Going into care home without consent?

Grandaughter 1

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Jan 17, 2006
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Hampshire
Just thought I'd give you an update on events.

My Nan had a breakdown on the bus yesterday. My Mum went to sit with Grandad so Nan could get out for a bit. Nan was sitting on the bus and she heard 2 ladies chatting and giggling. My Nan was so distraught about how her life is at the moment and how lonely she is. She wished she was one of those ladies. She broke down in tears and couldn't stop.

The social worker came out and booked emergency respite for Grandad for Wednesday. This is great on paper but we have to get him there with his consent so we are unsure if this will happen. We are not allowed to trick him or just take him, he has to know he is going. Nan says that if he goes, then she doesn't want him back. I don't know what we are to do. He kicks up such a fuss if we even mention respite.

Apparantly there are no care homes in the area with vacancies that specialise in dementia/parkinsons etc. There are very few (if any) in the area at all apparantly.

I'm just at a loss as to what we can do and feel really out of my depth with this all. I just want to make it right but can't.
 

daughter

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Mar 16, 2005
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I'm sorry it's come to a crisis point Louise, although it is very hard for you, you may find it helps to try and concentrate on the practical things and help out in finding a home. Nothing is ideal in all this, I know, and we all so wish to make things right - all you can do in the end is your best.

Who says you are not allowed to "trick" your Grandad? It's an awful word to use and I suppose that is what we did with my Dad at times but it was the only way we could see to give everyone a bit of space. We found it best not to mention trips anywhere until the last minute - although this may look cruel and even devious perhaps, but your Nan is obviously at the end of her tether and the easier you make it for her now, the better. At least your family will have some time to think about what to do from now on.

This is a terrible time for everyone in the family but hang on there Lousie, we're all here for you.
 

Grandaughter 1

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Jan 17, 2006
141
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Hampshire
daughter said:
Who says you are not allowed to "trick" your Grandad? It's an awful word to use and I suppose that is what we did with my Dad at times but it was the only way we could see to give everyone a bit of space. We found it best not to mention trips anywhere until the last minute - although this may look cruel and even devious perhaps, but your Nan is obviously at the end of her tether and the easier you make it for her now, the better. At least your family will have some time to think about what to do from now on.

This is a terrible time for everyone in the family but hang on there Lousie, we're all here for you.

Thanks "daughter"

The Respite home have told us that they will only take Grandad with his consent. Last time we told him he had a hospital appointment and he might have to stay overnight. Once we got to the home he realised it wasn't a hospital and really kicked up a stink. The staff told us just to leave and they'd deal with him. They have said now they will only take him next time if he is aware where he is going and he is in agreement!

Louise x
 

daughter

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Mar 16, 2005
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Sorry Louise, I must have missed that bit. I guess your Grandad is more aware than Dad was - but my Dad didn't believe he was at home, even when he was at home - if you see what I mean, so it would have been impossible to try explaining to him about going into a Care Home.

What I find difficult to understand about this agreement thing is that lots of residents in Care Homes keep saying they want to go home anyway, so do we assume they are not in agreement and they shouldn't stay there? Sorry, that doesn't help, I'm just wondering aloud to myself.

Is there another care home that might offer respite? Has the social worker suggested how the respite might be achieved? I hope someone else has something more constructive to offer!

Hazel. x
 

noelphobic

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Feb 24, 2006
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Liverpool
daughter said:
This is a terrible time for everyone in the family but hang on there Lousie, we're all here for you.

It's strange how much of a difference a minor typing error can make, isn't it!

I do find it strange that the respite home say they will only take him if he is willing. This seems to create a vicious circle - the fact that he is not willing to go puts an extra strain on his wife which cannot be alleviated because the home won't take him.

I hope this is resolved soon with the minimum of trauma to everyone.
 

Helena

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May 24, 2006
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Unfortunately its quite true that no NH or care home can or will take patients if they refuse to go
This is precisly the appaling dilema anyone with a VD patient faces because as my Mothers GP said

" its actually extremely difficult to get someone sectioned especially when they have good days and bad days "

He told me that despite all my Mothers problems and the hell she is creating for neighbours, self and my sister and even though she is currently in hospital following a fall at home and laying there for 4 days unconcious unless the Hospital can persuade her to agree theres no way we can get her into a NH
 

Kathleen

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Mar 12, 2005
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West Sussex
Hello Louise

Of course you want to make it right, life seems awful for your family at the moment........no-one's fault, just everything so out of control.

As the socal worker has arranged the respite, I suggest you get on to her and say the home she has arranged will only take him with his agreement....surely they would have told her that when the respite was booked!

As she knows the situation, maybe she could help to either mediate with the home in question or find another that will take him.

If your Nan doesn't get some help urgently, she could be the one in hospital, then social services will be forced to act to get a suitable placement for your Grandad.

Thinking of you

Kathleen
 

Grandaughter 1

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Jan 17, 2006
141
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Hampshire
Hiya,

Well I've just had a very quick word with my Mum. Apparantly my Uncle went to talk to Grandad about respite tomorrow. Grandad as expected got very agitated and wasn't having any of it. He refuse's to entertain the idea at all.

As you can imagine Nan was very upset. I don't know what happens now but we are going to go back to the social worker again and see what she can do.


Louise x
 

Nicky

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Sep 5, 2005
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63
East Sussex
This sounds so familiar

Hi Louise, I have been reading this thred hoping to get some ideas for my own situation!!! I want to use last minute trickery as someone suggested but the social Worker is convinced that we must discuss the move to residential care to help my mother in law to adjust. She has lived with me for the last year and I know exactly what the reaction will be. At the moment I maintain my sanity by keeping her happy and am not prepared to rock the boat and then have to deal with the abuse and hostility and sleepless nights if she gets agitated again. If the social worker moved in for a week perhaps she'd change her tune....tho' ma would throw her out the minute she saw her or do a runner...if she could open the gate! I will read on and hope for some ideas....I have found subterfuge the best tactic and avoids uneccessary upset for everyone and without it the 20 minute assessment with the SW would never have happened. could you support your nan to make her decision even tho' this is very hard and then work from there? GOOD LUCK
 

merlin

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Aug 2, 2006
139
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Surrey
Hi all

Have also been reading this thread and have in many ways a similar situation insofar that my wife is in complete denial of her AD and therefore refuses to co-operate with anyone.

The problem of consents puzzles me because it seems to me that somebody is interpreting the human rights act a bit too literally. Surely if there is an EPA in force then the carer who has this EPA can make decisions on the behalf of the patient. This must mean that trickery or whatever is irrelevant.

The wording of the my EPA says you are making decisions on property and affairs. I had assumed that affairs meant any affairs for the benifit of the patient.

In the light of this correspondence I shall have to check this definition with my soliciter.

Anybody any definitive info?
 

jenniferpa

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Jun 27, 2006
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Actually, I don't think it does at the moment. This is one of the issues that the new Lasting Power of Attorney is supposed to address. An EPA currently only deals with financial matters (unless you're in Scotland, where they also have a health power of attorney - can't remember what it's called)
 

Skye

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Aug 29, 2006
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SW Scotland
Welfare power of attorney. I've got one for John, but our solicitor warned that doctors are reluctant to take notice of it. It's comparatively new, 2001 I think, so perhaps things have improved. I haven't had to use it yet.
Skye
 
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noelphobic

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Feb 24, 2006
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Liverpool
merlin said:
Hi all

Have also been reading this thread and have in many ways a similar situation insofar that my wife is in complete denial of her AD and therefore refuses to co-operate with anyone.

The problem of consents puzzles me because it seems to me that somebody is interpreting the human rights act a bit too literally. Surely if there is an EPA in force then the carer who has this EPA can make decisions on the behalf of the patient. This must mean that trickery or whatever is irrelevant.

The wording of the my EPA says you are making decisions on property and affairs. I had assumed that affairs meant any affairs for the benifit of the patient.

In the light of this correspondence I shall have to check this definition with my soliciter.

Anybody any definitive info?

I agree with Jenifer that the EPA in its present form only gives control over finances. The irony as far as the Human Rights Act is concerned is that, while it may stop someone being forcibly put in a nursing or care home, once they are there they are no longer covered by the Human Rights Act!

I am also not so sure that sectioning is as difficult as people are being led to believe. My mum has been in residential care (first a care home, then a nursing home) for the 2 years since my dad's death. Prior to that she was at home with occasional respite care in a council run home that has since closed. The Social Worker was very keen for my mum to go into full time care even before my father died and my sister and I were very resistant to the idea. The Social Worker did at one point say that if we didn't support the idea she could arrange for my mum to be sectioned! My mum was never violent and she never left the house, luckily, so I don't see how they could have had her sectioned, especially as we were opposed to the idea. I am telling this 'tale' to illustrate that sectioning is not as hard as people make out. I think the basic criteria are that the person 'poses a significant danger to themselves or others' (not necessarily 100% correct wording but I think that it is pretty close). I would think that in Louise's case her grandad could be argued to pose a danger to her grandmother because of the effect on her health. What about her human rights! If her grandmother just walked away and noone else volunteered to pick up the pieces the Social Services would HAVE to find him residential care.

Whilst I don't condone it, I can understand to an extent the cases you hear of where people either 'abandon' a relative at A & E or refuse to collect them on discharge from hospital. If you phoned Social Services up and said you could not cope with a child any more they would be obliged to act, what is the difference with an elderly person?!

Brenda (climbing down from one of many soapboxes!)
 

Grandaughter 1

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Jan 17, 2006
141
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Hampshire
I would think that in Louise's case her grandad could be argued to pose a danger to her grandmother because of the effect on her health. What about her human rights! If her grandmother just walked away and noone else volunteered to pick up the pieces the Social Services would HAVE to find him residential care.

Whilst I don't condone it, I can understand to an extent the cases you hear of where people either 'abandon' a relative at A & E or refuse to collect them on discharge from hospital. If you phoned Social Services up and said you could not cope with a child any more they would be obliged to act, what is the difference with an elderly person?!

Brenda (climbing down from one of many soapboxes!)

You get on your soapbox as much as you like Brenda, you talk a lot of sense!

I feel really guilty for admitting this but sometimes I wish Grandad would have a small fall or something that would cause him to be admitted to hospital because hopefully that could start the ball rolling. I feel really bad for thinking that but desperate measures and all that......
 

noelphobic

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Feb 24, 2006
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Liverpool
Grandaughter 1 said:
You get on your soapbox as much as you like Brenda, you talk a lot of sense!

I feel really guilty for admitting this but sometimes I wish Grandad would have a small fall or something that would cause him to be admitted to hospital because hopefully that could start the ball rolling. I feel really bad for thinking that but desperate measures and all that......

Loiuise, no one could blame you for feeling that way. I know you don't wish harm on him but you are obviously at the end of your tether, as is your poor grandmother.

My mother had several hospital admissions prior to going into full time care and. once they found out that she lived alone with her physically disabled husband they were quite reluctant to let her go! However, their 'solutions' were also far from ideal! I spent many unhappy hours in A & E and I could have recorded the conversations and played them back to the next doctor on the next visit and saved us all time and patience!

I do believe that the elderly, and especially the elderly, fragile population are treated disgracefully in this country. I rather startled a colleague today by saying that at least the eskimos were honest about what they do! (I also said a similar thing a couple of years ago when drunk to a senior manager on a works 'do'!) I don't mean that 'Joe Public' treats the elderly the same way the eskimos do(inuits is more politically correct I believe!), rather that the 'system' does!

Brenda (climbing down from yet another of her beautiful, carefully colour coordinated soap boxes!)
 

Sandy

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Mar 23, 2005
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There's another interetsing fact sheet on frequently asked legal questions here:

http://www.alzheimers.org.uk/Caring_for_someone_with_dementia/Dementia_and_the_law/info_legalFAQ.htm

About two-thirds of the way down the page there is a section on What are the rights of a carer who feels that they cannot care any longer?

This other factsheet on the Mental Health Act and guardianship could also be relevant:

http://www.alzheimers.org.uk/Caring_for_someone_with_dementia/Dementia_and_the_law/info_mentalhealthact.htm

The bit on guardianship (half way down the page) is interesting, but guardians only have the power to require the person to live at a specified place, they have no powers to authorise the detention of someone or sanction their removal from somewhere if the person is not willing to go.

Have you contacted the Alzheimer's Helpline, they can be a very useful source of information?

Another option for respite (albeit a bit of a longshot - though it works for some) is for your Nan to go somewhere for a break and for Social Services to arrange round-the clock carers to come in to look after your Grandad. Given his frame of mind, he might not take to "strangers" coming in to look after him.

I'm sorry, but I wasn't clear if the respite home was dedicated to the care of people with dementia or not?

Take care,

Sandy
 

Nell

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Aug 9, 2005
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Cate said:
How about asking for respite for your nan, she really sounds as if she is the one who needs the TLC at the moment.

Just maybe this will force the SW into some positive action re support for her at home with you granddad. Or simply saying that Nan needs respite, so what at they going to organsie for granddad?

I agree 150% with 'he who shouts loudest gets the action'.
Cate

I know it sounds awful but you really DO have to play the game according to the bureaucratic rules. If the "rules" won't allow your grandad to have care without his consent, then it will have to allow granma to HAVE care if she says she must have it.

This is rather convoluted, but I'm really saying that Grandma must now insist on being hospitalised / given respite etc. because she "absolutely, positively" has reached the end of her tether. If this means a great acting debut ;) crying, wailing, gnashing of teeth, throwing herself into bed and refusing to get up, turning her face to the wall and refusing to speak, etc. etc.!!!:D then so be it! (Tell her to think of how great an actor is Dame Judy Dench and GO FOR IT!!)

In my line of work I find that the only way to make the system work sometimes, is to use its own rulles against it. Unfortunately (!!) most people are reluctant to do this and feel they "ought" to keep going - when in fact it is dangerous for their own health and those they care for, if they are forced to do that. Your Grandma's breakdown on the bus is surely evidence that a genuine collapse is very near. If you have to, use your wiles to force the hand of the bureaucrats.

We all regret this is necessary, but sometimes it is unavoidable.
Best wishes to your Granma, your Grandad, and to yourself and your family.
You have all my sympathy. Nell.