Please can you give emergency advice tonight?

Discussion in 'I care for a person with dementia' started by AG78, Feb 14, 2015.

  1. AG78

    AG78 Registered User

    Apr 11, 2011
    11
    Hi all,

    My Grandma is in her mid 90s and been in hospital for about 6 weeks.
    Previously living in a care home on a best interest decision as has dementia and was self neglecting at home.

    Doesn't have a power of attorney for care and welfare.
    Her NOK wants her in Scotland (200 miles away) with him so he can visit more but the rest of her family want her back in her local care home where she can keep all visitors and routines. This is in the town she has lived all of her life.

    Had discharge meeting Weds to debate NOK wanting her in Scotland and all others wanting her to stay local.
    The plan was for discharge back to care home, full social work and CPN assessment and a local authority panel to decide the type of care she requires. In this time span her capacity could be further assessed once in familiar surroundings, including the support of an Independent Mental Capacity Advocate (given that family opinions are opposing). Then the options to meet her needs could be further discussed in a best interest meeting.

    I have now read in her nursing notes that discharge is planned for Monday to Scotland. She says she doesn't want to go as she'd lose all contact with familiarity. Have played it down so as not to distress her.

    Duty Social Worker advises that authority decided later in the week that as there are no safeguarding issues her NOK can be "decision maker" and take her to Scotland. I wasn't updated.

    I referred for a SW assessment in September because her NOK was not managing the financial power of attorney appropriately - denying access to clothes and shopping etc; assessment has not yet been carried out.

    Please can anyone advise as I cannot believe that a best interest meeting will not be carried out to ensure the least restrictive decision is made in her best interest.

    Many Thanks in advance.:confused::confused:
     
  2. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,955
    In your shoes, I'd be talking immediately to the hospital, your Gran's consultant and the duty Social Worker to remind them of the results of the previous best interests meeting and say the plan must be reinstated and given a chance to work. Also talk to the Patient Liaison Service (PALS) at the hospital to ask for their help. Your grandmother can't be shipped off to Scotland simply because the Next of Kin would like more opportunities to visit her.

    Tell the consultant your grandmother has already been living in the care home and the plan was for her to return to what is her home, pending further review of what her care needs actually are. Your grandmother hasn't lost all her rights to personal autonomy just because she is now resident in the care home - her statements (witnessed by whom?) she doesn't want to go to Scotland should be respected, unless there's good reason not to (which there isn't in this case). No-one has power of attorney so the Next of Kin doesn't have authority to make the decisions for your grandmother.

    I suspect the Duty Social Worker and the Discharge Nurse have been badly briefed or have simply forgotten the details of the case.

    Good luck! Do kick up a stink!
     
  3. AG78

    AG78 Registered User

    Apr 11, 2011
    11
    Thank you AlsoConfused. I am waiting for the ward to ring me back. Seems PALS and Social Workers aren't working and transport is booked for 1st thing Monday. So worried.
     
  4. Ash148

    Ash148 Registered User

    Jan 1, 2014
    276
    Dublin, Ireland
    Dear AG I'm so sorry I can't help with advice as I live in Ireland and don't know the UK system but just wanted to send my best wishes and sympathies. I completely understand how worried you must feel.
     
  5. AG78

    AG78 Registered User

    Apr 11, 2011
    11
    Thanks Ash148. I am worried too because I don't understand the Scottish system.
     
  6. Feline

    Feline Registered User

    Oct 25, 2012
    164
    East Devon
    Transport can be cancelled, if things are not resolved yet, even if it is first thing,
    Best of luck
     
  7. AG78

    AG78 Registered User

    Apr 11, 2011
    11
    Morning all, if anyone has had any bright ideas please get in touch. Many Thanks.
     
  8. nitram

    nitram Registered User

    Apr 6, 2011
    19,021
    Male
    North Manchester
    You need to somehow or other stall the transfer to Scotland on Monday, you will then need expert legal advice.

    I would contact everybody involved arguing that the role of decision maker is not relevant until the person has been formally assessed as lacking capacity to make the decision. This may not be true but it could stop or delay the transfer.

    Have a read through
    http://www.bestinterests.org.uk/
    http://www.mind.org.uk/

    As your Grandma is not detained under the MHA the info, especially on Mind, will not be strictly relevant but you may gain some useful buzz words and phrases. Remember that most of the people you contact will not be fully versed in the minutia of the law.

    This post will also bump your thread.
     
  9. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,046
    Staffs
    If your Grandma still has capacity and she doesn't fancy going to Scotland then she just has to say "NO".
     
  10. AG78

    AG78 Registered User

    Apr 11, 2011
    11
    Hi thanks for the info. Trying desperately to delay discharge.
     
  11. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,955
    Probably the most important thing to do is to ensure family members aware of the best interests plan (determined to carry it out and polite but forceful) stay in attendance at the hospital early on Monday to stop the move going ahead. Speak to the Ward Sister and ask her to contact the Consultant and Hospital Manager as the proposed arrangement is illegal and must not happen in the way planned. Make it clear you'll speak to the hospital manager, your MP and the press if necessary.

    Would the Next of Kin be amenable to the argument he / she should back you in telling the hospital the move shouldn't happen until the best interests plan has been tried?

    Throwing as many spanners in the works to stop the move happening can be a good idea.

    Could you ring up the hospital switchboard and say you need to speak to whoever is organising the transport side for your grandmother, because you've got some information about her needs they must have? Try to avoid going into details and let them assume it's something to do with her travel sickness, need for loo stops etc. They'll probably pass you through without too much hassle.

    Then speak to the transport organiser pointing out the legal ramifications of the situation mean that if they take your grandmother before it's sorted, the ambulance will be stopped at some stage on the journey and they'll be told to bring her back to the hospital again.

    Transport hates this happening. Also in many cases transport can't reschedule the move very quickly (transport needed 48 hours notice to book a non-emergency ambulance in a specialist hospital I attended).

    Tell transport you're clearing up the situation with the consultant, hospital manager and hospital social worker and hope to have it sorted out by Monday afternoon - but it might take longer. At what hour had they planned to pick up your grandmother before you gave them the bad news? Ask what the procedure is about rebooking the transport should your grandmother be cleared to go (that gives you an idea of what "window" you've got to change things; also it suggests to them you're not being uncooperative, there is a real problem and you're their ally in sorting it out).

    Good luck. I find this situation gob-smacking.
     
  12. AG78

    AG78 Registered User

    Apr 11, 2011
    11
    Many thanks for the further useful information.

    I have spoken with the Ward Manager alongside my Grandma who was pointing out her view that this was absolutely against her wishes.

    The Ward Manager has instructed her staff not to book transport at this stage or authorise her discharge as I have advised I am applying to the Court of Protection in the morning for an urgent authorisation to challenge the discharge plan on the basis that it is not in her best interest.

    I think it is expensive - about £400 but I guess it may be the best £400 I'll ever spend whether I get the outcome I hope for or even if I can sleep at night knowing I tried.
     
  13. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,955
    Your grandmother is very lucky she has you to protect her interests and I'm so pleased your efforts are beginning to turn round this situation round. However, I'm appalled that you and your family have been put through this hassle (and expense)so unnecessarily. It should never have happened!:mad:

    If you or your grandmother do get involved in expense that you wouldn't normally have faced to protect her rights then please investigate the prospects for getting them reimbursed from the hospital. PALS should help here.

    Please keep us posted. Congrats on what you've achieved so far.
     
  14. Ash148

    Ash148 Registered User

    Jan 1, 2014
    276
    Dublin, Ireland
    Glad to hear you have some positive progress AG. Good luck tomorrow.
     
  15. wobbly

    wobbly Registered User

    Feb 14, 2012
    313
    Mid Wales
    hope it goes well today...thinking of you....:)
     

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