Capacity and declines support/care

I’d like to know more about this issue
I support someone who declines all forms of support, be it personal care, making dinner, tidying room, putting clothes away.
This affects the other residents in the building as the person smells bad, low hygiene is a health risk, cups of tea are knocked over all over the floor; and I ask myself what are we doing to help this person ?

In the old days or in a more nursing / hospital environment it would be unacceptable to consistently refuse personal care, and i wonder what has gone wrong with the system. We seem to be under the cosh of mental capacity act, which yes is a good thing to stop forcing ; but haven’t we just swung the other way and the system is so liberal that we just shrug our shoulders and let a person sit in not washing, or helping themselves at all …
How are we supposed to care in these situations? or make a difference or improve their lives ?

Hi David.

Very little on the statute book on this one.

Best I can come up with … MIND on safeguarding :

The only real answers will , probably , be more of a practical nature … as opposed to any found in a text book ?

( I very much suspect that the links to what’s already on the statute book did not provide an answer to your last thread ? )

Thanks very much chris I’l explore self-neglect as far as possible and mention to the care providers
test the limits and see what the scope is … hope to find something :slight_smile:

Your welcome.
( In 2019 , that age old accidental discharge of a fire hose solution wouldn’t go down too well ? )

“under the cosh”? or just lazy Social Workers who use it as an excuse to do nothing???


years ago my school had a PA system, we were so fed up with one guy not washing
we sneaked into the Principals Office and it blasted out on the speakers
“Nik Toni to the showers please, Nik Toni to showers”

Another copy cat lot snuck in announcing
“Nik Toni to collect his washbag please” :laughing: .

not far wrong there,
the managers select the tenants which we the carers have to struggle with in supporting where we can’t do anything
the managers themselves are rarely ever on site, and if they are disappear into the office
morale is low, we don’t properly communicate , write notes no-one reads and its depressing for everyone
But they got a contract from the council and the money so everything is rosy for management :frowning:

I can totally relate. My husband is ‘non compliant’ according to the District Nurses. It is a nightmare trying to care for him yet he has MENTAL CAPACITY. No one gives a dam about me having to live with a man who won’t do his teeth, won’t apply the cream for his bed sores as directed, sits in a dirty gown all day when a clean one is available. Wan;t take the pico sulfate/lactulose as directed so I have to deal with ‘explosions’. Yet until a crisis happens, no one will do anything. I wish I was in a position to withdraw my care but cannot leave my home and why should I? I just pray he collapses and then he gets taken to hospital against his will. He is deaf but maybe this is because he has syringed his ears…with body wash.He can get aggressive if challenged so I won’t put myself at risk.

His sores have flared up again but he won’t or cannot accept it is maybe due to him sitting in a dirty gown with no underpants on for hours at a time! Yes some think I should be more pro active and apply the cream and his underpants, but I weigh 7st and trying to get him to do things against his will is not going to happen.

I do agree that older people need their dignity respecting but it is a nightmare for carers and in fairness, the District Nurses when they won’t comply. Surely t his self neglect suggests a lack of mental capacity?

I cannot see how someone is deemed to have mental capacity if they lack the insight to see that they way they are living is causing others to suffer.

Surely if someone who was once an intelligent responsible clean and tidy member of society can’t see that they are now unkempt, dirty, dressed inappropriately, behaving inappropriately, and using inappropriate language, then they lack he mental capacity to care for themselves.

It is surely the difference between what they used to be like and what they are like that is important?

We have gone too far to respecting the right of the individual to make “unwise decisions” at the expense of the well being of the carer.

My brain damaged son is deemed to lack capacity over financial matters because he can’t read, write or do any maths, therefore cannot manage his money.
On the other hand, he is clean, tidy, keeps his flat far tidier than my cottage, showers every night, shaves every morning and particular about his appearance, is polite and not a bit aggressive.

If he lacks capacity to handle his money, doesn’t a dirty aggressive elderly person also lack capacity to manage their hygiene?

Is the real problem that ever changing medical staff don’t have long term relationships with patients, don’t know what they used to be like, and don’t listen to carers??

Is the problem really the status of carers, whose views are simply ignored, although in some cases have known the patient for many years?