Needs assessment and Capacity Assessment - any advice?

[JayGun]

They're coming to do a needs assessment and a capacity assessment at MIL's this week, have you been through this? Is there anything I need to do? (Or not do?)

I'm a bit anxious that something I say might make life worse for MIL. I've told them that I can't talk about her in front of her because she can't remember things so she doesn't know any of this stuff. As far as she's concerned she can still do everything she used to. How much do you tell them? Chapter and verse - or do you dial it down a bit? At her worst mother in law is completely unmanageable, a frequent danger to herself and sometimes a concern with others too. (She bares her teeth, lunges, grabs, claws, barges and shoves.) We (and Memantine) mostly manage to keep her calm nowadays though. And the barging and shoving is not so much aggression directed at people as the most efficient way of getting from A to B is by removing the obstacles, even when said obstacles are a baby buggy and an old fella with two sticks

Can anybody take me through what happens?

 

[AndreaP]

Well I live in Australia but the system is probably much the same here as these things seem to be standardised these days.

We sat at a table with mum to my right and the assessor to her right so the assessor could see mum and me but mum couldn't see me.

They asked her lot of questions about what she was doing for herself which mum answered truthfully and untruthfully. When she said something true I would nod at the assessor and gave a quick shake of the head or a meaningful look when she was misrepresenting the situation. She was also asked to count backwards in 7s, spell a word backwards and draw a clock face and put in a specific time. She was asked to write a sentence about anything but she was unable to grasp the concept.

She was asked if she saw things that might not be there which she denied. I then mentioned the man who comes nightly and taps on her window. Mum immediately confirmed this and I explained that we had set up a camera but hadn't been successful in catching him. The assessor read between the lines and ticked "yes" to that question.

I made sure the assessor got an accurate picture without mum feeling I was dominating the session. Most of it was knowing looks and winks to get the information across without humiliating mum.

When she'd gone mum asked what that was all about. I said the doctor sent her to make sure mum was coping at home okay. She seemed to accept that.

 

[Shedrech]

AndreaP has given you a good précis, JayGun.
I too used to sit out of dad's eyeline but so I could be seen by any consultant etc. without them having to turn their head - so it wasn't obvious they were looking at me.

You might prepare a written account beforehand to give to them (with a covering excuse for your mum's ears).

And definitely tell it like it is! Do not hold back - her needs on the worst day must be assessed or how could they be supported - and they need to have an accurate idea of her capacity. They're not trying to trick her or you.

 

[cragmaid]

Always give a worse day scenario when you want help...a good day might happen once in a while, but the help is needed for all eventualities.
I always gave a written report to cover the changes in Mum, and to explain how much I was doing to keep things on an even keel. I also always sat out of Mum's eyeline.
As far as a financial assessment goes... if you can produce this year's Pension Statement, bank statements or passbooks showing current balances and any ( if there are any) details of any private pensions, mortgages etc it will help things to go smoother....but remember as far as savings and incomes are concerned only ones in Mum's name solely count.

 

[Spamar]

And don't forget that a managed need, ie by medication, is still a need. So tell it like it us without the medication. Worse case scenario as I think someone has already said!

 

[JLSW]

With regards to the social care needs assessment, try to provide a description of what life is like for your mum as if she had no support in place whatsoever and how this affects her well-being, i.e. the impact on her independence, physical, mental and emotional health. This is at the heart of the assessment.

The support she is assessed as eligible to have will be based on this information - there are no right or wrong answers, so be as honest as you can be and arrange to speak to the assessor in private if necessary (or you could email or speak to them over the phone at a different time). A skilled assessor will be able to realise what insight your mum has into her needs very quickly and judge how truthful what she is telling them is.

Here are some of the areas of the social care needs assessment that should be covered:
Health; medication; mobility; personal care; nutrition; home environment; keeping safe; cognition and capacity; finances; social interaction; family life.

Also, ask for a carers assessment as well; this should detail the impact of the caring role on the carer's well-being.

Good luck
JLSW

 

[tryingmybest]

Mum lives with me and had to have a capacity assessment last week as requested by the judge for a contentious court of protection case. The assessment took half an hour or so but I was not allowed to be in the room with mum which upset us both. Every meeting be it social workers, occupational health worker, psychiatrists has been held with just them and Mum and I've had to make myself scarce. It really annoys me as its my home and all mum wants is for me to sit with her and hold her hand for reassurance. ☹

 

[Amy in the US]

Jay, I'm sorry, I've not been through this and am in the States in any case, so cannot give you first hand experience. However, I'm sure others here have and will.

When I attend any kind of appointment with my mother, who has dementia, I always sit next to her, but a little farther back, so I am out of her direct line of sight (her peripheral vision is bad). By using a very slight shake of the head and facial expressions, I can "cue" the doctor/nurse/staff person/whomever, that my mother's answer is not correct or is off base. I find that they are usually pretty savvy and pick up on my body language, no problem, and I don't have to say anything in front of my mother, which would be a disaster.

I like the idea of preparing a written letter/report in advance. I'd put it in a sealed envelope and if you must hand it to them in front of your MIL (with luck you can slip it to them unnoticed), then I'd just say something very casual like, here is the paperwork you requested, and then change the subject or offer everyone tea or something.

What you tell them is up to you, but I don't think you will do your MIL any favors if you don't tell them everything exactly the way it is. How can they accurately assess, and address, her needs, if they don't know what they are? Again, I'm not in the UK, but it sounds like many people have to fight pretty hard/wait some time for services so I would think that not giving them accurate information, might slow things down even more.

I'm not sure I understand what you mean when you say you are concerned about making life worse for her? Perhaps you are worried about making her sound like a bad person or something similar? The things that are happening, such as her aggressive behaviour, are not a reflection on her as a person, but rather the disease. Her safety and well-being are important, as are yours!