Who can actually make a formal diagnosis of Dementia?

[Pete R]

I have been reading this wonderful forum for a while picking up valuable information along the way. It is amazing how similar others experiences are to my own. A big Thanks to all those that have unknowingly helped so far.

I was doing well looking after my Mom but have now hit a brick wall in the shape of a Social Worker so need to ask a few questions.

Both myself and Mom have known for many years that something more than just being forgetful was going on. Mom refused to see the GP but was living a good life.

She is currently in hospital after a fall at home. Whilst there she fell again and banged her head. The floor was undamaged but a CT scan was ordered. She then burst a stomach ulcer and somehow survived.

The consultant who dealt with that saw the CT scan and said Mom had Vascular Dementia. She has been tested twice by the dementia team and they too say Vascular Dementia.

It has been agreed ( A mighty battle ) that Mom should get up to 6 weeks reablement care in a Nursing Home to see if it possible for her to ever come home. Excellent Nursing Home less than 20 yards from current hospital, Social Workers office and where the reablement team work from.

Not sure if "ward" is the correct term but the Home only have spaces on an EMI ward. They have assessed Mom as needing an EMI ward.

Social Worker is refusing to place Mom on an EMI ward and will only fund a General Nursing ward, as she does not have a formal diagnosis of Vascular Dementia. Social Worker also says that Mom cannot get a formal diagnosis whilst she is in Hospital. Social Worker cannot find an alternative Home.

Not sure if all that waffle was necessary but the original question stands who does make the formal decision? Or is there never one?

Also does anyone know the official guideline that determines if someone should be placed in a EMI ward?

Thanks




Just as an aside. With this experience of dealing with officialdom we all get used to using their jargon, abbreviations and acronyms. However I have found that Vascular Dementia never seems to get shortended. Strange

 

[Grannie G]

Hello Pete

It looks to me as if your mum has a formal diagnosis.

She has had a scan, the scan has been examined by the consultant and the consultant has declared she has vascular dementia. What more does the Social Worker need?

It does not have to be put in writing.

What on earth is this social worker talking about. They need to take note of the facts.

 

[BeckyJan]

Hello and welcome to Talking Point although sorry you need to be here.

The consultant who dealt with that saw the CT scan and said Mom had Vascular Dementia. She has been tested twice by the dementia team and they too say Vascular Dementia.

This seems to show that your Mother has got a definite diagnosis and the SW needs to be given written evidence of this. It seems that his/her decision is based on room availability and/or costing and somehow you need to get over this. I suggest you speak to the Consultant to see if he can help. Also locate PALS and get them involved. (This link explains about them:
http://www.nhs.uk/service-search/patient-advice-and-liaison-services-(pals)/locationsearch/363

If you have further problems it may also be worth you ringing the Society's helpline - details here:
http://forum.alzheimers.org.uk/faq.php?faq=resources#faq_resources_website

In my early days here on TP some used to write VD but myself I preferred VasD as an abbreviation

 

[jeany123]

Hello Pete and welcome to Talking Point, I would have thought hospital would be the very place you could get a formal diagnosis,

I would ask the SW how much more she would like than 3 doctors saying the same, it all seems strange to me, what on earth is she talking about,

I hope you get it sorted soon,

Best wishes to you and your mum,

Jeany

 

[di65]

So sorry to hear of your hassles - something we don't need along with all the other things that go with this terrible disease.
Have you told the doctors about this Social Worker ( sorry, but she doesn't sound either social or a worker to me )? They may be able to get through to her.

 

[nitram]

Before your Mom is discharged an agreed post discharge care plan should be in place.

This plan should define the level of care required which would presumable indicate a dementia placement.

Does such a plan exist?

 

[Pete R]

Thanks for the quick reply Grannie G but I must warn you about assuming common sense is ever applicable when dealing with officialdom.

I have been through Mom's medical records and Vascular Dementia is mentioned many, many times by various medical professionals.

This same SW told me originally that there was no reablement care funding available in our area of South Staffs and it was off to a Nursing Home for good for Mom.

It took 6 weeks of battle and the intervention of her managers Boss to get the reablement package agreed so I feel someone's nose (and budget) has been put out of place by that.

I have found that lots of research and knowing the correct law or guidance helps however I cannot find any EMI guidelines on the web.

 

[Pete R]

Thanks for the advice. Pals are already involved with other aspects of Mom's treatment.

I too think the main problem is funding.

In my early days here on TP some used to write VD but myself I preferred VasD as an abbreviation

Just had a school boy giggle which often helps me cope, although it does tend to annoy officials when everyone knows they have just said something stupid.

 

[Pete R]

Hello Pete and welcome to Talking Point, I would have thought hospital would be the very place you could get a formal diagnosis,

I would ask the SW how much more she would like than 3 doctors saying the same, it all seems strange to me, what on earth is she talking about,

I hope you get it sorted soon,

Best wishes to you and your mum,

Jeany

Thanks for all that.

It is nice to hear others agree that what is already diagnosed is enough.

The SW refuses to budge and she has purse.

 

[Grannie G]

The SW refuses to budge and she has purse.

Ask for another Social Worker. Put in a formal complaint to Adult Social Services to say this SW refuses to accept a medical diagnosis.

 

[Izzy]

I think you said the SW's boss had been involved before. Can you contact this person again?

 

[Pete R]

Again thanks for the kind words. After reading lots on here I consider myself very fortunate indeed that Mom is a "Happy Sufferer" and although no longer on the same planet as me she is, apart from a few brief moments of total understanding of her situation, quite content.

Have you told the doctors about this Social Worker ( sorry, but she doesn't sound either social or a worker to me )? They may be able to get through to her.

It is the weekend so only the hard working medical staff are around. Monday I will continue the struggle.

 

[Pete R]

Before your Mom is discharged an agreed post discharge care plan should be in place.

This plan should define the level of care required which would presumable indicate a dementia placement.

Does such a plan exist?

I think so

We had a Multi Disciplinary Meeting almost 2 weeks ago which was chaired by the SW's managers Boss.

He knew nothing about my Mom before anyone spoke. Everyone spoke including me of Mom's Dementia and that she needs 24hr Nursing care. He decided on the reablemnt package I had previously asked for but had been told does not exist.

I snapped his hand off as it is the last chance Mom will have of going home.

Everyone present agreed.

It sounded like a plan to me but it appears not enough of one.

 

[Pete R]

Ask for another Social Worker. Put in a formal complaint to Adult Social Services to say this SW refuses to accept a medical diagnosis.

I think you said the SW's boss had been involved before. Can you contact this person again?

Thanks

Both points are on my list for Monday.

However before I do anything I like to know the rules involved and am struggling to find EMI guidelines.

 

[Grannie G]

I don`t know if there are any rules for EMI.

I do know EMI units are secure.
I do know EMI units have a higher staff /resident ratio

 

[Pete R]

I don`t know if there are any rules for EMI.

I do know EMI units are secure.
I do know EMI units have a higher staff /resident ratio

There have to be rules for SW's to follow as there is around £18/week funding difference involved. Surely they cannot just make it up as they go along?

 

[Oxy]

Could be wrong but I understood that EMI was for very challenging/aggressive behaviour. Please correct me if wrong and someone has a bigger handle on it. It's just that a friends parent went into one when symptoms manifested themselves in that way. Some may never be aggressive as such.

 

[Pete R]

Could be wrong but I understood that EMI was for very challenging/aggressive behaviour. Please correct me if wrong and someone has a bigger handle on it. It's just that a friends parent went into one when symptoms manifested themselves in that way. Some may never be aggressive as such.

I think the same but the rules have to be written down somewhere

 

[2jays]

This is a very old thread asking a similar question

http://forum.alzheimers.org.uk/showthread.php?15904-EMI-Nursing-care-v.-EMI-Residential-care


Another one

http://forum.alzheimers.org.uk/show...-between-EMI-Care-Homes-and-EMI-Nursing-Homes





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[1954]

As far as I am aware if you mum goes into a NH and they can't cope she will have to go into an EMI