PoA: Care home v live-in care

[jstmcm]

My brother and I disagree about how to provide 24 hour care for our mother, and I am hoping someone here can clarify how the Powers That Be see things.

Mum now needs 24 hour care. My brother and I both live a long way away from her and each other (him Devon, me Surrey, Mum Bath). Brother and I agree that we would both prefer her to move to a lovely care home which I have found near me, and she has agreed, reluctantly, to a one month trial. However, Mum says repeatedly that she doesn't want to leave her home, where she has lived for 52 years, and she has reluctantly accepted that if she doesn't move to the care home then she must have live-in carers in her house. We are in the process of finding live-in care and will again organise a trial period.

As I said, brother and I both agree that we would prefer Mum to be in the care home near me. Where we differ is that I feel that while Mum is able to express a preference, we should respect that. She is currently stating very loud and clear that she wants to stay in her home, and ultimately I want her to be as happy as possible given the circumstances, so if after trying both options Mum still says she wants to stay at home with live-in care, then I will support that. My brother says that since we have power of attorney we can force her to do whatever we want, and since we want her to go into the care home then she has to go there no matter she wants. He doesn't understand why she should have any say, given that we have PoA.

The question of mental capacity is not easy. Mum doesn't understand most things you say to her, but one of the few things she does understand is the question of moving out of her house forever. I would like to know where we stand legally, but for me it isn't so much about the legal situation as what will be the least worst option from Mum's point of view, so would also be very grateful to hear from other people who have had similar problems with different views amongst the family.

Many thanks
J

 

[Bod]

There comes a time when the best thing has to be done.
You are lucky that your brother agrees with you, as to how mother should be looked after.
Your mother will never agree to a permant Care Home place, no matter how good and careing. They never do, and when your time comes you won't either!

Grit your teeth, smile and do the "temporary" move. All Care Homes know how to handle these moves, take their advice on a settling in period.

Many folk have been in your position, myself included, so know how you feel, and what you are faced with.
Its hard, but has to be done.

Good luck
Bod

 

[jaymor]

See how the temporary care goes. Your Mum may settle and your problem will be sorted.

If she does not then try the own home and care within the home. Again if it works then great but if it does not then you, your brother and hopefully your Mum will agree that the care home is the way to go. You can at least rest easy that you tried to do it the way your Mum wanted and it did not work, we just don't know until we try.

Jay

 

[jenniferpa]

I agree with the idea of the trial period - it's great that you have the opportunity to do that.

Having said that, I feel I should point out that your brother isn't entirely correct. While having a welfare LPA does put you in a stronger position with regard to designating where she would live, it does not automatically give you and he the right to ride roughshod (not that you would, but you know what I mean) over her wishes. The whole ethos of the Medical Capacity Act 2005 is that the donor should be consulted as much as possible.

You might want to have a look at this fact sheet about deprivation of liberty http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=1327

This is the procedure that would have to be used if you both wanted your mother in a specific care situation and she disagreed.

 

[pippop1]

We had to use deception ("we are going out for tea") to get my MIL to go into a care home. Once there we said that there was decorating to be done in her home and the Dr said she was not allowed to sleep with the smell of paint in the air and we'd let her know when it was OK to go back. We just kept repeating this story fora few weeks (and told everyone else to say the same story) and she eventually settled.

Now she thinks she's in a day centre.She never would have agreed to go into a care home because she doesn't think she has any memory problems, just a bad hip.

Fortunately, she says how marvellous it is there and how wonderful that it's all free (in truth just under £1000 per week, self-funding). She's happy and what a relief it was not to hear the phone ring with a carer telling us what else had gone wrong or needed sorting out.

 

[jstmcm]

Thanks for the replies, especially Jenniferpa - your reply and that fact sheet gave me exactly the information I needed. Riding roughshod over Mum's wishes is exactly what my brother wants to do, whereas I don't want to and didn't think we could even if I did want to. I am glad to have that confirmed. He thinks that because we have PoA, he can do what suits him best no matter how wrong it is for Mum.

I do very much hope we can persuade Mum to stay in the care home, but knowing how adamant she is at the moment, and how she was when she had a one week trial in the care home last year, I am not optimistic. She said then that the care home staff were lovely, the food was wonderful and the rooms were very nice, but she was still absolutely adamant that she was going home and was never going to live anywhere but her home. One day she won't know where she is, and at that point we will move her into the CH, but while she knows where she is and what she wants, I am not going to try to force her to be miserable every day when she could be happy at home.

J

 

[Forestridge]

We had a disagreement . Brother was abroad and hadn't seen her for 5 years, I was tipping close to the edge with her at home as she wouldn't tolerate daily Carer, things deteriorated and I felt she was a risk to herself . SW involved, Psychiatrist did capacity assessment, said did not hab it. No LPA.

We agreed to stick to Best Interests decision. Before it happened, Mum fell so went into a home. All along she said she wanted live in care. I couldn't see how it could work when she wasn't compliant with one care visit a day.

Best interests meets kept being cancelled. Relationship between myself and Brother non existent, he accused me of financial abuse to SS. He wanted to take her home but was warned by SS thy woukd take him to COP if he tried. Eventually he got zinder dn't Capacity Assessor and she went home with live in care.

I wasn't involved at this point. Most people would have given up sooner than my Brother, he managed all his fom abroad, he was determined tk make it work as it was Mum's wishes. One left after 4 days, Mum shoved her. She woukd lock them out of the house, was difficult, wouldn't let them in living room or conservatory, they couldn't sleep and I was awful.

She stopped taking meds and deteriorated and after 6 differen carers (all refused to come back) sh had to go back into care. Unfortunately a CH has now become a place o escape from and she is always trying ways to be difficult and go to another.

She refuses to have her legs bandaged so is caught herself damage with her cellulitis. current NH can't cope so no option but for her to go to Dementia Home this week. Her parting words to me on Sunday were to forget I have a Mother. The sad thing is she was startin to settle at first place until Brother said he'd get her out but once he said that her attitude to accepting care changed .

We have healed our rift and now work together and had a sad conversation about the use of sedation the other day. Not sure what you will take from this but wanted to tell our story in case there is anything that helps. On the flip side live in care working well for my FIL in Spain but he is much more compliant.

 

[Oystie]

I can't add to the legal information already provided but can give my experience of live in -v- residential care. We tried live in with Mum, with a carefully selected very reputable agency that has won awards for dementia care - but after only 2 weeks we had to ask them to remove the carer. She was awful! didn't seem to have a clue, hadn't the slightest understanding of dementia, didn't do anything we could see to help Mum and worst of all Mum was very unhappy with her around. We're now in the process of trying to get money back from the agency and Mum will be moving into a care home shortly (not looking forward to it but there's no other option now).

Mum is very similar to yours in that the one consistent wish she's expressed is that she's never going to live in a home, which is why we went down the live in route. But she was so unhappy, what she really means is she wants to live on her own at home - and it's just not possible for her to be safe doing this. We are lucky to be local and so could see what effect the live in care was having on Mum and step in quickly. As you're a long way away you won't be in this position so, if you do go down this option, are there neighbours or friends near by who could regularly check on how your Mum's getting on?

It's a very difficult time for you and I do hope you find a solution soon.