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Who determines mental capacity (or not)

Discussion in 'I care for a person with dementia' started by MissDiane, Apr 10, 2015.

  1. MissDiane

    MissDiane Registered User

    Oct 18, 2013
    73
    Hello, I posted a few weeks back about the 'impossible situation' with my mum and dad who both have dementia. To summarise, they live at home with carer's visiting 4 times a day but they argue incessantly and I am concerned there is verbal and physical abuse. Mum is petrified of going in a care home (her dementia is more advanced than dad's so it would have to be mum who goes) and dad simply cannot cope living with her 24 hours a day. He has just come out off hospital for 2 weeks with exhaustion etc. Social Services have just said mum needs to go into respite but we can't force her and she point blank refuses to go. I've asked GP to request a capacity assessment which she has put in motion, and I've asked social services to do a care home assessment for mum. But these things take 2-3 weeks. I have LPA for mum for Health and Welfare and financial property. The thing is, the memory clinic told me today that it is my decision to force mum into a care home as I have LPA, as long as its the least restrictive option. THey said the care home would have to have a best interests meeting and also apply for DOLS. Surely this can't be right, that it is my decision to assess mum's capacity? I thought this had to be done by a qualified professional. All this waiting around is making mum worse and she now says she feels suicidal because she is living with the fear of being put in care but then nothing happens, and the arguments with dad continue. So now i'm told to just get a home sorted and get her in for a couple of weeks so we can all have a think about what to do long term. Does this sound right?
     
  2. reedysue

    reedysue Registered User

    Nov 4, 2014
    4,563
    Scotland
    We have just arranged POA for my mum and the solicitor asked her whether she would accept her GP or a hospital doctor's opinion on capacity or whether she would want a full phsyciactric assessment so I would check the terms of your POA as it may state who can decide on her capacity.
     
  3. clareglen

    clareglen Registered User

    Jul 9, 2013
    325
    Cumbria
    It sounds right to me. You are the best person to assess her capacity. Find a home you think is best, going on your gut instinct after checking the cqc reports website. Look at the care & not necessarily the surroundings. Tell her it's convalescence for a couple of weeks or anything that she'll accept to get her in. If you're self funding, unfortunately, you end up doing it all yourself. Been there & got the T-shirt.
     
  4. Carer Bear

    Carer Bear Registered User

    Apr 11, 2015
    3
    Different experience

    I have been told by an experienced CH manager that she cannot accept my mother against her will or get a DOLs without the involvement of a social worker who will perform a capacity assessment. Otherwise the CH cannot prevent my mother leaving if she wants to. I also have POA for personal welfare but have been told this is not enough. You need to check with a CH in your local authority area and ring adult social care for a second opinion too. It's all v confusing :(
     
  5. Not so Rosy

    Not so Rosy Registered User

    Nov 30, 2013
    580
    I agree it's a huge minefield.

    Dads SW, the Police and his CPN said he didn't have capacity but months later his Consultant Psychiatrist said he definitely had capacity. :confused:
     
  6. MissDiane

    MissDiane Registered User

    Oct 18, 2013
    73
    Wow, something like mental capacity which you would expect to be watertight clearly isn't which is extremely worrying isn't it?! You are putting your trust in the system which clearly has many holes in it. How can we all be told different things by professionals?

    If I ever get an LPA done for myself I will make sure I want at least two professional opinions that i have lost capacity before it can be activated. THe way things are going with my head spinning this may be sooner rather than later for me never mind my dear mum:confused:
     
  7. #7 DazeInOurLives, Apr 11, 2015
    Last edited: Apr 11, 2015
    You are entitled to assess her capacity as her daughter, but as this has significant implications and especially if her capacity is variable you, in her best interests would be doing the correct thing to request a professional opinion on it (if only for your peace of mind). If her capacity is deemed inadequate, only then should you be within your rights to use the H&W Power of Attorney. A financial POA can be acted upon before capacity is lost, but absolutely not for the Health and Welfare POA.

    The arrangement for respite is a separate issue and you certainly should not have to just get on with it because she is self funding. Social services can and should advise and support you, especially with regards the DOLS if your Mum may vehemently resist being in respite and may demand to leave.

    You cannot be forced to do this alone.
     
  8. Blackfield

    Blackfield Registered User

    Mar 8, 2015
    21
    As long as your mum has received a diagnosis and is being treated by the doctor, the CH should be able to accept her. Ours certainly has. Your mum will never agree to go but once she is through the door she is very unlikely to walk back out again. The disorientation alone will throw her off guard for. A while and the hopefully the nurses can do their wonderful job of persuading her to stay for a while. This is about more than just your mum and if you don't make these decisions you dad will not recover.
     
  9. MissDiane

    MissDiane Registered User

    Oct 18, 2013
    73
    Social Sevices told me today, they can get someone to assess her capacity, but if deemed to be lost then they do the best interests meeting to decide whether to force her into respite to give dad a break. But they said they would be putting mum's best interest first, not dads. So if the thought of going into respite causes her anguish and upset, then she would not be forced to go.

    So my dad rings me constantly day and night saying he can't cope, and we don't get any further forward with any solution. I would find it easier to support them individually, if they lived separately, but not together because I am just constantly caught in the middle of their constant arguing. I've just about had enough of their constant phonecall's as I don't know how I can help anymore.

    Social Services said it would be easier if dad left mum and then the best interests meeting would be easier as she would not have anyone with her 24/7 so it would probably be in her best interests to move her into care. But nether mum nor dad will leave their home, they are both digging their heels in. So I have a meeting with my parents and the community physchiatric nurses tomorrow, but what point it is I don't know. They told me it was all my decision! I guess unless i tell them about the aggressiveness towards each other nothing will happen. But i fear that the whole situation is then out of my control and I've caused it. I hate being stuck in this position. I guess i have to wait for a capacity assessment.
     
  10. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,624
    USA
    Diane, I am so sorry to hear about your complicated and stressful situation. I just wanted to say that I hope the meeting goes as well as it possibly can. Of course I can understand you feeling the need to speak up about possible abuse; nobody wants that. I can't offer any practical or legal advice on the situation, I'm afraid.

    I know what you mean about you feeling like you've caused the situation and then you're stuck--I remember what somebody said to me (when I was upset about my mother being in the hospital/going to the care home, and her blaming me for it being all my fault she was there etc). They told me to remember it wasn't my fault and I didn't cause any of it to happen; the dementia did, and I should remember to blame the disease, and not myself. I'm not saying this is easy or always helpful, but at the end of the day, they were right.

    If you get a chance, please come back and let us know what happens.
     
  11. MissDiane

    MissDiane Registered User

    Oct 18, 2013
    73
    Thank you for everyone's helpful and supportive comments.
    No further forward...
    No allocated social worker since meeting on Tuesday
    Cannot use LPA -H&W mum refuses respite
    Dad rang at midnight - mum supposedly attacked him
    Can't find a home i'm happy with anyway, and no one is advising me from SS
    It all seems too much to deal with, main problem is they definitely can't go on living together but neither will move out! And i'm driving myself nuts trying to find a care home mum might like that meets her needs in an area she would want.(if I could persuade her to try it) Plus we are not self funding. Plus Social have not done a care home assessment yet from 3 weeks ago, or a proper capacity assessment that I asked for via GP, all they have done is said mum can has respite but she won't go. My head hurts. I've told them I am concerned for their welfare as they are getting more aggressive with each other and I don't want it to get worse and then one of them does something they regret.
     
  12. tre

    tre Registered User

    Sep 23, 2008
    1,353
    Herts
    Sounds like a nightmare. Just a thought- as your dad is at the end of his tether perhaps he would agree to go into respite for a couple of weeks. This would then mean SS would have to step up to sort something out for your mum as it is evident she will not manage at home without dad.
    Tre
     
  13. Boldredrosie

    Boldredrosie Registered User

    Mar 13, 2012
    237
    Sounds a complete nightmare.
    Why don't you give Age UK a call? I've only recently been in touch with them but they seem everso helpful and they have advisers who can help guide you through the multiple issues you're facing.
    The one thing I noticed you said is that they'll consider your mum's needs and not your dad's. Perhaps somebody else can advise but I thought that the new act that's come into place this month actually means that carer's have to be considered as well, which is sounds like your dad is for your mum. I know from our experience that Ma's (& while he was alive my Dad's) opinions took precedence regardless of whether the situation was driving me and my son bonkers.
     
  14. clareglen

    clareglen Registered User

    Jul 9, 2013
    325
    Cumbria
    How awful. I'm surprised they haven't got on with it quicker when you've stated the aggression. We had a situation locally where the husband killed his wife who had dementia. I used to work with her & she was an advocate for older people. I couldn't believe she'd got dementia. She went missing & that was in the media, then 6 months later he'd killed her & they'd been married 60+ years. Judge said it was a very tragic situation. Couple of days before the trial the husband went missing & they found his abandoned car & his body later, he'd killed himself. Our social services are mindful of this. Now it maybe that they had refused help or it maybe that SS had been slow, but it was a terrible scenario. I think you need to chase them up everyday till they're sick of you. Them that shouts loudest, gets.
     
  15. MissDiane

    MissDiane Registered User

    Oct 18, 2013
    73
    I rang social services again today and before I spoke, was told we didn't have an allocated social worker despite me asking for one 3 weeks ago, along with a request for a capacity assessment and a care home assessment! I explained the aggression between them was increasing, mum had assaulted dad (due to his insults, belittling and the fact he is now ignoring everything mum now says) and things were getting worse and they were both vulnerable adults and it was a safeguarding issue and we can't let this continue. They said they would put it through as a priority 1 (again). I also rang GP who is on leave now for 2 weeks, and the community nurse not in till Monday. I'm trying to find mum a care home but I don't know how much will be funded so I don't know which ones they can afford. I will have to ring them everyday and become a real nuisance. I have so many other things going on too this is so draining. I will mention the awful story about the couple married for 66 years. Dad said mum had threatened to stab him with the kitchen scissors. I don't think it could get much worse than that.
     
  16. MissDiane

    MissDiane Registered User

    Oct 18, 2013
    73
    Just to add Dad won't go into respite either but it is a good idea as SS would have to act then
     

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