my mother's Alzheimer's was pretty advanced - not washing, no idea about anything, unable even to make herself a cup of tea, etc., plus she'd had quite a bad fall, leaving her terribly bruised, but she had no recollection of it, or of how it had happened. She was then 89. We explained all this to the manager of the (dementia only) care home, which was close to my house, but 60 miles from my mother's.

As I recall, there had to be a sort of assessment visit to her at home (I think arranged by the CH) but it was quite short and evidently something of a tick-box exercise, since it would very soon have been clear to anyone with a grain of sense that my mother no,longer had capacity and was in urgent need of 24/7 care.

We were dreading the actual move - it was all planned like a military operation. We were asked to arrive at the care home in time for lunch, and it's a measure of how bad my mother was then that she didn't realise that it was a care home (you'd have thought it perfectly obvious that it was a CH dining room, albeit a rather nice one) - she really thought we were in a restaurant.

Not sure any of this will have been much help, but I do wish you all the very best - I know all too well what a worrying time it is.
 

Kevinl

Registered User
Aug 24, 2013
5,937
0
Salford
As I recall, there had to be a sort of assessment visit to her at home (I think arranged by the CH) but it was quite short and evidently something of a tick-box exercise, since it would very soon have been clear to anyone with a grain of sense that my mother no,longer had capacity and was in urgent need of 24/7 care. rather nice one) - she really thought we were in a restaurant..
With all due respect, that was then and now is now. Care homes still assess if they'll take a resident or not but the process since the West Cheshire Case means that many more people have to have a DoLS and like it or not social services will become involved and probably an Independent Mental Capacity Advisor (IMCA) too.
What happened a "while ago" isn't necessarily the way it is now, social services have to use the "least restrictive option" so the family no longer make the decision unless they're self funding, SS do and an IMCA do and if either of them think a care home is over restrictive you can't necessarily "put" someone in care just because the family think it's for the best, family are only part of the decision making process these days, "the least restrictive option" is the key phrase now.
K
 

kindred

Registered User
Apr 8, 2018
2,935
0
With all due respect, that was then and now is now. Care homes still assess if they'll take a resident or not but the process since the West Cheshire Case means that many more people have to have a DoLS and like it or not social services will become involved and probably an Independent Mental Capacity Advisor (IMCA) too.
What happened a "while ago" isn't necessarily the way it is now, social services have to use the "least restrictive option" so the family no longer make the decision unless they're self funding, SS do and an IMCA do and if either of them think a care home is over restrictive you can't necessarily "put" someone in care just because the family think it's for the best, family are only part of the decision making process these days, "the least restrictive option" is the key phrase now.
K
But what if the family is unable to care for their loved one, or has a breakdown as I did? What then? It isn't a case of putting someone into care because it's the most convenient thing to do. What if the situation is so bad that no one can take it on any more Kindred.
 

Amethyst59

Registered User
Jul 3, 2017
5,776
0
Kent
My husband is in his third week at his care home. I visited the home, took him in the afternoon, then three days later the deputy manager came to my home to assess him. He moved in two days after that. No dols, no Soc Sers assessment, no metal capacity assessment. And I’m really pleased with the home.
 

Witzend

Registered User
Aug 29, 2007
4,283
0
SW London
With all due respect, that was then and now is now. Care homes still assess if they'll take a resident or not but the process since the West Cheshire Case means that many more people have to have a DoLS and like it or not social services will become involved and probably an Independent Mental Capacity Advisor (IMCA) too.
What happened a "while ago" isn't necessarily the way it is now, social services have to use the "least restrictive option" so the family no longer make the decision unless they're self funding, SS do and an IMCA do and if either of them think a care home is over restrictive you can't necessarily "put" someone in care just because the family think it's for the best, family are only part of the decision making process these days, "the least restrictive option" is the key phrase now.
K

Yes, I do appreciate all that, but if the PWD is in need of 24/7 care, there's no viable alternative to a care home, and SS/the powers that be, still say it's not possible, then what? Is the person to be left with sporadic and inadequate care until a real crisis occurs?

My mother was of a naturally very private and often suspicious nature, which only got worse, and emphatically would not allow carers (except family and her very long term cleaning lady) into the house. She had refused entry even to the person who was merely coming to make sure she took her Alzheimer's medication. 'No, you're not coming in! What medication? I'm not on any medication - there's nothing wrong with me!'
I'm sure that such cases are not at all uncommon.

She lived 60 miles from me, and a 20 minute drive from my brother, who was still working full time. What on earth we'd have done if anybody had said a care home wasn't on the cards, I dread to think, since moving in with either of us simply was not an option.
 

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