I don't know if it really is in her best interest

[AG78]

I am new on here. My Grandma has Alzheimers. She is amazing for her age (early 90s) and lives alone. I am the most local relative she has and I see her only once a week to have a nice meal and chat together. I also constantly think about her and contact professionals as and when required and generally look out for her. She has no official power of atourney etc.

I am in a dilemma. She cannot manage safely at home because she has no insight what so ever into her inability to remember medication, meals, drinks etc. We have tried carers for the past 2 weeks as she was discharged home from hospital with a care package against her wishes after a mental capacity assessment deemed she could not make that decision herself. She has not engaged at all well, and the lack of insight and unwillingness to engage has resulted in agitation and unusual behaviours such as pushing people etc.

Her wishes are definitely to remain at home, but it is difficult to see how that can really work when she cannot and will not engage with carers (we don't call them that for obvious reasons!).

My Dad, having been ad hoc at best with his involvement (mainly financial) has turned up, and I understand has organised an urgent psychiatric social work assessment for tomorrow morning in his hope to admit her to a care home so he can return home hundreds of miles away. He has said the urgency is due to her having no care (family are not able to care permenantly and because she won't see the need for carers he feels this is not an option either).

I am worried to death as I am afraid his agenda is an easy life for him as opposed to a well thought out plan which keeps her wishes central. She does not have an allocated Social Worker as she has been self funding and my Dad has excluded me from discussions with duty Social Workers at this stage.

I did ring a Social Worker yesterday to convey my need to be involved and the fact that I would say I am her key person in terms of stability and reliability. I suggested a meeting and an allocated Social Worker but it seems he has said otherwise and I have not heard anything back.

Can anyone please advise me? Many Thanks.

 

[min88cat]

Hi there, unfortunately I don't think you will be able to have much, if any input as to what happens, as your Dad is next of kin.

If you read your second paragraph, you would appear to be agreeing with her being unsafe at home, in which case a CH would seem to be the only option.

 

[AlsoConfused]

It's very difficult when you're not even confident you know what would be best for your Grandma, however you think you'll feel awful if she gets pushed into a CH for reasons other than her "best interests".

How about if you take time now to work your way through your Grandma's options and come to a view on what she'd want for herself if she could say, what the risks and benefits of each option are for her and so on? You'll probably become more clear in your own mind what the issues are as you write this document.

You can contact the duty Social Workers yourself, explain your role in your Grandma's life and say you want whoever is to organise your Grandma's "best interests" meeting to read your document beforehand. Ask for the name and contact details of the person who is to chair the "best interests" meeting (you'll want to be sure they've actually read the document and have the opportunity to ask you any relevant questions).

You can ask that your document be treated as confidential to Social Services if your Dad would get sniffy about this initiative.

 

[Butter]

This is so difficult for you and for your grandma and for your dad too.

I think you should continue to spend time with her as you always have done. Continue to meet with and talk to all the agencies, as you have done. Maybe you can let your dad be the 'bad guy'? The one who pushes for full care. And then you can go on visiting and having your times together as you always have done?

I wish you luck and courage - she is lucky you are there. I hope you find this website as helpful as I have done.

 

[2jays]

My thoughts

I don't think your dad is looking for the easy way. I think he is being practical. A lot of Men can do that, see the problem and sort out the practicalities, without letting their emotions get in the way.

Moving Gran to a care home is, in my opinion, the best decision for her.

It is also the best decision for all of Grans family.

The overwhelming exhaustion of caring for someone with this disease can, and does, grind you down so low. Added to the mix is the guilt... Guilt can only survive because it eats away at your emotions.

It could been seen as its moving her too early. It could also be seen that its the right time as she has some capacity to be able to settle into the care home and have some quality of life, safe, fed, medicated, and has company 24/7

Just my thoughts

 

[Delphie]

When someone has no insight and refuses to engage with carers and continually turns down help, and they're clearly not managing on their own, well, options soon start becoming quite limited.

I supported my mum's 'independence' in such circumstances for a very long time. To be honest, it was exhausting because everything had to be done behind her back as any whiff of support would send her into a rage.

I couldn't stop her from self-neglecting so I could have played the waiting game until a crisis resulted in her being sectioned, or the self-neglect became the trigger, or I could find a good care home while, as 2jays says, she had the capacity to form relationships with staff and get some enjoyment from the facilities.

If I look at the situation objectively, her independence was made up of being cold (wouldn't put the heating on or allow it to be put on), eating rotting food, being scared of imagined people in her house, being vulnerable to opportunists who could harm her/take advantage, being lonely, increasingly getting lost, being smelly, wearing dirty clothes and so on.

At the care home, she's restricted as far as going out into the big world but all the other things are now taken care of. She's safe, warm, clean, medicated and full of nice food. She has company and activities such as singing which she adores.

She wants to travel but then she wanted to travel when she was back at home, and it wasn't going to happen then either.

So all in all, residential care can be the right step. Think hard AG about what the gains and losses might be in your gran's case.

 

[AG78]

Thank you for all of the advice. Things have taken a side step as my Grandma is now in hospital where I am pleased to see she will have a thorough assessment for discharge.