Does lack of capacity automatically mean residential care

[Perservere]

What are implications if person assessed not to have capacity?

My LO has vascular dementia, lives at home on his own and is physically very fit and able. He is able to undertake activities of daily living although doesn't eat well but has refused help with that for over 18 months. However things are progressing as is expected, he is increasingly muddled, undoubtedly he needs more support as do I- i live 150miles away (which i have for many many years). I have tried to introduce carer (private) - he wouldn't entertain idea - or via community mental health (referred by OT), but he refused to let them in the house. They deemed him to have capacity at that time and said rightly they could not force him to accept. Social work suggested getting capacity assess by GP- but If his capacity is formally assessed and he is deemed not to have it- this still doesn't make him want to let people into the house (fiercely independently minded before dementia and even more so now)- so does this mean he would then have to go into care.
I know care is coming - which he will not go willingly when the time comes- but now still doesn;t feel like the right time as there is so much he does for himself, pottering in garden etc

 

[Alisongs]

What are implications if person assessed not to have capacity?

My LO has vascular dementia, lives at home on his own and is physically very fit and able. He is able to undertake activities of daily living although doesn't eat well but has refused help with that for over 18 months. However things are progressing as is expected, he is increasingly muddled, undoubtedly he needs more support as do I- i live 150miles away (which i have for many many years). I have tried to introduce carer (private) - he wouldn't entertain idea - or via community mental health (referred by OT), but he refused to let them in the house. They deemed him to have capacity at that time and said rightly they could not force him to accept. Social work suggested getting capacity assess by GP- but If his capacity is formally assessed and he is deemed not to have it- this still doesn't make him want to let people into the house (fiercely independently minded before dementia and even more so now)- so does this mean he would then have to go into care.
I know care is coming - which he will not go willingly when the time comes- but now still doesn;t feel like the right time as there is so much he does for himself, pottering in garden etc

 

[Alisongs]

Welcome to the Forum. You'll find all sorts of opinions, advice, experience and expertise here, mixed with compassion, empathy, sympathy and humour. My mum lived in her own home until well over 103.....Almost totally helpless in the end. Carers came in twos as Mum lashed out physically and verbally. They then did the minimum and left. Sister sacked carers and ended d up doing 4 or 5 visits a day. I was 100 miles away, still full time working. Long story short, sister kept asking Social Services for assessments. All came back as has capacity, as mum told them to get out, with several four letter descriptions we didn't know she knew.... Mum had capacity to live without Social Services intervention, in their opinion. Quite frankly she was a safeguarding issue to herself and others, but sister was conveniently on tap, and was hoping mum could die in bed in her own home. My sister didn't (want to) realise she could/ should hand over responsibility for mum's safety and care to Social Services.... And I didn't then know that.
An independent adult at risk, needing safeguarding is the legal responsibility of Social Services, not the family.
If you feel your LO is at risk, report your LO to Social Services as needing safeguarding, and make it clear you know Social Services should take responsibility and at least assess again, as family are not involved in the care. And step back

 

[Jools1402]

@Perservere - this is SUCH a common problem. My Mum was the same - would not accept carers as they were "too expensive and I don't need them". Social services and GP thought that she had capacity as she presented well. Ended up with her making herself ill through neglect and hospitalised. Once out of her familiar surroundings it was very apparant that she definitely did not have capacity and so straight to a care home.
Would your LO accept being told he needed help by someone in authority such as a doctor or nurse?

 

[Perservere]

Welcome to the Forum. You'll find all sorts of opinions, advice, experience and expertise here, mixed with compassion, empathy, sympathy and humour. My mum lived in her own home until well over 103.....Almost totally helpless in the end. Carers came in twos as Mum lashed out physically and verbally. They then did the minimum and left. Sister sacked carers and ended d up doing 4 or 5 visits a day. I was 100 miles away, still full time working. Long story short, sister kept asking Social Services for assessments. All came back as has capacity, as mum told them to get out, with several four letter descriptions we didn't know she knew.... Mum had capacity to live without Social Services intervention, in their opinion. Quite frankly she was a safeguarding issue to herself and others, but sister was conveniently on tap, and was hoping mum could die in bed in her own home. My sister didn't (want to) realise she could/ should hand over responsibility for mum's safety and care to Social Services.... And I didn't then know that.
An independent adult at risk, needing safeguarding is the legal responsibility of Social Services, not the family.
If you feel your LO is at risk, report your LO to Social Services as needing safeguarding, and make it clear you know Social Services should take responsibility and at least assess again, as family are not involved in the care. And step back

thank you appreciate your advice.

 

[Perservere]

@Perservere - this is SUCH a common problem. My Mum was the same - would not accept carers as they were "too expensive and I don't need them". Social services and GP thought that she had capacity as she presented well. Ended up with her making herself ill through neglect and hospitalised. Once out of her familiar surroundings it was very apparant that she definitely did not have capacity and so straight to a care home.
Would your LO accept being told he needed help by someone in authority such as a doctor or nurse?

Thank you. LO didn;t accept opinion of OT when they recommended support but maybe would do from GP. As its vascular dementia, he has been discharged from Consultant pysch with no further follow up and together with good physical health- we therefore have no reason to go to Dr so getting him in front of one is a challenge. However, i will maybe have to invent a reason to get him there.

 

[Collywobbles]

Thank you. LO didn;t accept opinion of OT when they recommended support but maybe would do from GP. As its vascular dementia, he has been discharged from Consultant pysch with no further follow up and together with good physical health- we therefore have no reason to go to Dr so getting him in front of one is a challenge. However, i will maybe have to invent a reason to get him there.

If you quietly phone or email the surgery and explain, they might be able to proactively invite LO in for a ‘routine checkup’ without mentioning the dementia. We do this for our Mum and her GP is very good at slipping dementia-related checks in between standard things like taking blood pressure.

 

[Sirena]

It's a good idea to try to get him to the GP. My mother's GP invited her for an 'over 70s health check'.

However you (or someonelse) would probably have to accompany him, because even if he agreed to attend he may change his mind or forget unless there is someone there prompting him immediately beforehand. Even if the GP recommends having carers coming in, I suspect there could still be a problem with your dad agreeing at the time then changing his mind and refusing.

Is there something he acknowledges he can no longer do, e.g. carry heavy shopping, which would allow you to say "nice lady is coming in to help with x" (never call them carers!)

Do you have LPAs for him?