Best Interest meeting & Advocacy

[Suzie G]

Hello and Good Morning
I'll keep this as brief as possible. A Best Interest meeting was scheduled for next Monday following deterioration in mum's condition. (Lots of 'risks' for me to worry about but she refuses to go into a care home.) Her care package is now 3 visits a day, meds locked etc. Main risk in my opinion is overdosing. She gets bad headaches (all investigations show nothing wrong) and the Carers give her paracetamol, but she can't deal with them so in addition begs paracetamol from neighbours, goes to local shop and buys them. No memory at all in relation to taking them. EG a week ago took 7 tablets in 5 hours. On Sunday she bought a packet of 16. The next day when I visited, all gone. I can't prove she took them, but can't be sure she didn't either. She also threatens to overdose to 'end it all'.
She took herself off to A&E on Tuesday. 2nd time in 2 weeks. When I collected her from the ward yesterday the consultant was VERY reluctant to let her go home. She wanted to begin a Section 2 and send mum up to the Geriatric ward. I'd told her about the paracetamol issue. She only agreed to let me take mum home because I told her we have the Best Interest meeting on Monday. She wrote on mum's discharge letter her concerns and that the process of getting a care home for mum should be accelerated.

Now the crux of my need for advice....The social worker (who is lovely, we have a good relationship...so far...) emails me late yesterday (she's aware of mum at hospital and consultant's comments etc) to say that the Best Interest meeting is now postponed because they need to put an ADVOCATE in place for mum. Delay might be 2/3 weeks before we can meet. I would NOT have taken mum home if I'd known this. I know what an advocate is and does, but my questions are:
Why is the idea of an advocate only just being mentioned? Why now?
How can I best prepare myself for the meeting when it does happen?
Mum can present to others really well....she's quite capable of telling the advocate she's fine and has nothing wrong with her!
Can anyone who's been through this give me any tips on how best to proceed?
All thoughts welcome!

 

[Alex54]

We had a 'best interest meeting' a few weeks ago and not much happened other than another meeting in two months time.
Personally, I would not worry about the advocate as they will remain impartial and not contribute much to the meeting.
My advice (not that it is worth much!) would be to talk to the social worker now and try to get an understanding of what the options are and what path they are trying to go down.

 

[Dog5Body4U]

Hi
Advocates can be helpful, but some can be not so helpful. We ended up with advocates for my Mother-in-law as her dementia set in so quickly, I remember once we had gone early to visit due to the best interest meeting but I had forgotten something in my car and had to pop out for it. As I was in the lift going back up there were 2 people I had never seen before chatting about having to come to the place so often they should have their own parking spot (it was a very small lift so I couldn't help but overhear them), one said to the other one who was it today? the bloke who likes to take his trousers off ?? and the other said they were here for a lady. the other said is it the nice lady or the one who swears a lot ? he replied it was a new lady.
I didn't realise they were talking about my Mother-in-law until they walked into the room. they were very nice and seemed to have the best interests of my Mother-in-law firmly in mind (once they got the right paperwork out), in my opinion they are great but sometimes very overworked.
Our local social services initially wanted my Mother-in-law to stay at home, with 3 to 4 visits per day to ensure she ate and had her medication, but we explained that she had a habit of not knowing where she was and was always going out looking for a dog she didn't have or even just trying to go home (even though she was in her own home). They suggested a sensor at the front door that would say "Stay in the house." or something of the like, and we explained that she would ignore that and still go out at random times of the day or night. but it took her being admitted to hospital before we got the ball rolling on her being put in a care home.

I hope you get the situation sorted for your Mum asap don't be afraid to bug them about moving the meeting up, in the best interest for the care of your Mother.

 

[Suzie G]

Many thanks. I possibly over-reacted...the word 'advocate' sounds very formal, doesn't it! I just wondered how 'powerful' they are. Mum has been admitted to hospital twice in the last 2 weeks, all the staff on the ward including the consultant say she has no capacity, and yet social service still want to keep her at home....waiting for a disaster before they're prepared to act.

 

[Jaded'n'faded]

The advocate system can be quite adversarial. When the PWD says things like 'I want to go home' but their relatives (and often medical people) say they need full time care, SS will often appoint an advocate. This happened to me and I was livid! It was explained to me that because my 'opinion' differed from what mum said she wanted, I wasn't acting in her best interests, hence the appointment of an advocate.

The situation was eventually resolved when SS finally accepted mum didn't have a clue what was best for her, but it took several months during which time the advocate would visit her - never when I was there. I was lucky if someone told me about the visit afterwards. Unfortunately, the advocate would ask mum very leading questions, e.g. 'Wouldn't you like to live in a nice flat of your own?'. A carer told me this later as she was there when the advocate visited.

It's incredibly frustrating. Even when I pointed out to SS that mum hadn't the foggiest idea where 'home' was, thought she was on a cruise ship and would have said yes to living at the Ritz or on the moon, I was still told, 'Even so, she says she wants to go home so that's what we have to listen to.'

I think SS use the 'excuse' of PWDs saying they want to go home to keep them in their homes longer than is safe. Because it costs much less than a care home and that is their bottom line unfortunately.

Stand your ground.