The time seems to have arrived

[uknick]

The time has come to put my partners mother in a care home. Or at least that is what I think the hospital is going to tell us this week. Sorry in advance for such a ramble but I think we have tried to put our head in the sand on this issue hoping the day would not arrive.

First, some background. She has suffered from Alzheimer’s for nearly 4 years and has been living at home by herself for most of that time. Recently though, since Xmas, she has had to have carers visit at meal times as she had stopped eating as a result of an hallucination. However, she has now taken to falling over and banging her head. The last fall resulted her in being taken to hospital for assessment.

The questions I have are;

If we want to put her back in her house for one last time, do we have that right? I get the impression the NHS will be against this course of action.

If we have to put her in a home and my partner signs the contract, will she be liable for the costs once her mother’s funds run out? Or, is this when the state steps in to pay the costs? I ask this because the contract is with the daughter not the mother.

What right does the state have to put somebody in a care home without their, or the families, consent? I think they do have the right but this is only from hearsay and I have not seen anything concrete.

If we put her in a home what right do we have to take her back out after a few months?

If she is put in a home for her own safety, is this not for a medical reason and not social care?

 

[Sandy]

If we want to put her back in her house for one last time, do we have that right? I get the impression the NHS will be against this course of action.

You say that your partner's mum has "taken to falling over and banging her head". This lack of mobility with resulting falls is part of the progression of dementia. Once someone has reached that stage, it's generally accepted that they aren't safe to live alone.

You might want to look at the Alzheimer's Society's factsheet on Hospital discharge:

http://www.alzheimers.org.uk/factsheet/453

If the hospital feels that she no longer has the mental capacity to decide where she should live, then there will be a Best interests meeting (where your partner should be able to put her views) to decide what living arrangements are in her best interests.

If we have to put her in a home and my partner signs the contract, will she be liable for the costs once her mother’s funds run out? Or, is this when the state steps in to pay the costs? I ask this because the contract is with the daughter not the mother.

Does your partner have a power of attorney for her mother? If so, she would be signing the contract as POA for her mother.

You might want to look at the factsheet on paying care home fees:

http://www.alzheimers.org.uk/factsheet/468

Your partner should never be liable for paying fees in her own right, only as her mother's attorney.

The only possible issue in the long term is if her mother is in a care home charging 800 pounds per week and her funds drop below the limit and SS has to start paying. If the local SS budget is say 500 pounds, it's possible that they will try and tap your partner for a top-up or threaten to move her mother.

In reality, I'm not sure that such moves really happen that often as it can be argued that such a move would damage the person with dementia's health.

What right does the state have to put somebody in a care home without their, or the families, consent? I think they do have the right but this is only from hearsay and I have not seen anything concrete.

As I said above, when it can be demonstrated that the person lacks mental capacity and the result of the Best Interests meeting indicates 24/7 care is necessary.

You might want to look at these:

http://www.alzheimers.org.uk/factsheet/483

http://www.alzheimers.org.uk/factsheet/483

If we put her in a home what right do we have to take her back out after a few months?

If it was judged to be in her Best Interests to begin with, you would have to demonstrate why it was no longer the case or propose an alternative that was even better.

If she is put in a home for her own safety, is this not for a medical reason and not social care?

We can argue this until the we're all blue in the face, but the current situation is that the fact that dementia is caused by underlying medical conditions does not make any difference under the current provisions on offer by the state.

The type of care required is what dictates whether it is social care or medical care. Social care is means tested and medical care is covered first by NHS Nursing care contributions:

http://www.alzheimers.org.uk/factsheet/452

and at a higher level of need by NHS Continuing Care:

http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=75

Your partner's mother should have her needs assessed as part of the discharge process.

Take care,

 

[uknick]

Sandy

Thanks for this, really useful.

 

[uknick]

Update.
The NHS have now assesssed and said for her own good she is to be "locked" away in a nursing home. They will fund about £100 per week. The reason, her dementia leads to halluciations which cause her to do silly things.

For example, her last fall was due to running away from an autistic boy with his dog who she fantasied had entered her bungalow. To get away she tried to climb the stairs to her bedroom. Unfortunately, being in a bungalow she used a step of kitchen steps in place of stairs. We think she climbed to the top of the steps, about three steps and then fell off the top step. The fall caused her to cut her face.

Physically there is nothing wrong with her.

Interestingly, during her assessment the nurses at the hospital said they have never witnesed her having any aural hallucinatons. Funny that, every time I have been with her over the last couple of years she is always talking to her daughter (who is not there) or a dead cousin.

Anyway, it does seem strange the NHS can lock somebody up against their will for what is clearly a medical problem without picking up the majority of the costs.

No doubt we are now in the same boat as thousands of others and have no way to go. But any thoughts would be welcome.