Mum does not want to go into care home but no alternative ?

Tammer

Registered User
Dec 15, 2019
20
0
Hi, I have a problem and hope that you can help. It is very stressful and difficult for my mum, and for me and my brother. A potted history is:

  • We are in Scotland.
  • My mum has suspected parkinsons and has been, apart from 3 days, in hospital since September 2019 when she was admitted with an infection and was intermittently incoherent and falling over.
  • Mum was briefly allowed home with care support but starting falling over immediately and it had to be abandoned.
  • I have POA for welfare and finance - drafted in 2015.
We have got to the stage where the hospital aren't treating my mum and so she needs to leave hospital. At the moment there is nowhere for her to go. She can not go home as it would not be safe. She cannot live with her children as they have partners and children and work full time. The only viable route seems to be a nursing home as she is incontinent, has memory problems, and can now only walk with a zimmer.

My mum thinks it is the year 2000 but is adamant she does not want to go into a care home (possibly understandably). The doctors' say that she does not have capacity to decide where she should go on leaving hospital. The social worker has raised the issue of "deprivation of liberty" and says that the POA does not allow us to put mum in a care home against her will. Social work say that guardianship will be needed. I have raised this with a solicitor and they think that this is unnecessary and also expensive and time consuming, as it doesn't change anything or help anyone (I am summarising somewhat).

I feel like major decisions are resting on me and am feeling the pressure. I think the hospital and social work will also have key roles here? I am considering saying that I will not seek guardianship. I do not know what the implications of this will be and am worried.

There are also contextual issues of hospitals needing beds and care homes not taking on any new residents, and courts not sitting, due to SARS-COV-2.

What do you think will ultimately happen if I refuse to progress guardianship?

Thanks in advance
Tammer
 

Batsue

Registered User
Nov 4, 2014
4,893
0
Scotland
@Tammer
If you hold POA for Health & Welfare and your mum is judged to not have capacity then you can make the decision on her behalf, you do not need Guardianship if you hold POA.
 

Sarasa

Volunteer Host
Apr 13, 2018
7,195
0
Nottinghamshire
Hi @Tammer, do you have both the LPA for finance and health and welfare, I had both and moved mum to a care home but subterfuge last year. If I had asked her she would have refused, but she wasn't safe at home any more so it was the only solution. The home organised the Deprivation of Liberty Safeguarding order shortly after she arrived. I was worried as at the time mum did have some capacity and would have certainly said she wanted to go home. However the social worker felt she had lost capacity and though she asked if I had the H&W LPA but didn't ask to see.
I think the Social Worker has got it wrong and you don't need Guardianship, and as far as I understand it is rarely granted for H&W anyway. I'm sure someone with more knowledge will be along soon to clarify, but in the meantime if your mum would be self funding you could see if any homes would take her, though I think that will be pretty tricky. In the meantime what does the social worker want or expect to happen?
 

Shedrech

Registered User
Dec 15, 2012
12,649
0
UK
Hello @Tammer
A warm welcome from me too

A good idea to contact AlzScot

In England (I believe the system is not quite the same) as I understand it the LPA for health and welfare becomes effective when the donor no longer has capacity so the Attorney acts for the donor
If the donor is saying they do not want to move into residential care a 'best interest' meeting can be held and decisions made on behalf of the person
From what you describe, it isn't safe for your mum to return home even with a hefty care package so probably the decision would be residential care... however, sometimes Social Services insist on trying at home first to see if it might work... From what you say, this has already been tried so you should be in a good position to push for residential care
 

Tammer

Registered User
Dec 15, 2019
20
0
Thanks for the replies.

Social work say that more recent poa include wording that addresses the deprivation of liberty issue but that mine does not.

I think social work expect me to get guardianship then arrange for mum to go into a care home. I will push back on the guardianship and see what happens.
 

Weasell

Registered User
Oct 21, 2019
1,778
0
A long long time ago I did some capacity testing.
I am very very out of date and have not kept up recent changes in legislation so what I have to say may have little value.
At the time capacity was not all or nothing. You could have areas of weakness where you didn’t have capacity and areas where you did.
Example. I want to cook my own food.
so the capacity test would contain questions like ’ if you undercook chicken and eat it what do you think will happen’.
’ Do you think sausages should be kept in the fridge’
But if you failed the test for cooking your own food it didn’t necessarily mean you couldn’t do other things , example control your own money. You may do that very well?
So as suggested above , the key would be to call a multi disciplinary meeting. Let the hospital decide she has no capacity, if that is no good get a capacity tester in to test capacity around where she will be living. ( If that is still what can happen?)
it doesn’t matter how old your POA is if she has no capacity, it counts.
 
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Tammer

Registered User
Dec 15, 2019
20
0
Hi,
The hospital are now in the position of needing to discharge my mum as there is some pressure on available beds with the COVID 19 cases that are in the hospital. She cannot go home and needs to go into a nursing home, rather than a care home. The plan is that she may go into a care / nursing home temporarily until her ultimate nursing home can be arranged.
There is a lot of discussion in the news about COVID 19 infections in Care Homes and numbers of deaths in the homes in Scotland and the wider UK. I am terrified that putting my mum in a care home just now is really dangerous. What realistically can I do though? I am really at breaking point now.
 

canary

Registered User
Feb 25, 2014
25,018
0
South coast
(((((((((((((((((((((((((((((hugs)))))))))))))))))))))) @Tammer

I hear your worry, but there isnt anything that you can do. Even if you brought her home there is still the risk of coronavirous then too. Yes, there are people who die in care homes, but there are even more who die who were living in their own home when the virus struck. We all live on tenterhooks. A Nursing home will know how to care for her, though and hopefully, she wont get it.
 

Tammer

Registered User
Dec 15, 2019
20
0
Hi,
The Social worker has provided a list of care homes with vacancies and a list of care homes in the area generally.

The lists have useful information in them such as whether they currently have a covid 19 infection or a suspected one.

The hospital has said that a care home has offered my mum a temporary place as they are understandably keen to get the bed back that my mum is occupying in hospital..

I checked the social worker's spreadsheet and the place has covid 19 infections/ suspected infections. I am not keen for her to go there as I feel it would effectively be a death sentence.

I never thought I would be having to make life or death decisions. I will try to find an alternative care home asap.

Is this situation what I should expect?
 

Palerider

Registered User
Aug 9, 2015
4,160
0
56
North West
Hi @Tammer

Just read your thread. I just want to reassure you these decisions are not life and death ones. Your mum is at risk staying in the hospital, as this is where the really unwell Covid-19 patients are, so its important to get her placed in a better environment than a hospital, which also isn't the best place for meeting the rest of her needs.

Placing a loved parent in a care home is difficult at the best of times let alone in the current situation with coronavirus. But what you have to remember is that wherever she goes there will be a risk of contracting Covid-19, but that is the same risk for all of us, with social distancing and the interventions care homes are taking that risk has been reduced. Contracting Covid-19 and becoming unwell with it are two very seprate things, so don't confuse severity of illness of Covid-19 with the risk of getting it.

My mums wing in her EMI unit has had five Covid-19 positive residents (sadly three of these have died since) and mum is a wanderer, she has remained symptom free despite having residents with it that she has been in close proximity. It is worrying, but equally there is no way I could provide alternative care for her as she is now, the risks of other harm are equally problematic.
 

Sarasa

Volunteer Host
Apr 13, 2018
7,195
0
Nottinghamshire
Hi @Tammer , you must feel between a rock and a hard place at the moment as no option is going to be ideal during this current crisis. I agree with @Palerider that a nursing/care home is the least worst option. The fact that there the home willing to take your mother should mean they feel confident that they have enough safeguards in place to look care for your mother, otherwise I assume they’d have refused to take her. Even if you find a Covid free home that will take her there is no guarantee it will remain that way.
Hospital is not a good place for someone at present unless they need to be there, and from what you’ve said going home isn’t an option so I’d take the offer of the care home and look on it as a chance for you mum to have some rehabilitation. Later you can review it and see if anywhere else would be better.
My mother’s home also has cases of Covid 19. I know several residents are in hospital and others are being treated in the home. So far my mother, also a wanderer, seems to be OK.
 

Sasco

New member
Apr 22, 2020
2
0
I understand how you feel. We do have P.o.A. Over my mums health and monies but it doesn't make it any easier. She refuses to go in a home and l feel l can't push her. I'm not well and am trying to get into my own sheltered home that l have waited 5 years for but she keeps crying when l say l need to go where l am helped. I think it's going to come to a head when something seriously happens to me and she won't be able to cope. She can't do anything now at all even though she says she could without me. She can't even stand without her zimmer so l have no idea what she thinks will happen. I haven't slept for 3 days as she won't stop talking. Repeating the same things over and over again. And with this Virus, l can't go home and return incase l pass anything to her, so l am having no break from her nuttiness.
It's so hard, l know but l am glad l gave found this forum. Even if it's just to moan and run off the mouth. Thanks Sasco X
 

Weasell

Registered User
Oct 21, 2019
1,778
0
My observation from reading a lot of posts is the truth is not always helpful.
previous examples include ‘ you have to go into care while the boiler is fixed.’
‘I am having a small operation and require three weeks to recover’.
They then use a technique called ‘ kicking the can along the road’ where other disasters prevent the person returning home.
you may not like the idea but the people who posted these are some of the most loving individuals you could ask for!
It also seems to cause the least pain for the person with dementia, who often then can’t remember they ever lived anywhere else.
 

Shedrech

Registered User
Dec 15, 2012
12,649
0
UK
hi @Sasco
a warm welcome to DTP

you need a break ... it's understood that family care visits are necessary so it's acceptable for you to go back to your home and visit your mum each day

the risks are for you to weigh up ... and that includes risks to your health and welfare

I hope Social Services and her GP are aware of your mum's situation ... your own move is very important and you must go ahead ... it may indeed be the catalyst to cause a best interest meeting, which you can request, and a decision for your mum to move to residential care ... your mum will never grasp that her care needs are such that this move is necessary so trying to talk her into it won't succeed ... I'm afraid using 'love lies' is the kindest way forward in her best intetests
 

Tammer

Registered User
Dec 15, 2019
20
0
Thanks to everyone who has replied. I can see that others have some very difficult circumstances too. I cannot imagine what it is like for others and I can only do what I think is right in my own circumstances. I phoned the care home that the hospital are proposing for my mum and they were helpful but weren't willing to give any information at all on their COVID cases. The home looked otherwise nice but this did not fill me with confidence.

The POA requires me to make decisions to benefit my mum. I cannot place her in a care home where she is immediately exposed to COVID 19, compared to putting her in a care home with no symptoms or deaths. I have told the social worker and hospital this and will try to find one with a vacancy as soon as possible.