Partners nan has mixed dementia and the adult social care from council were rude

[mattdragon2]

My partners nan has been diagnosed with mixed dementia.

• She lives by herself at 84 and has full time care (3 visits a day 15mins-30mins each visit) in a house, bathroom upstairs.
• She has 1 dog and 2 cats, we have found she hasn't been feeding or filling up their water and the dog has started getting very possesive of her and growling at the carers and eating her nans food off her plate. The dog is the size of a dalmation for reference. She has a dog walker to walk the dog.
• Due to her dementia she has hurt herself in the shower and caught sepsis and never told anyone and she went to hospital. This is what triggered us to get her tested and realising she doesn't even remember what she has eaten for breakfast by 6pm on the same day.
• A few months later she then went outside to take the bins out fell over and couldn't get back up, she had her mobile and had a pendant alarm which she never pressed. We were lucky that someone found her.
• She then fell again during the night and was on the floor all night also with the pendant alarm and mobile phone on her. The carer found her in the morning and she went to hospital.
• She has since fallen over two other times inside the house (the carers refuse to pick her up, so we have to come do it), due to this we moved her bed downstairs.
• She then went into hospital due to dehydration and malnourishment as she wasn't feeding herself and she tells the carers about what drinks she has had and food even though she hasn't and has been seen to go for a day without drinking.
• She also has low blood pressure which causes her to fall more often.
• My partner now has power of attourney along her with mum.
• My partner has setup two cameras in the house to check up on her she is rehoming the animals because her nan doesn't feed or provide water to the dogs.
• Her nans dementia is pretty bad that she doesn't remember anything she has done activity wise, food, water etc after 5-6 hours later.

We had a chat with the council and going through a financial assessment based on her current needs and income - she hardly has any savings but owns her own house.

My parnter just had a second chat with the adult social care run by the local council visit to discuss about putting her into a home, the reason being is that she keeps falling and many close calls and the doctor who diagnosed her with mixed dementia also stated she should go into a care home because it's unsafe for her to be climbing the stairs. The carers can't go behind her in case she falls, so it's almost tempting fate.

I wasn't present but the social worker was very rude to my partner, here some of the things they said:

• She was accusing my partner from denying my nan from a shower - she still goes upstairs with a carer but it's the fact she keeps falling and we are concerned about her falling downstairs due to her low blood pressure.
• Insisting we don't get rid of the dog even though the dog has started growling at the carers and stealing food from her nan.
• Saying my partner was being controlling and the cameras are illegal if my nan doesn't know about them - she does know about them, but the cameras are there for her safety so that she can be checked when the carers aren't there.
• She accused my parnter from questioning her nan - this social care worker appears to know nothing about her nan as this is the first visit.
• There is a type of medication to slow down the dementia she has, but the doctors refuse to give it to her while she is home alone and the social worker belittled the drug and said she doesn't even need it, are they even qualified to say that?
• The social worker doesn't want to put her into a home and she would only go into a care home if she has another accident and the hospital refuses to send her home.
• The social workers excuse for her nan not going into a home was because she isn't wandering the streets and not wetting herself and doesn't require rolling at night.
• The social worker has now scheduled another visit with the manager present next week because my partner disagreed with everything she said.

I will be present this time as it feels like they will gang up on my parnter when she only wants the best for her nan and the social workers are not helping the situation and bery very argumentitive.

Any advice would be appreciated on what we do or say in the upcoming meeting. Are the council being unreasonable or are we? It feels like we have to wait until she falls over and hurt herself again rather than preventing this happening in the first place.

The doctors have said my partner has done everything possible and recommends her nan go into a care home but it seems the council have the final say.

 

[Sarasa]

Welcome to Dementia Talking Point @mattdragon2, I'm sorry your concerns for your partner's nan and the difficulties with the social worker have brought you here.
Social workers are in a bit of a cleft stick at the moment as funds are so limited they try to keep people at home as long as possible. They also look to the least restrictive option. Was anyone else there when the social worker visited your partner's nan. People with dementia can often go into what round here is called hostess mode and the social worker may well have though your partner's nan was more capable than she actually is. I'd send the social worker's manager a bullet point list of all the incidents that have occurred and the doctor's opinion about a care home being a more suitable place. This will mean that she is more aware of what is actually going on when she visits next week.
This is a very friendly and supportive place and I'm sure others will be along soon with their suggestions.

 

[try again]

It sounds as though a care home is the safest place for her now. If the sw disagrees then unfortunately you may have to wait until she falls and goes back into hospital
If she has fallen, let the carers do what they should do and phone for an ambulance

If you keep helping yourself then this will only mask the problems,
I speak from experience with my mother.
Once she is in hospital demand a full discharge plan that doesn't rely on you and speak to the social services at the hospital who should be linked to the discharge team

 

[Jessbow]

One sentence- she has her own house- you dont need social services involvement at all - she'll be self funding, so just get looking at residential places and get the house sold to free up her money.
Enter into a defered fee arrangement with the home until her house is sold ( = they agree to wait for the fees, in return you'll have to pay a small ammount of interest after about 12 weeks have passed)

 

[mattdragon2]

Thank you for all your kind replies and information.

It feels like something bad has to happen before she gets some real help.
We will try writing down a list of points to the manager, maybe see if we can get it in writing on their decision in case they ever deny it.

 

[SherwoodSue]

As Mattdragon says, if she owns her own home it isn’t up to social services.

 

[dq79]

Hi, is the power of attorney for health and welfare or just for finances, is the LPA registered with the Office of the Public Guardian? I.e. who is the decision maker under the Mental Capacity Act, has an assessment of your partner's nan's mental capacity been undertaken by the person who has decision-making authority in respect of her welfare? has that decision-maker followed all the necessary steps set out in the Mental Capacity Act as to making decisions on behalf of someone who may lack capacity to make a particular decision e.g. whether to consider a care home at this point? There's a lot of questions there I realise but may be along the lines of where social care are coming from. It may not be quite as straightforward to place her privately particularly if social care are not on board with this at present. It sounds a contentious situation, I hope your family and social care can work together x Sorry there's a PS iin my edit - you mentioned doctors don't want to give the medication whilst she is at home alone - it might be worth following this up with the clinical team who don't want to give the medication as to the ins and outs of why this can't be given at home. Whether that may help or hinder your partner's family I'm unsure but may be worth querying as to any support from community mental health services is being provided and if medication cannot be given safely at home, they can discuss that with social care for a way forward wherever that may be. x

 

[mattdragon2]

The power of attorney is for both health and finances. The decision is split between my partner and her mum.
My partner took her nan to a memory clinic where she was officialy diagnosed with mixed demntia.

She has fallen 4 times in the past 4 months, this is simply by walking from the living room to the kitchen. She hasn't injurred herself but she doesn't tell anyone and she can't get up herself, so she spent two nights on the floor.
We are affraid of her going upstairs and falling and no-one is around to call for an ambulance and we want to preserver her mental state by allowing her to have the medication.

The medication can't be given to her at home because she has low blood pressure and the medication would increase the risk of falls even more.

The problem we have is we considered selling the house to put her in a care home, but the social worker said that under their current assement she doesn't qualify for the funds, so when her funds run out from selling her house, they won't fund her care home, so does that leave her homeless? My partner will be asking this question on Monday.

I understand funds are low and she might not be able to have funds for a care home, but we don't want her to get into a care home, run out of fees and then have no-where left to go.

I'm also annoyed the social worker was rude, she spent a max of 1 hour at my partners nans and deemed her to be in good health when she was unaware my parnters nan had mixed dementia.

 

[Jessbow]

With her current situation, no they wont fund a care home - her house would hve to be sold to pay for the care home. When her funds are gone, then they re-evaluatethe situation.

How often does she have carers? How come she spent two nights on the floor? How do you know what caused thse falls?

There are medications- but with low blood pressure, shes not a suitable candidate. She wont be in a care home either if low blood pressureis the reson for not giving it

You can be in good health AND have dementia- I expect Nan was in hostess mode.

SS do not even need to be involved at this stage

 

[mattdragon2]

She is in full time care at home - 3 visits a day.
She spent the night on the floor two times. We found out because the carer came in the morning to see her on the floor. An ambulance had to be called. She was in the hallway on the floor. Either she fell asleep and woke up and then fell or fell before getting to bed, but we don't know because she doesn't remember.

The doctor said she can have the medication as long as she is in a care home because their are no stairs to fall down and there is always someone on call.

The social worker basically said if we sell her house and she is in the same state as she is in now when those funds run out, they won't give her any funding.

She can't manage or maintain her nutrition, she has been in hospital due to dehydration and malnousirhment because she think's she has already eaten and drank.
The carers aren't helping because they ask her if she has eaten or drank but her nan always says she has.
She can't wash herself, last time she did she fell in bathroom, so we now have a carer to do that.
My partner believes going upstairs is too dangerous as she has low blood pressure increasing her likely hood of falling and the past experiences of falling.

Our options seems to be:
* Stay in the house, wait til she falls down the stairs and seriously injur herself.
* Sell her house to go into care home, her funds run out and carer won't fund the care home leaving her homeless?
* We sell the house and buy a bungalow and continue with full time care 3 times a day - Though I don't think she could get the medication and she is still at risk of falling in the night and being left there until the morning.

Are there any other options, cause they all seem terrible.

 

[sdmhred]

SS won’t leave her homeless. She is a vulnerable adult and they can’t do that. The SW is obviously trying to deter u from ever needing their funding, but sadly that is part of their job these days.

My Advice would be to sell the house if the family think it’s time. By the time the funds have run out she is likely to have deteriorated and the home she is in will provide evidence that she needs the 24/7 care. SS may well move her to a cheaper home - they won’t kick her out on the streets.

it’s terrible families are put in such a position these days 😢😢

 

[SeaSwallow]

@mattdragon2 @sdmhred has given you good advice. It really does sound as if your partner's nan needs to be in a care home, She is not safe to be left on her own. Three visits a day are not enough to keep her safe.

 

[mattdragon2]

My partner and her mum went to meet with the social workers.
Instead of selling the house, it was suggested either her nan goes to a care home place to get showered and then comes back home or have a wet room installed downstairs in the house.

However, the main focus the social workers kept suggesting was a stair lift, even though her doctor and memory clinic said she is a high fall risk with mixed dementia, meaning she could fall at the top of the stairs or get stuck and forget how to use the machine or just stand off while it's moving. My partner said no, but the social workers don't care about their opinions and are sending in an occupational therapist, who will have the final say - I don't see how they can overrule my partner and doctors advice?


The other issue was my partner has one camera setup to check on her nan to check if she has fallen over as she is a high fall risk and my parnter lives an hours drive away. The social workers where trying to entrap my partner by claiming it could be classed as controlling behaviour and asking questions such as what would my partner do if her nan left the house, would she call the police etc. So they have said they want to do a test called MCA (mental capacity assessment), if she fails that, then they will perform an acid test (deprivation of liberty). I don't understand why this needs to be done, isn't having cameras on the house to check on her well being a good thing? Are the council using this against my partner to not use cameras?

She has a pendant alarm which has fall detection, however when she fell and couldn't get back up, it didn't go off, even after a carer tested it worked, so I guess you have to fall at a certain speed for it to trigger.

Their suggestion was sensors but with 2 cats, cleaners, dog walker, carers and a dog that doesn't tell her if her nan has fallen.

How does my partner prepare for this, I can't tell if the social workers are helping or being a hinderance because she doesn't want her nan to use the stairs and possibly try to claim my parter is being controlling?

​

 

[Jessbow]

Again, a DOLS ( Deprivation Of Liberty Safeguarding order) at home is almost pointless- never heard it called an Acid test.

Why do you think the are trying to entrap your partner? to what end?

What stops you selling her house and putting her in a home? why do you need SS permission?