Care home v soon

[Brother47]

Hi again. My brother 73, with advanced FTD is now struggling at home alone even with the three daily care visits - it used to be just two because he slept so long but I was advised to add a morning visit in as he had a fall but was ok, but also because his deterioration seems to be accelerating these last few weeks with him sometimes asking the carers which way to the kitchen etc, asking what the noises are (kettle, central heating going on and off) and generally responding to any conversation with the same set of phrases and shouting and making odd noises. Today, Social Services have visited him to finalise a Mental Capacity Assessment but said he may need two separate visits.
I haven't had feedback from them yet. However, in the last couple of weeks, he has had a few more issues. The new morning visit, 30 mins was started about 4 weeks ago and was to check on him and make sure he hadn't had a fall, and to take him up a hot drink and something to eat in his bedroom as he doesn't get up til lunchtime. However since these morning visits, which he dislikes, he has not touched any of the drinks or snacks left for him so the lunchtime carers tell me. However, during the last week he has been throwing the food and drinks (including the mugs) down the toilet when he gets up to use the loo, which consequently got blocked up with cereal biscuits in their wrappers, toast and odd things from the bathroom, flannels, bars of soap.
Today, ahead of the Assessment visit, the morning carer found him on the floor of the bathroom unable to get up. She called the paramedics who came and checked him over and got him up. He was ok and totally unaware that he was on the floor! I checked the monitoring system I have in his house and it appears he may have been on the bathroom floor since midnight. Thankfully the heating is on constantly so he probably fell asleep whilst he was on the floor but thankfully would have been warm if that's any consolation. I've relayed this to Social Services ahead of their meeting today. I really think it's time for a care home. Social Services told me they help me sort a care home out if, after the assessment, if they think he's ready for 24.7 I do not want a live in carer for him. I don't think he would cope with that and his house really does need work doing because he's neglected it since he got dementia. Because I don't have PoA over his health and welfare I'm relying on todays assessment to give me their support for him to go into care. They have said they will help and back me if they agree. My concern is that they won't agree. I'm convinced that he's not safe at home now and I think he must be lonely. He's had 2 falls in less than 5 weeks and he has a steep set of stairs to negotiate. Social Services offered to put a second bannister in but the technician who came to do it was concerned that the wall wouldn't take it as it's an old house. Social Services have put in other aids for him but he doesn't use them other than the toilet frame which I don't think he realises is there. The only toilet is upstairs and he doesn't recognise the commode downstairs nor can answer the phone or use it at all. Sorry but this is more of a rant than anything. I really don't know what to do if Social Services come to the conclusion that he's better off at home. I intend to try him with a few days in a home and see how he copes if that happens. I think he is getting to the stage that soon he won't care or know where he is anyway. Sorry to have vented this but it does help!

 

[Frank24]

Your right he isn't safe at home. Dont focus on the lonely side of things with social services. Be firm. Insist. Good luck.

 

[canary]

@Frank24 is right - SS wont care whether he is lonely, they are only interested in whether he is safe, so tell them about the safety aspects

 

[Sarasa]

Good luck today @Brother47. Write a bullet list of the points you've made in your post and email it to them. I think they will probably see that he needs a care home, but if not stress how he is no longer safe at home.

 

[karaokePete]

I agree with the others @Brother47.

When we had a safeguarding issue a couple of years ago I had to take a tough line with SS. I reminded the Social Worker that it was SS that had the legal duty of care towards my wife and that ensuring her safety required input from them.

I hope you get a satisfactory result for you and your brother.

 

[Brother47]

Your right he isn't safe at home. Dont focus on the lonely side of things with social services. Be firm. Insist. Good luck.

Thank you Frank 24. My brother is self funding so they ought to agree. I have a phone call scheduled with them tomorrow pm.

 

[Brother47]

@Frank24 is right - SS wont care whether he is lonely, they are only interested in whether he is safe, so tell them about the safety aspects

Thanks Canary. I’ve a phone call scheduled with them tomorrow pm. I already contacted them with my concerns for his safety on Friday, hence today’s meeting.

 

[Brother47]

I agree with the others @Brother47.

When we had a safeguarding issue a couple of years ago I had to take a tough line with SS. I reminded the Social Worker that it was SS that had the legal duty of care towards my wife and that ensuring her safety required input from them.

I hope you get a satisfactory result for you and your brother.

Thanks KaraokePete, I hope so too. They even said that if he had to go into hospital for any reason, the hospital would probably recommend that he doesn’t return home. It’s frustrating that SS know that he’s self funding!

 

[Brother47]

Good luck today @Brother47. Write a bullet list of the points you've made in your post and email it to them. I think they will probably see that he needs a care home, but if not stress how he is no loner safe at home.

Thanks Sarasa, I’m on it now and making a list so I’m prepared for my phone call with them tomorrow.

 

[Brother47]

Thank you all for your advice and support. It helps a lot. Good to feel I’m not fighting this battle alone.

 

[tsgc84]

Safety is social services concern, my dad went into a care home because he was unsafe and kept falling. He has moderate/severe FTD with vascular dementia. It’s difficult, but since he has been in the change is wonderful. He’s eating, getting dressed and talking to everyone. Before he wouldn’t get up, wash or eat and constant falls. It’s a tough call, but he now lacks capacity before he never so when he went in we struggled if it was the right decision. It was 100% the best choice and he loves it. Contact your GP and speak to social services and push the fact he is unsafe and a danger to himself, they then act. We found it easier to write everything down, pros and cons and what they can and cannot do, so when they ask you’ve got everything available and do not miss stuff. Hope it all goes well and remember it’s to help them and for them to be safe.

 

[Brother47]

Safety is social services concern, my dad went into a care home because he was unsafe and kept falling. He has moderate/severe FTD with vascular dementia. It’s difficult, but since he has been in the change is wonderful. He’s eating, getting dressed and talking to everyone. Before he wouldn’t get up, wash or eat and constant falls. It’s a tough call, but he now lacks capacity before he never so when he went in we struggled if it was the right decision. It was 100% the best choice and he loves it. Contact your GP and speak to social services and push the fact he is unsafe and a danger to himself, they then act. We found it easier to write everything down, pros and cons and what they can and cannot do, so when they ask you’ve got everything available and do not miss stuff. Hope it all goes well and remember it’s to help them and for them to be safe.

Thank you tsgc84, that's good to know. I have to say that my brother has been an 'awkward' person all his life and so very independent. That still comes through sometimes. I think he would be safer in care. I've already contacted his doctor with an update of the latest issues. It's so tough making decisions for others when all I want to do is keep him safe. Thanks again.

Hi again. My brother 73, with advanced FTD is now struggling at home alone even with the three daily care visits - it used to be just two because he slept so long but I was advised to add a morning visit in as he had a fall but was ok, but also because his deterioration seems to be accelerating these last few weeks with him sometimes asking the carers which way to the kitchen etc, asking what the noises are (kettle, central heating going on and off) and generally responding to any conversation with the same set of phrases and shouting and making odd noises. Today, Social Services have visited him to finalise a Mental Capacity Assessment but said he may need two separate visits.
I haven't had feedback from them yet. However, in the last couple of weeks, he has had a few more issues. The new morning visit, 30 mins was started about 4 weeks ago and was to check on him and make sure he hadn't had a fall, and to take him up a hot drink and something to eat in his bedroom as he doesn't get up til lunchtime. However since these morning visits, which he dislikes, he has not touched any of the drinks or snacks left for him so the lunchtime carers tell me. However, during the last week he has been throwing the food and drinks (including the mugs) down the toilet when he gets up to use the loo, which consequently got blocked up with cereal biscuits in their wrappers, toast and odd things from the bathroom, flannels, bars of soap.
Today, ahead of the Assessment visit, the morning carer found him on the floor of the bathroom unable to get up. She called the paramedics who came and checked him over and got him up. He was ok and totally unaware that he was on the floor! I checked the monitoring system I have in his house and it appears he may have been on the bathroom floor since midnight. Thankfully the heating is on constantly so he probably fell asleep whilst he was on the floor but thankfully would have been warm if that's any consolation. I've relayed this to Social Services ahead of their meeting today. I really think it's time for a care home. Social Services told me they help me sort a care home out if, after the assessment, if they think he's ready for 24.7 I do not want a live in carer for him. I don't think he would cope with that and his house really does need work doing because he's neglected it since he got dementia. Because I don't have PoA over his health and welfare I'm relying on todays assessment to give me their support for him to go into care. They have said they will help and back me if they agree. My concern is that they won't agree. I'm convinced that he's not safe at home now and I think he must be lonely. He's had 2 falls in less than 5 weeks and he has a steep set of stairs to negotiate. Social Services offered to put a second bannister in but the technician who came to do it was concerned that the wall wouldn't take it as it's an old house. Social Services have put in other aids for him but he doesn't use them other than the toilet frame which I don't think he realises is there. The only toilet is upstairs and he doesn't recognise the commode downstairs nor can answer the phone or use it at all. Sorry but this is more of a rant than anything. I really don't know what to do if Social Services come to the conclusion that he's better off at home. I intend to try him with a few days in a home and see how he copes if that happens. I think he is getting to the stage that soon he won't care or know where he is anyway. Sorry to have vented this but it does help!

OK, thank you all for your support. The assessment meeting with my brother took place on Tuesday afternoon, which was a few hours after the paramedics had been post his fall in the morning. My brother had recovered and totally forgotten about what had happened by the time they arrived. The meeting was only about 40 mins it seems. I had the call from the social worker the following day to say that they still haven't reached a decision and are having another internal meeting tomorrow (Monday) to discuss what they think is best for my brother. Initially in the conversation again, it was suggested that my brother has a live in care which I do not want and told her so - the house isn't suitable and would need money spending on it to accommodate another person and I think someone else living with him would add to his confusion. Then they suggested another option of adding a further r daily 'check' visit to the other three. My argument with that is that he sleeps pretty much all the time between visits but I think another visit, which they suggested to be done late evening, won't do anything but wake him up. Apart from the very odd occasion when he stays downstairs, he usually goes to bed after the 6/7pm visit so it would only serve to make sure he's ok and also wake him up for no apparent reason. Social Services admitted the stairs were steep and potentially a risk, and they agreed he doesn't seem to understand a lot of what is being said to him which seems to me to be an admission that he can't manage alone any more. I got the impression that there are more 'tick boxes' which have to be addressed before they will agree that he needs 24/7 care. She said that putting in another care visit would illustrate that we've tried everything to keep him safe at home. The care worker actually said it was a pity that the paramedics didn't send my brother to hospital as she thinks that would have tipped the scales in the direction of him going into care and she thought that the hospital may well say they didn't think it safe for him to continue living alone. So it sounds like SS would prefer that he fell/hurt himself before they agree to him going into care which is awful. They sent me this link
www.alzheimers.org.uk/get-support/legal-financial/deprivation-liberty-safeguards-dols
which I've had a read through but I don't think it really changes anything about what I feel is right. I am going to wait for their call tomorrow and tell them what I want to do if they still say he's better off at home. I have spoken to two dementia care homes in his area and both are able to offer a short term stay for him to see how he copes. Ideally I would like Social Services to help me choose the best one to suit his needs which they said they would in a previous conversation but I wonder if they will help if they still think he's better left at home. My dilemma is that if he settles and I think he's so far advanced in his condition that he may, then when to sell his home. I'd rather not leave it empty and have to continue paying all the energy standing charges etc for couple of months. I can't look after it for him as I live too far away and there's nobody else to help. He can afford to fund himself for a year or two but selling his house would give him more 'back up' funds. Since my conversation with Social Services after the meeting I have sent them a long email detailing all the recent issues, falls, odd things that he does and all the things he can no longer do. So after I've had the conversation tomorrow, if they still maintain he's better off at home, I will ask them to help me choose a suitable care home for a trial stay. I spend every day checked his Canary System at home to make sure he's moving around. I can't talk to him on the phone any more when he's alone as he doesn't recognise the landline or what to do with it, so I can't check he's ok other than using the system. I only speak to him when a carer is there which although nice to hear his voice, he can no longer hold a conversation for more than a few minutes. I'll let you all know what happens.

 

[Sarasa]

It sounds like social services are being ultra careful about making sure your brother has lost the capacity to make decisions, hence directing you to the information about Deprivation of Liberty. I moved my mum to a care home when she appeared to have far more capacity than your brother, she could just about look after herself and knew how to use the phone. However she was putting herself at risk with her behaviour so I moved her into care for her own well being. Like you I was going for a respite stay but in the end I moved her in as a permanent resident as I knew I could give a month's notice if it didn't work out. A Deprivation of Liberty Safeguarding (DoLS) was issued a few weeks after mum moved into care when it was agreed she no longer had the capacity to make informed decisions about her care.
See what social services say tomorrow, but if your brother is self-funding and you have Lasting Power of Attorney I think you would be allowed to move him into a care home. I'm sure others will be along to correct me if I am wrong.

 

[Brother47]

It sounds like social services are being ultra careful about making sure your brother has lost the capacity to make decisions, hence directing you to the information about Deprivation of Liberty. I moved my mum to a care home when she appeared to have far more capacity than your brother, she could just about look after herself and knew how to use the phone. However she was putting herself at risk with her behaviour so I moved her into care for her own well being. Like you I was going for a respite stay but in the end I moved her in as a permanent resident as I knew I could give a month's notice if it didn't work out. A Deprivation of Liberty Safeguarding (DoLS) was issued a few weeks after mum moved into care when it was agreed she no longer had the capacity to make informed decisions about her care.
See what social services say tomorrow, but if your brother is self-funding and you have Lasting Power of Attorney I think you would be allowed to move him into a care home. I'm sure others will be along to correct me if I am wrong.

Thanks Sarasa, that's useful to know. I think you're right, they are only being careful but it does worry me that he's had a couple of falls recently, moreso that he can't get up. It doesn't take more than a few minutes with him to see that he just doesn't understand what's going on any more. DoLS is a good thing in the case of people who are more aware than my brother. Trouble is I only have PoA over his property and finances and not his health and welfare. He was happy to let me handle his finances but reluctant to let me have PoA over his health. That was over two years ago. Back then he realised he couldn't manage his finances when he realised that he didn't know how to write a cheque. When things got worse, he tried hard not to agree to having carers coming in but eventually, he let it happen when he realised he didn't know how to prepare food any more. By then, he was losing the ability to think logically about anything. I probably could have got him to sign a PoA for his health and welfare at that point and he would have done it but I knew he would be signing it without understanding what it was so I just couldn't trick him into doing that. Let's see what tomorrow brings. I think Social Services will agree to me trying him with a few days/week in a care home. Thank you again!