Mental Capacity issues? Any advice ?

Discussion in 'ARCHIVE FORUM: Support discussions' started by stardust123, May 1, 2008.

  1. stardust123

    stardust123 Registered User

    Apr 11, 2008
    Long story but basically my Dad has got 'mild/moderate' dementia and is in hospital. He's 80. They say in the hospital that he has 'mental capacity' and he says that he wants to go home so the OT's have suggested that he comes home with carers coming in 3 times a day. Have visited him tonight, doesn't know where he is, forgets what he's talking about mid sentence, didn't know where his bed was, wandered off down the corridor in the wrong direction, admitted to himself that he felt 'lost'. My Mom is in respite at the moment but will probably come home. She is in poor health and also suffers from depression and anxiety and we believe may also have the start of AD. After having seen Dad tonight, my and my sister have decided that we have to push for a care home due to the fact that we feel that my Mom can't cope with him at home and we feel that he wouldn't cope with carers coming in 3 times a day (adjusting to new routines etc). Lots of other issues too, see my previous thread 'New Member needs help!' Tonight he said he didn't want to come home, cos there's nobody for him to talk to/company etc. Then later on, he said he just wants to get home ??? I suggested care homes and he didn't totally dismiss the idea.

    My question is, how the hell can they say that My Dad is mentally capable after I have seen him in the condition that he is in tonight. OK, he might have been having a bad day but there are going to be a lot of bad days! Also, do you feel that we could push for care in light of the circumstances with Mom and also that Dad is so bad (his short term memory is really bad, can't remember something that I told him 5 minutes earlier).

    Thanks all, this forum has been a godsend to me.
  2. lesmisralbles

    lesmisralbles Account Closed

    Nov 23, 2007
    Hi, stardust123

    I cannot offer advice on this subject. But other's will come along I am sure.
    I feel for you.
    My hubby has problem's. And I have had LOT'S of help and advice.
  3. Deeessex

    Deeessex Registered User

    Jul 16, 2007
    You certainly have the right to push for what you feel is in your dads best interests. Independent advice regards Mental Capacity and your fathers ability to consent or not can be sought. Although I am not familiar with your area there are independent Mental Capacity assessors who will often intervene especially if there is a difference of opinion.One of their roles is especially to do with when people move I am sure. I am sure your local social services would be able to point you in the right direction. Nevertheless if you feel your dad is at risk you can still push for the support you think is right to maintain his safety. Its awful and heartbreaking when time for such major changes happen and I am sure these decisions are not taken lightly. Heres hoping you can get some help .
    Best Wishes Dee x
  4. helen.tomlinson

    helen.tomlinson Registered User

    Mar 27, 2008
    Hello Stardust123

    The OT's have suggested the above but presumably that is only a suggestion. I don't have experience what happens when a care/nursing home is needed but I would imagine that a thorough assessment of your father's care needs and the carer's needs would be done. If your mother is to be the main carer then she would certainly need an assessment because she is not well herself. If these assessments are done then it would be a good idea for you to be present to share your concerns.

    Hoping all goes well for you all.

    Love Helen
  5. stardust123

    stardust123 Registered User

    Apr 11, 2008

    Thanks for responses all. Forgot to mention earlier that the OT made the recommendation that he comes home with a carer 3 times a day, despite knowing that there may not be a 'carer' at home at all because at the time, we weren't sure that my Mom would be at home !!!! Does anyone else think this is acceptable ?? I cannot believe this. Even though Mom may well be at home, she is in no fit state to be classed as anyone's carer. I understand the need for the mental capacity act, but it's not just a case of scoring so many points on a test, so therefore, you must be okay. Going to see the Dr and the Discharge Nurse tomorrow, so am going to make them fully aware of the situation. I cannot put my Mom through trying to cope with Dad as she is so unwell and for Dad's own safety too, I feel I have to insist on care. Going to look on net now for independent mental capacity assessors.

    Thanks all
  6. Helena

    Helena Registered User

    May 24, 2006
    Does your Father actually have Vascular Dementia rather than Alzheimers because the severe swings in ability and awareness in VD are acute and in their Good periods they will say they are OK yet within minutes or hourse they have absolutely no clue whats going on or where they are
  7. stardust123

    stardust123 Registered User

    Apr 11, 2008

    I don't know whether he has got vascular dementia, no one has said! He did have a CT scan last week, so perhaps this would tell us, am seeing Dr this morning so will check. Awake again at 5.30 a.m. this morning after getting to sleep at 1.15 and waking up again with my little boy twice in the night. Hope I can stay awake. Would the fact that he has got VD if he has it have any impact on the mental capacity issue? Thanks
  8. AnnS

    AnnS Registered User

    Apr 26, 2008
    Risk Assessments are the answer

    Sorry to hear you are having such a difficult time. Just been through a similar situation with my mum who has Vascular Dementia and Alzheimers. She lived alone was getting confused about times, not washing regularly, not eating properly couldn't take her meds and was a wanderer. Had the carers coming in 3 times a day but she wouldn't stay in so that didn't work. I cracked up about the situation as I was pretty much told I had to wait for a "crisis" to occur to move things forward. Also mum somehow always managed to find her way home which was taken as a "she's managing" indicator. Everything seemed to pivot aroung the social workers risk assessment - did mum staying at home present an acceptal level of risk? I basically just listed everything that was goning wrong and started sending e-mail reports to the social worker. It took about 4 months but they finally agreed in Feb this year that the risk was too high and that nursing care was appropriate. So my experience is show the risk is too high by listing all the things the sufferer is not coping with and all the problems they experience. If the social worker can't present a mitigation that adequately reduces the risks then that tips the scales in your favour.

    Hope this is of some help!
  9. Helena

    Helena Registered User

    May 24, 2006
    "have to wait for a crisis"

    Yup thats the stock phrase of Doctors/GPs and Social services

    They are incapable of diagnosing or understanding the state of so many Vascular Dementia patients

    Funny how my Sister and I and the Paramedics diagnosed her with mini strokes 5 years before the stupid GPs or the Hospitals did

    By which time she had collapsed alone at home and lay there out of it for 3 days stark naked and got pneumonia .......they pulled her through that only to give her C Diff
    Although in a way C Diff was a kindness because it relieved her and us of the miserable state she was in and would have violently objected to being kept in
  10. hendy

    hendy Registered User

    Feb 20, 2008
    West Yorkshire
    #10 hendy, May 2, 2008
    Last edited: May 2, 2008
    Dear Stardust
    I am sorry you are so worried, not only about dad, but about mum also. That is a very big burden. Please do not let hospital rush you into making a decision. I am sorry that I am going to sound so bossy(I have a very jaundiced view of occ th's) The fact is that you dont know what kind of dementia Dads got, so why are occupational therapy 'pushing' a care package that may not be suitable for dads circumstances. You must stick to your guns, you know dad and mum better than they. You should be given appropriate time to consider all the facts, given the crcumstances with mum, this is not straight forward. You also need more information about your dads needs and diagnosis. Stand your ground, if Dad is in moderate stages of dementia, he will be able to have some say. Things become more clear cut when the stages are advanced. But you are the main carer. If there is a diagnosis of dementia, then mental capacity is not in question. I remember the early days when Dad was diagnosed, it is very scary and you cannot make decisons until you have been able to get the full picture from the medics(not the occupational therapists!)If in doubt, speak to the consultant. They will aslo be able to advise you of capacity issues with out needing to go to a third party.
    I hope things become more settled soon.
    take care
  11. Margarita

    Margarita Registered User

    Feb 17, 2006
    #11 Margarita, May 2, 2008
    Last edited: May 2, 2008

    I have just had the social worker around telling me that he has to do a mental capacity test , to find out if my mother can make a decision

    So I ask him what question do you need to ask my mother to know if she can make a decision .

    He say that he has to find out if

    1 . If she knows her surrounding .

    2 What date is it today .

    3 what country is she in

    4 what date was it yesterday .

    Now I can not understand how they can come up with the conclusion, that my mother can make a decision or not from answering those question.

    as to me that sounds like the memory test they do , but SW said that whay he has to ask

    Do you have a social worker , because if so call them ask them to do the test on your father .

    I get the impression with this new act that come out it does not matter what type of dementia they have . If they can pass those question about what they have to ask the person , Then person can make they own decision to live at home or not

    so like someone said above get back up from doctors, but if they pass those question doctor letter going to be of no help .

    because of this New Law .
  12. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    I ask my husband if he wants tea or coffee. He says he will have whatever I`m having.

    I ask my husband what he wants to eat. He says he`ll have whatever I`m having.

    I ask my husband what time he wants to eat. He says he`ll eat when I eat.

    I ask him if there`s anything he would like to watch on the television. He says he`ll watch what I watch.

    I ask him if he`d like to listen to a CD. He says he will if I want to.

    Decisions, decisions, decisions.
  13. Margarita

    Margarita Registered User

    Feb 17, 2006
    #13 Margarita, May 2, 2008
    Last edited: May 2, 2008
    So if you ask him those question what would he say ?

    SW said he won't ask mum direct question he put it in a conversation so do it around about way working up to it so that won't distress her put her on the spot , thinking that its a wrong or right answer. If you get my point .
  14. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    Does he know his surroundings?
    He knows he is in Broadstairs, but when we see the consultant at the hospital in Margate, he doesn`t know where he is.
    If he was in Mnchester he would know.

    What date is it?
    He would look at the paper. But if it was yesterday`s paper he would still say the printed date.

    What counry is he in?
    He would say the UK.

    What date was it yesterday?
    He would count back as long as he remembered today`s date. But it could be yesterday`s or the day before.
  15. Tender Face

    Tender Face Account Closed

    Mar 14, 2006
    NW England
    Stardust, so sorry your going through this - and AnnS your reply has helped me enormously (left me with even more moral dilemmas!!!) And I think risk assessment is just that - a question of our ideas .... yes, we might be guided by the wisdom of medics ... necessarily at times ..... but looking at it from my own point of view just now - mum has been admitted to a NH (more physical than AD problems although of course there has been a knock on effect) ... and I just want to get her home .... no, there won't be 24/7 care even if I get a barrage of support 'calling in' .... - but sadly neither is there where she is .... (OK - more than I can usually provide but it's not exactly 1:1 intensive care) ....and I would even rather risk her dying in her own home (as I know she wishes) than in a place which is alien to her .... best I can do is make her environment as safe as I can (but fortunately so far she has never been a 'wanderer' and that has always been my 'milestone' for a rethink) - most other things I believe can be 'risk managed' and perhaps even that?

    I think we have to remember that anyone (vulnerable or otherwise, young, old, able etc ) could have an accident in our own homes .... (there speaketh my own wise GP!) ...

    It is very hard to get the right perspective on indepedence versus risk?

    Sorry, probably no earthly use at all .... Karen, x

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