mental capacity

[iggypop37]

very difficult one this. My father has moderate vascular dementia, gets confused and has been picked up by the police wandering around in his pyjamas in town,he has also slapped his wife (my mother) and has proposed marriage to his daughter recently amongst many other incidents.

My mother who is 82 and not in the best of health is absolutely totally exhausted with him, and we have managed to get him into a good residential EMI home for 2 weeks respite care with the idea that it hopefully becomes a permanent arrangement.

We are now concerned that he will pass an upcoming mental capacity test as some times he can appear very lucid. a characteristic of vascular dementia.

if this happens and the CH discharge him my mother (who is his carer) has said that she will walk out and will not have him home. Her health is on the verge of going into rapid decline because of this.

we really seem to be between a rock and a hard place now. I cant see either of them entertaining the idea of live-in carers. Us children visit at weekends but cant be there the whole time.

surely any assessmsnt needs to take into account my mother's poor state of health . she has suffered with nerves and depression for years.

 

[Dave K]

We are now concerned that he will pass an upcoming mental capacity test as some times he can appear very lucid. a characteristic of vascular dementia.

Maybe you could catch your Dad's antics via video (Phone app)

I say this as my OH can turn on / off her reasoning depending on who she is talking too.

Anyone but an official she is bombastic, unreasonable etc. but to an official she tries her hardest to be the perfect example of someone that is being wronged

The memory clinic doctors are not stupid but if in my OH case if she can hold out for the 15 minutes and contradict me in front of the doc then maybe a video to show unreasonable behaviour may help in your case

I have thought of doing this myself but could not (threatened to do so) do this to my OH, sort of betrayal in my eyes but I wish I had the courage to do so

 

[iggypop37]

i think you need peoples consent to video them .

 

[Dave K]

I do not believe so if you have serious concerns regarding their mental health and only use it to asses their mental capacity and/or health to a professional to prove or show your case

Yes you would if you wanted to put it on YouTube or share it in non related media for the sole purpose of getting a buck or two or to humiliate the person

But I may be wrong...

 

[BeckyJan]

I think you should in writing your concerns for your Mother and make sure those concerned have a copy. Would you Mother's GP also support you in making it clear that she is not fit enough now to care?

 

[Lindy50]

Hi iggypop

This is a horrible situation to be in, I agree

I am not clear from your post whether your father has already been assessed by adult social services? If so, I agree with BeckyJan, put your concerns in writing to the social worker. Your mother's condition certainly should be taken into account in their assessment.

Also make sure that your father's GP has a copy of this information, also any specialists who are involved. The CH won't be able to keep your father against his will unless they are given the authority to do so through these assessments, so it is essential to give those involved the information.

Good luck

Lindy xx

 

[FifiMo]

By way of trying to reassure you, it is not just a capacity test that is a deciding factor. The care home will have been observing your dad throughout his time there and whilst someone with dementia can put on a superhuman effort when a doctor etc is around, it is too difficult for them to maintain that for a long period of time, say, a week or 2 weeks. Even if he is judged to have capacity to make his own decisions, if they consider that he is in need of full time care due to other aspects of the dementia, then they can apply for a DoLs (Deprivation of Liberty (Safeguarding)) order from the courts. This would give the care home the authority to retain him there and if he managed for some reason to get out, they would have authority to return him to the home. This is the very reason that this is available so that someone cannot claim they have been held against their will when they are considered to have the mental capacity to decide where they live, but other behaviours or aspects of the dementia make him unsafe to be on his own and unsafe towards others.

It would be well worth sitting down with your mum and making a note of all the issues that she has had to deal with and why she feels she can no longer act as his carer. You can give a copy to the home and ask them to make sure that the person doing the capacity test has access to it. In addition, either go with your mum to her GP or send a copy to them also, and if necessary remind them that they have a duty of care towards her too and for her to be able to live in her home and feel safe. If your mum or your dad have a social worker then it would be useful for them to have a copy of the note too.

Ultimately, the decision about whether your mum can cope with him at home again rests with her. Please ensure you speak to her about how she is feeling and encourage her to stick to her guns. Of course there will be pressure put to bear on her to relent and very often the person caves in under this pressure. She therefore needs to know that everyone is supporting her and will back her up.

In all of this, your dad is an innocent party. He is someone who is suffering from a disease and what he needs is the proper attention to deal with the issues which he is struggling with. There is nothing to say, for example, that will proper medication that he might cope fine and your mum would feel comfortable with him being at home again. It is so sad when a couple end up with all these dilemmas after living together for so many years. I hope you find a solution that is the best for both of them.

Fiona

 

[Dave K]

Again, many apologies if I have spoken out of turn.

They way I work is that you can either fill in reams of paperwork sending them to various departments for help or you can simply show a real time video of your concerns

Maybe I am not cut out to deal with this other than my own way as the way I think a picture speaks a thousands words but a video can speak a million+ words

I will keep my nose out of this topic as my ideas seem to be in the minority here

I wish you all the best iggypop37

 

[JayGun]

I don't think it can be against the law to film people without their consent because so many people do it. You can't film anybody in a public place without getting loads of other people in the background can you? The roving reporter on the news doesn't get consent from people walking past, and the artist at the concert doesn't get consent from the crowd to appear in his tour DVD.

We filmed MIL, well, we took a film of the ceiling and captured the sound of her asking the same question over and over again and getting very shouty and difficult apropos of nothing because she's losing her vocabulary, and I planned to film her standing in the supermarket completely unable to make a decision about anything, the referring to the scraps of paper all the time, plus all the other situations in which she was having problems.

(When we saw the consultant she diagnosed MIL with only mild cognitive impairment and told us to come back in a year because the dementia "wasn't affecting her daily life" even though MIL scored 19/30 on the MMSE and obviously had no short term memory since she asked repetitive questions in front of her, and was extremely agitated and paranoid - so we thought we'd better start accumulating evidence that IT WAS, but luckily the consultant had a change of heart and put MIL on Aricept.)

 

[ASH74]

My relative similarly would "keep it together" in front of memory clinic docs.....it was like watching a different person! I found the best way to approach this was to bring (casually) into the discussion one of his trigger/obsession subjects (driving ATM) and he would revert to his normal day to day behaviour (confrontational, aggressive, lack of self awareness etc).


Sent from my iPad using Talking Point

 

[FifiMo]

Dave,

Your suggestions are not wrong at all and many of us have resorted to photographs or video's on our phones as a means of providing information. Like has been said, this is not a case of taking video's and publishing them online - this is merely to provide evidence that someone requires proper care and attention and I for one, have never had anyone complain about it as a method. We are, after all, working in the person's best interests aren't we?

Fiona

 

[Witzend]

If the worst comes to the worst and he passes the capacity test, and they want to send him home, could you take your mum to stay with you or another relative for a while? And tell SS categorically that your mum CANNOT cope any more and there will be nobody there to look after him. Besides that, I would make sure he has no house keys, so nobody can take him home anyway.

Sorry, I know this sounds a bit drastic and I do hope it won't come to that, but sometimes it would seem to be a case of needs must.

 

[FifiMo]

The idea of the keys is a good one as on one occasion the hospital sent my mother home in a taxi - with no support - no food in the house - just her slippers on her feet and no coat! Next time she was in hospital we made sure she had no keys and no money to speak of with her! They daren't have tried that trick again!

Fiona

 

[Linbrusco]

How exactly is someone assesed as not having mental capacity to make decisions?
We are about to see Mums GP for this, so that we can register our POA.

If it was a decision concerning what she wanted for dessert, not a problem
If it was a major decision concerning her health, Mum would look to me or my sister for our say so... Unless it was something very simple like do you want one paracetamol or two.
If it was a decision concerning money she has already proven that she has no capacity to think things through by giving my brother her credit card and PIN no. Who promptly spent way more than Mum "thought" she said he could spend.
When she got the bill for it she didn't even realise the fact, or that he wasn't even paying it on time.

Anything she did decide on would be forgotten either within minutes or given time.

 

[JayGun]

How exactly is someone assesed as not having mental capacity to make decisions?
We are about to see Mums GP for this, so that we can register our POA.

If it was a decision concerning what she wanted for dessert, not a problem
If it was a major decision concerning her health, Mum would look to me or my sister for our say so... Unless it was something very simple like do you want one paracetamol or two.
If it was a decision concerning money she has already proven that she has no capacity to think things through by giving my brother her credit card and PIN no. Who promptly spent way more than Mum "thought" she said he could spend.
When she got the bill for it she didn't even realise the fact, or that he wasn't even paying it on time.

Anything she did decide on would be forgotten either within minutes or given time.

When we went to the doctor regarding the POA, the GP had a good chat with MIL and was happy in that moment that she understood the need to have somebody set up who could make decisions for her in the event that she was unable, and that was that.

 

[Witzend]

The idea of the keys is a good one as on one occasion the hospital sent my mother home in a taxi - with no support - no food in the house - just her slippers on her feet and no coat! Next time she was in hospital we made sure she had no keys and no money to speak of with her! They daren't have tried that trick again!

Fiona

Heavens, I would have gone absolutely ballistic!

 

[whitehorse]

When we went to the doctor regarding the POA, the GP had a good chat with MIL and was happy in that moment that she understood the need to have somebody set up who could make decisions for her in the event that she was unable, and that was that.

you were lucky then! My Mum's GP decided that she did NOT have capacity so I proceeded with COP. Several weeks later the same GP decided that she DID have capacity with the result that I cannot get either POA or COP. After 8 months, there is still no decision and I am in despair. I am being chased for care home fees, I cannot manage bank accounts etc. She saw a CPN a month ago but refused to take any memory test, and then walked out of the room! The GP says that this is 'not an NHS affair' and will not agree to another assessment. Complete nightmare.

 

[Grandma Joan]

Hi Iggy how are things going ? I notice you haven't been on here for a while (nor have I)

Your post reminded me of our situation last year with my Dad. We had a SS assessment who suggested respite care for my Dad to give Mum a break. We should have had an NHS assessment of his needs but his condition went downhill so fast we were in a whirl and no one was giving us good advice at the time. So he was self funding and respite turned into permanent EMI care.

Hope you are okay and things have settle down for you.