Do we have any say over fil living accommodation?

Discussion in 'I care for a person with dementia' started by lori107, Feb 15, 2016.

  1. lori107

    lori107 Registered User

    Nov 4, 2014
    45
    I have posted before about my fil who is registered blind and has alzheimers. He fell and broke his hip in October and has been in a care home since November. He is self funded but he constantly gone on about returning to his flat and looking after himself. We have tried to get him to settle at the home but the conversation revolves around going home. We asked social services to assess his mental capacity as we do not think he has the capacity to understand that he is unable to live on his own safely and needs 24 hour looking after and have been waiting for them to come to a decision. He has had a 3rd visit from the social worker who said she was bringing the dementia nurse with her but she didn't. She has sent an email this evening to say he has the capacity to make a change to his accommodation and that she wants to set up a meeting. My husband has poa for his health when he eventually is deemed not to have capacity but the care home manager has told us that fil needs 24 hour as he cannot go to the loo without help, cannot walk without falling over and fil completely disputes there is anything wrong with him at all, he doesn't even believe that he broke his hip. How can he return to his flat when he can't manage these things but is also in complete denial that there is anything medical wrong with him.
    Do we have any say in where he wants to live if we know he is going end up back in hospital almost immediately he is let out. He kept telling us how well he can walk again now and then the following morning the home call to say he has had another fall. When he broke his hip he wasn't wearing his alarm pendant as he had forgotten to put it on. How many times does he have to end up falling until we are taken notice of?
    We just want him in the safest place, for him to be looked after and to know that there is always someone to help him. He admitted to the care manager that he doesn't know how to go to the toilet, he can't get any food or drinks for himself and he also previously told the social worker he understood he needed 24 hour care but now it seems that she isn't looking at any of this. Surely the care home are in a better position to understand his mental capacity. Even the dementia nurse who saw him recently said he had declined a lot since she last saw him.
    We only want what is the best outcome that will keep him safe.
    What do we do, if anything?
    The other day he the home said he wanted to talk to us. He came on the phone saying he was going home. When we said we had the keys safely with us he said he would go and lay in the road by his flat then, is that deemed as having mental capacity?
    I am in poor health myself due to chronic pain from a back injury and stress of all of this is awful.
     
  2. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,289
    SW London
    What a worry for you. Is a single social worker, on her own, allowed or qualified to decide whether someone has capacity? Seems entirely wrong if so, especially since many SWs apparently want/choose to believe whatever will be cheaper for the LA.

    When my mother was assessed for capacity, very late in the day when there could be no possible argument, it was a SW plus a psychiatrist who were sent officially to see her in her CH.

    I do hope the SW will see sense and you won't have this awful worry to contend with.
     
  3. sinkhole

    sinkhole Registered User

    Jan 28, 2015
    268
    From what you've said he clearly doesn't have the capacity to care for himself, but that may not mean he has lost mental capacity.

    A social worker probably can make the decision about capacity to care, but I would expect others to be involved when it comes to deciding on mental capacity.

    I hope you get what you need to keep him safe.

    This might also help (information from AS):

    "Mental capacity means the ability to make decisions or take any actions affecting daily life. This can range from everyday decisions (such as what time to get up, what clothes to wear, what to eat, or whether to go to the doctor when feeling unwell) to major decisions (such as consenting to medical treatment, where to live or how to manage larger sums of money).

    Some people could have difficulty making such decisions, either all of the time or just on specific occasions. The difficulty to make decisions can have any of a number of causes such as:

    · dementia

    · a mental health problem

    · a learning disability

    · a brain injury or a stroke.

    If someone is unable to make a specific decision at a specific time, they can be said to lack the mental capacity to make that decision.


    The legal definition says that someone who lacks mental capacity cannot do one or more of the following four things:

    · understand information given to them

    · retain that information long enough to be able to make a decision

    · weigh up the information available to make a decision

    · communicate their decision - this could be by any possible means, such as talking, using sign language or even simple muscle movements such as blinking an eye or squeezing a hand.

    A person's mental capacity is:

    · task specific - they may be able to make decisions about one thing and not about another.

    · situation specific - people may be less able to make a decision in certain situations depending on their environment.

    · time specific - people may be able to make a decision at different times.

    A person should be given every best possible chance to make a decision. This means asking them in a place which offers the least distraction and asking them at different times.

    If it is thought that a person does not have the capacity to decide on their care, formal mental capacity assessments must be made by the substituted decision makers, if they are making serious decisions on someone’s behalf."
     
  4. Bod

    Bod Registered User

    Aug 30, 2013
    1,166
    Get your husband, using the POA to arrange an appointment with a Consultant Geriatric Psychiatrist, either via the GP or privately for your Fil as a matter of urgency to determine the level of mental capacity.

    This level of diagnosis, will outweigh the SW's.

    Bod
     
  5. Shedrech

    Shedrech Volunteer Moderator

    Dec 15, 2012
    8,077
    Yorkshire
    Hi lori107
    I wonder if the SW is just having to follow procedures - I hope so
    from your description I doubt if anyone would consider it safe for your FIL to be in his own home, whatever he may say - the SW has a responsibility to listen to the care home staff and any medics involved - and yes, with POA you too must be listened to

    are you able to go to the meeting? if so please make sure a care home staff member is there too to back you up, as they have evidence of your FIL's behaviour and needs

    a member here made a good suggestion - when your FIL is asked where he wants to be and says 'at home' follow that up immediately with questions such as 'where is home' 'who is at home' 'how will you look after yourself' etc his answers to these more probing questions will show that his idea of being 'at home' doesn't fit with the reality of his situation and that he will be unsafe in his own home

    best wishes
     
  6. lori107

    lori107 Registered User

    Nov 4, 2014
    45
    My husband spoke to the SW this morning and she said that even if he is danger going home he is allowed to do so. She said he may have mental capacity that day but not the next but she takes it from that time. She said fil is aware he needs help but has told her all the things he can do himself, when the truth is he can't. When we arranged carers for him last time to make meals etc he sent them away early and then tries to do it himself (he can't even turn the oven on) but he says this was not true. OH has told SW that if he goes back home he will not arrange any care for him, if he is capable he can sort it out himself. Also if he falls over in the flat and ends up in hospital again there will be no home for him to go. There is a meeting arranged for middle of March to discuss his needs and OH is going to challenge all the things he says he can do. How can someone who is blind, has poor mobility and alzheimers be considered to have mental capacity when he says he wants to go home for a few hours and then spend the night in the care home so he is looked after. Then he tells SW that he doesn't need help at night. Care manager had said she was on our side and didn't think he had mental capacity for complex decisions such as where to live. Hubby has poa, fil will be completely self funded and we were under the impression that SW alone did not make the decision but she said if she decides he has capacity then there is nothing we can do to stop him.
     
  7. Shedrech

    Shedrech Volunteer Moderator

    Dec 15, 2012
    8,077
    Yorkshire
    Oh lori107
    my immediate thought is 'How ridiculous! This is effectively a theoretical situation - in our real world we can all see that your FIL can say whatever he wants (fair enough) but he's in no state to actually DO'
    my sympathy - all you want to do is the best for him and the SW's stance is just stirring things up - I appreciate there are legalities but ....
    so I think your OH has exactly the right approach - maybe 'there's nothing you can do to stop him' (!!!!!) but you certainly can make it clear that you will do nothing to enable a stay at home so the responsibility is all on the SW's shoulders
    such a shame when really you want all your energies to be put into supporting your FIL in his new environment
    very best wishes
     
  8. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,289
    SW London
    If he is going to be self funded, I don't understand why the SW is digging her heels in like this. The usual reason for SWs choosing to believe that someone can decide they want to go home, when it's quite clear to others that it's no longer safe, is that it's the cheaper option for them.

    If it were me, and she continues to insist that he can go home, I think I would be inclined to withdraw from any contact with her - certainly not agree to take him home, or hand over his house keys to anyone else.

    And TBH I still don't see how a SW alone is qualified to judge anyone's mental capacity. If this is officially allowed, then IMO it certainly should not be.
     
  9. RedLou

    RedLou Registered User

    Jul 30, 2014
    1,162
    Can you not tell the social worker you want her opinion in writing, so that should he return home and then be hospitalised it can be proved that she put a vulnerable adult at risk? She sounds like a right lemon tbh.
     
  10. angelface

    angelface Registered User

    Oct 8, 2011
    1,086
    london
    What a stressful situation you are in.

    My aunt was also self funding, and the SW said just the same as yours.It seems the local council did not want my aunts money to run out and they would have to fund her - so they wanted to leave it as long as possible before she went into care.

    Can you get the occupational therapy people to come in and check out what fil is actually capable of doing? Usually they will be taken seriously by SW.

    Otherwise I think your husband has the right idea - make it very clear to SS that you cannot be involved in fils care.
     
  11. BeckyJan

    BeckyJan Registered User

    Nov 28, 2005
    18,972
    Derbyshire
    I feel strongly about this. My suggestion is that you send a letter (registered post for proof of posting/receipt). Clearly outline that if she does not agree with your thoughts and those of the care home manager + anyone else you have on your side, then if your FIL goes home you will hold her and her department totally responsible for this person who is at high risk, vulnerable and unpredictable.

    The italics are important to emphasise as I believe this will make this person think again!

    This reminds me so much of the SW I had when my husband was ill :eek:.
     
  12. Bod

    Bod Registered User

    Aug 30, 2013
    1,166
    "I'm fine."
    "I can manage perfectly well!"
    "I do all my own shopping/cooking."
    "There's nothing wrong with my memory, I well remember the day war broke out. Now where's my glasses?"

    Hands up all those who have had this conversation, whilst looking around at the actual situation.
    There comes a time when the best care we can give, is not at home, but in a Home.
    We may not like it, they certainly won't agree to it.
    But after settling in, it was a move for the best, for everyone.

    Bod
    Whose hand is up.

    Above is a copy of a post I made a while back, in response to a similar thread.
    Your position is not uncommon, it's the Social Worker who is causing your problem.
    She backs off compleatly, or takes Fullresponsiblity, her choice!
    You are self funding, as such you don't need SW input.
    Be very firm with her!

    Good luck
    Bod
     
  13. tigerlady

    tigerlady Registered User

    Nov 29, 2015
    427
    From this post the SW said that he could have mental capacity one day and not the next which is ridiculous, but if she believes that, why didnt she believe him when he admitted to the care manager that he couldnt go to the toilet, or get food and drink on his own and admitted to her in your first post that he needed 24 hour care

    From your first post
    He admitted to the care manager that he doesn't know how to go to the toilet, he can't get any food or drinks for himself and he also previously told the social worker he understood he needed 24 hour care but now it seems that she isn't looking at any of this.

    If she thinks he has mental capacity she should have taken this statement into account, and realise that it is not possible in his own home. And I agree with others that a social worker on her own should not have the authority to decide mental capacity.

    Anyone who has any knowledge of dementia knows that the "going home" mantra is almost universal, but home means somewhere safe that exists only in their mind. Even people in their own home want to "go home" and although care homes cannot legally keep someone there against their will, most have a DoLS order on them which makes it legal. I strongly agree you should challenge everything that your FIL says he can do and get the care home staff and a psychiatrist to back you up.
     

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