My 93 year old father, who has a diagnosis of dementia, has been in and out of a care home for respite for my elderly mother over the past 2 - 3 months. We would have liked him to stay in the home permanently (earlier post from me, back in June, reported how he had started to push her and prevent her from leaving the apartment and he is also verbally bullying), however he has always refused to stay permanently (we have no POA - he’s refused to do one) and has insisted on coming out of the home. The time before last, my mother lasted a week before he had to go back in because she couldn’t cope and this time (last week) it was 24 hours. She ended up dialling 999 at 6am, having been up all night with him. He was totally confused, wouldn’t do anything she asked, had soiled himself twice within 12 hours and was standing at the door of their apartment, in his night clothes, refusing to come inside. She was desperate. Fortunately, an ambulance was sent and my father was taken to hospital. He had a fall there within a few hours of arriving but is OK and has been there for the past 6 days. I have spoken to the Mental Health/Memory team and the Social Worker at the hospital and explained what happened and that he now CANNOT come home. I was told to say there had been a ‘carer breakdown’ (and I was advised by the Mental Health nurse to refuse to have him back home, if the hospital tries to discharge him). The social worker at the hospital seemed ‘on side’ but I am still waiting (3 days later) to hear back from her. Just wondered if anyone else had been in a similar situation and if you had any advice on what I should/shouldn’t do? We are visiting my father every other day (it’s a 140 mile round trip for me). By the way, just before he left the home last time, there was an incident in which he threatened other residents (was angry, shouting and waving his stick around). The home will not have him back unless he has a complete medical review and they are satisfied that he does not pose a threat to anyone. They reported it (this is the second such incident) to Social Services. Thanks for any advice you can offer and sorry it’s such a long post!
Others have been in similar situations, whereby the only option left, was for their relative to go into a home, hopefully they’ll be along to advise.
In the meantime I’ll share what I’ve gleaned from the forum etc.
Definitely don’t accept him home. Although there isn’t a POA in place, his mental capacity will be in question due to the dementia. The professionals involved also have a duty of care for your mother as they have to safeguard her, she should be classed as a vulnerable adult.
A best interests meeting will probably need to be called, with a range of professionals to formulate a plan.
It would be better for your Dad to go to a home for the Elderly Mentally Infirm, as they will be more geared to cope now and as his dementia progresses.
Is there anyone closer to your Mum who can support her, to ease the pressure on you a d reduce the number of journeys you need to take?
I will assume that CHC / NHS Continuing Healthcare is NOT a factor here ???
Sorry to hear about your father and the situation you find yourself in.
I was in a very similar situation some years back with my mum. Do NOT allow him to be sent home. Stand your ground. As Melly says, there will need to be a best interests meeting at the hospital and the main issue will be if he has “mental capacity” to make his own decisions. The fact that an ambulance has recently needed to be called will be evidence to the contrary. The hospital should make a CHC assessment while he is in hospital as that will determine how his care is paid for (a huge complicated document). In my mum’s case, she failed to get CHC funding, a common scenario with dementia patients.
Do you want him to return to the home where he had the respite, or do you have another home in mind? The home needs to be a nursing home (not just a care home) as this will avoid him having to move again. It is worth speaking to the manager of the care home as frequently they have good contacts within the hospital.
In my mum’s case they tried to send her home. I refused to provide the keys to the home and said that if they insisted on sending her home, and she ended up back in hospital, I would sue the hospital trust for an unsafe discharge. It was to this day the worst time of my life. I also asked if I could record the best interests meeting in case needed for legal purposes! I did not do so but it was worth asking to keep them on their toes. I did take numerous notes. It goes without saying that you need to be at that meeting. I was at the meeting with ELEVEN medical professionals including the hotel social worker.
Yes, I would chase up the social worker to point out that your mother is a vulnerable adult, that if he is allowed to go home, you will withdraw all support and that no care package will be sufficient. You wish him to be assessed for CHC funding and to state which care home you wish him to go to. Once that is agreed, a funding assessment will be done to see if Social Services pay or he is self-funding.
Good luck, stand firm and you will get through this. Ask away if you have any questions.
Thanks Anne - and others - for your advice. My father has now been transferred to a community hospital (over the weekend) and I expect that, over the coming days, we will have contact with the social worker to decide what happens to him now. Ideally we would like him to return to the home in which he’s been having respite, as he seemed fairly settled there but, due to an incident just before he came out last time, when he ‘threatened’ other residents (he was shouting and waving his stick around - and it was reported to Social Services, once they calmed him down), that home will not accept him back unless he’s had a full review of his medication and they are satisfied that he does not pose a danger to staff, other residents or himself, so at the moment we are unsure whether it will be possible for him to return there or whether we will have to find somewhere else. The additional problem is that we don’t have POA. Feeling quite helpless and stressed - as I have been for the past few months. Agree with what you’ve said, that we need to stand our ground. I will let you know how we get on!
if you don’t have POA, then look into Court of Protection.