Hi, Just wanted some advice. My mum is an advanced complex (multiple) dementia sufferer in her 80s. She has severe cognition and communication problems (but can speak), she can't mobilise without injury and needs hoisting by 2 carers with specialist equipment. She had hip replacement in July and cant walk, so mobilises by dragging herself on bottom. She is doubly incontinent with stomach pain. She has poor skin integrity , her weight has dropped to BMI 17. She has mental health problems - is paranoid, suffers from hallucinations and delirium. She doesn't sleep, and she is non compliant with care, can be verbally abusive and hits carers sometimes. She also says she wants to die. I think she was like this in January but she was CHC assessed as having no intensity of care need, so went into a normal nursing home with EMI but fell 5 times in a month and was punched by another resident as she is challenging. She also dragged herself around until she had no skin on her bottom or feet. We were so worried we took her home with two live in EMI qualified carers but that was not enough for her needs. A district nurse had visited her at home and said she could be fast tracked but then that came to nothing, although is in her notes. She's currently in an EMI home and is their most severe patient and they have her segregated and doped up on diazepam to help her sleep (otherwise is awake 23 hours), with constant 1:1 care (one hour shifts as she is so hard to be with) but has still fallen twice. It costs £3000 a week. I have logged a formal complaint about underassessment of care needs resulting in her injury, and am awaiting feedback. They have agreed begrudgingly to do a new assessment but I'm worried it will not be OK, as I don't think her needs have changed since Jan. Does anyone have any advice on what to do to persuade there is intensity of care need? Is lack of awareness of risk a factor under behaviour as well as cognition? Sorry, bit of a stressed ramble.