Yes, I think that's true. They don't have enough background information to ask the right questions!You are so right @Violet Jane there's good reason from what we have learned about this case to think that mental capacity has not been properly assessed according to law. Assessment of capacity involves testing understanding of relevant information. Hospital staff may not have much understanding themselves of the domestic circumstances of the patient, making it difficult for them to carry out the assessment at all.
Mental capacity is always a nightmare, but the problem is how else can someones ability to make appropriate choices be assessed?Yes, I think that's true. They don't have enough background information to ask the right questions!
It's all very well asking if he wants to go home. (Though in my opinion that's the most pointless, useless, unhelpful thing they could possibly ask!) If they ask him, 'What if you go home and you fall, how will your wife be able to get you up? How will she manage by herself if it takes two nurses to move you now? will he be able to give a sensible answer?
And the biggest question, which will never, ever be asked: 'Don't you think you're being unreasonable and unfair on your wife?'
I completely understand that no one wants a situation where old people get bundled off to care homes on the whim of an uncaring relative. But there are already enough safeguarding measures in place to prevent that. This business of 'does he or does he not have capacity?' needs a complete overhaul.
I suggest that the benefits of getting a solicitor involved are likely to be that more senior hospital management will focus attention on the case if they are threatened with legal action of any sort. In this case it seems as if @yorkie46 has been talking to quite junior people such as ward sisters etc. If they think there is a whiff of a medical negligence case they will pay attention. In a dispute like this the Court of Protection is the only body that could definitively resolve the conflict as to where the patient should reside. That would take time especially as there is a dispute about whether he has capacity or not. But the involvement of a lawyer might get the NHS Trust to get to grips with this properly.I think it would be a good idea to phone the support line too. Im unsure how effective contacting a solicitor is and how it will change anything quickly enough. Hopefully the people on the support line will be able to advise you.
I think the capacity issue does matter. If he really does have capacity he is entitled to decide for himself what to do. His decision may be unreasonable unfair and senseless but it will be his decision.And so the saga goes on! This morning I phoned the ward to enquire how my husband was and to try to speak to the sister to clarify what is happening on Monday. I wanted to know if she was expecting us to speak to him or is there to be a multidisciplinary meeting. It was a different sister on today who told , guess what,......he's been moved again!!!AND STILL NOBODY TOLD ME. She gave me the number for the new ward. Spoke to a nurse who was looking after him. Apparently he was moved because he needed a side room close to the nurses station so they could keep a closer eye on him! This as a result of the falls. I asked if she knew what they were expecting to happen on Monday. She said the discharge plan is to continue, he is to come home with carers. She asked if I'm happy with that!! I filled her in about the situation and said I'm not happy about it but that doesn't appear to matter. She told me it's recorded that my daughter and I will go to talk to him about his discharge and our concerns about him coming home. She said there would be a multidisciplinary discharge meeting but no indication of when. She will document our conversation and ask the nurse in charge on Monday morning to contact me. I then asked her questions which I thought of during the night. I'm not sure why this didn't dawn on me before. Can he walk at all? No. Can he support his own weight? No, he needs to use special equipment. So he's only moving bed to chair, chair to bed? Yes. So if he comes home he will be confined to one room? Yes. Nobody has actually been clear about this before. In fact the discharge officer actually told me he could get himself to the toilet!! This throws an entirely different light on things. I don't believe his bedroom will be big enough for the equipment and furniture he will need. The therapist who was supposed to phone me today didn't. When I do actually speak to one I'm going to tell them it's vital that someone visits me to look at the space available and layout. Why do I have to think of these things? I was in contact with one of the dementia nurses last week, in fact she was the people who told me I should refuse to do anything for him if he comes home. I don't think she actually saw him. The dementia nurse who knows him will be back from leave on Monday, I've left her an email and text message to ask her to see him and whether she can attend the meeting. I've written down what I want to say to him on Monday, fingers crossed I'll be able to do it. Ive pretty much decided now that it really isn't worth persuing the capacity issue. Whatever I say they will keep telling me it's been done properly and he has capacity. I now feel that's almost irrelevant and his physical problems are the more pressing issue. Log in tomorrow for the next unbelievable installment!!!
I totally get it. My dad is at home and moves from bed to chair and back again with the help of carers and equipment. Dad has a very small bedroom ( he has a hospital bed) and I and the cleaner had to move the chest of drawers to enable the carer to get the other side.. Dad has “ capacity “ and will not move out of a small bedroom to the dining room to enable the bed to be moved. The other room is twice as big. I have got the OT coming again to reassess him with his equipment ( Sara Stedy and stand aid) carers are saying he is unsafe. If he still refuses the stand aid then he won’t be moving anywhere. He will stay in the bed. His decision.With “ capacity and unwise decisions then he will have to accept them. You need to get the OT to come to your home to assess it. They cannot just send him home. Also you can refuse to do any caring. The GP and Social Services have duty of care. But always seem to rely on family. I hope things improve.( hugs)And so the saga goes on! This morning I phoned the ward to enquire how my husband was and to try to speak to the sister to clarify what is happening on Monday. I wanted to know if she was expecting us to speak to him or is there to be a multidisciplinary meeting. It was a different sister on today who told , guess what,......he's been moved again!!!AND STILL NOBODY TOLD ME. She gave me the number for the new ward. Spoke to a nurse who was looking after him. Apparently he was moved because he needed a side room close to the nurses station so they could keep a closer eye on him! This as a result of the falls. I asked if she knew what they were expecting to happen on Monday. She said the discharge plan is to continue, he is to come home with carers. She asked if I'm happy with that!! I filled her in about the situation and said I'm not happy about it but that doesn't appear to matter. She told me it's recorded that my daughter and I will go to talk to him about his discharge and our concerns about him coming home. She said there would be a multidisciplinary discharge meeting but no indication of when. She will document our conversation and ask the nurse in charge on Monday morning to contact me. I then asked her questions which I thought of during the night. I'm not sure why this didn't dawn on me before. Can he walk at all? No. Can he support his own weight? No, he needs to use special equipment. So he's only moving bed to chair, chair to bed? Yes. So if he comes home he will be confined to one room? Yes. Nobody has actually been clear about this before. In fact the discharge officer actually told me he could get himself to the toilet!! This throws an entirely different light on things. I don't believe his bedroom will be big enough for the equipment and furniture he will need. The therapist who was supposed to phone me today didn't. When I do actually speak to one I'm going to tell them it's vital that someone visits me to look at the space available and layout. Why do I have to think of these things? I was in contact with one of the dementia nurses last week, in fact she was the people who told me I should refuse to do anything for him if he comes home. I don't think she actually saw him. The dementia nurse who knows him will be back from leave on Monday, I've left her an email and text message to ask her to see him and whether she can attend the meeting. I've written down what I want to say to him on Monday, fingers crossed I'll be able to do it. Ive pretty much decided now that it really isn't worth persuing the capacity issue. Whatever I say they will keep telling me it's been done properly and he has capacity. I now feel that's almost irrelevant and his physical problems are the more pressing issue. Log in tomorrow for the next unbelievable installment!!!
So true. Good luck?Phoned hospital this afternoon and spoke to male nurse in charge. Felt he actually listened and had the information I needed. Seems my husband has been confused today, asking about his mother (not me). Wonder if he's confusing her for me?! Told nurse this is one of his usual confusions and told him about others. He confirmed he's expecting my daughter and I to talk to my husband tomorrow, he's also going to arrange for us to talk to a doctor. He asked who his consultant is in the community, he's never had one! He's going to speak to dementia nurse and therapist tomorrow. Said it looks like OT is planning to visit me to assess home situation. Asked if I have any equipment, No. I'm going to make a list of questions for the doctor. Not expecting to be able to change my husband's mind about coming home but I have to at least explain what will happen if he does.
I thought that tooI really do question how much capacity to make informed decisions your husband has. If he is asking for his mother the home he wishes to return to may well be his childhood one.