Mental Capacity Assessment

[SusanSh]

My Dad was admitted to hospital over two weeks ago, with sepsis, which has now cleared up. But all the time he’s been in hospital he’s eaten possibly the equivalent of 3 small pots of rice pudding. Has just about consumed enough fluids. Is no longer mobile. Is refusing to wash and or have his pad changed. All of this he was engaging in before he went into hospital with the help of carers at home. It’s been recommended he goes home with a POC 4 x day.
This is my question. Yesterday I was told by the nurse he was going to be referred for a MCA (mental capacity assessment). Which they did and I was told last night he was deemed unable to make his own choices. So now his option is a care home. Today my dad has said he wants to go home. The discharge team have jumped on this and say if this is what he wants they are going to organise it. When I questioned his MCA outcome from yesterday. I was told ‘we’ll do another one tomorrow while you’re here’. Can they keep doing MCA’s to suit a purpose or in this situation according whether my dad is having a good day or bad day??? I’m in this on my own, feel all the ‘systems’ in place to help and support are against me and the hospital is taking advantage of the situation.

 

[Louise7]

Hello @SusanSh and welcome, this is a friendly and supportive place where people understand. Sorry to hear about your dad, he seems quite poorly. Unfortunately infections such as sepsis can cause a bad downturn in dementia. Was the local authority involved in and paying towards your dad's carers before his hospital admission? If so, then it is usual for them to want to try a package of 4 care visits a day before considering a care home. However as your dad is due to be discharged from hospital it's possible that a short term care home stay of up to 6 weeks might be considered, so that he can be properly assessed to see what type of care is best for him, as sometimes people can improvement outside of the hospital environment. This is called the 'discharge to assess' process.

Do you or anyone else have Health & Welfare power of attorney (LPA) for your dad? If so they should be involved in the decision making process, which will consider what is in your dad's best interests when he is discharged. What do you want to happen to your dad? Mental capacity can fluctuate, but from experience of when my mum was in hospital, funding can play a part in the decision making process, unless your dad is able to self-fund his own care? The NHS would fund a 'discharge to assess' temporary care home placement and the local authority would fund a four care visits a day package. I think the best thing for you to do is to ask to speak to someone in the hospital social work team, or you could also contact the hospital Patient Liaison Service (PALS) for help and advice. The link below might be helpful too as it explains how the discharge process should work. Hope this helps.

What happens when a person with dementia is discharged from hospital?

How and when a person with dementia is discharged from hospital will depend on their circumstances. Some people with dementia will not be well enough to leave hospital and will need end of life care.

www.alzheimers.org.uk

 

[SusanSh]

Hello @Louise7
Thank you for your reply. My dad had a POC x2 day before he went into hospital. Which was part funded by the local authority. Even they didn’t notice he was getting ill. I have LPA but not for health, I was advised not to, now I wish I had applied.
I was told today even though i’m POA and NOK, this didn’t kick in until he had been assessed by an MCA, which is what had happened Tuesday and I’d been given the results of. I’m incredibly flustrated, as the hospital seem to be changing the rules to suit my dads current state of mind. I will make a request to see some one from PAL’s. I’ve screen shot the information regarding discharge process/ to assess. Hopefully if they think I might know the protocol they will stop trying to pull the wool. Fingers crossed. Thank you again for your support.