Legal position on assessment of elderly mum...

mamabuddah

This may be in the wrong forum (please move if necessary) but here goes...

Mum lives in sheltered accomodation (age 90) has done for the last 15 years. 4 weeks ago had a bump, went to hospital in ambulance because of slight confusion as to how it happened ( we believe she rolled over in bed and banged one of those useless rails that slides under matress)

A&E took xrays etc, no serious damage, doctor quipped "I'd hate to see the other guy"

Back home to fold, over the next week lost appetite and didn't take much fluid on board, started to sound confused, doctor said, get her into hospital, sheltered accomodation warden (well versed in treating/working with elderly) thought she was exhibiting all the signs of urinary tract infection.

Admitted to hospital, examination process starts, can't really identify any problem (MRI scans, blood tests, urine tests etc) we re-iterate suspicions of UTI...ignored by doctors who ask if she has alcohol related problems, thyroid problems, answer to which is no.

after 10 days they decide she may have some sort of infection (meantime she had become more confused etc) start program of antibiotics...4 days later...you may say miraculous recovery and with healthy eating etc (drips for fluids and vitamins etc) looking really well, talking lucidly and brief assessment showing mental agility much better than me on some occasions!

Discharged from hospital, bed found in Care Home for "assessment" (we've yet to be informed what process this may involve) now we find out after chasing social worker, she will be there for at least a fortnight until the assessment team can "fit her in". We say surely they would be better assessing her in her own home environment where she has lived for 15 years (bearing in mind she is practically deaf, blind and has a mobility problem). "we'll get back to you"...

We believe she is probably in better condition now than she was 3 months ago, she does not want to be in a care home, she gets more care with us calling 3 or 4 times a day and preparing her meals etc. she lives in her own flat within a large communal area with hairdresser, common room games and activities throughout the week. Yet the "social care" people now say "they need to assess her to see where she goes next"...

mum does not want to be there, we do not want her to be there, she wants to be back home not sitting bored in (as she puts it "god's waiting room") possibly to become more and more agitated and/or distressed...

We are now putting pressure on social care to get this resolved sooner rather than later and we do not want to get into the situation (like with abused children) where they step in and take her away against her AND our will.

What is the legal position as regards us removing her back to her own home etc, will the NHS STILL be obliged to treat her in future, if she does need a care home in 3 years, can this be denied.

For those that sometimes lurk here, financial restraints do not apply, she has no assets etc...so that will not be an issue.

meer53

My MIL fell in her sheletered accomodation bungalow 2 or 3 times, she's 89. She was admitted to hospital and diagnosed with a bad UTI which made her confused, exactly the same as your Mum. Once she'd got over the UTI, she was kept in hospital as we didn't feel that she would be able to cope back at home, the falls really shook her up. She was in hospital for 5 weeks in total and various assessments were carried out, one of which was to establish whether she was competant enough to make her own decision about where she wanted to live once she left hospital. It was decided that she was competant enough, but to be honest, even though she said she could manage with carers calling, we managed to convince her that a nursing/care home would be much better for her. She grudgingly accepted this and has been in the home now for 7 weeks.

Even with carers calling 4 times a day after the first fall, she was able to convince them that she had eaten/washed etc, even when she hadn't. It would only have been a matter of time before she had another fall.
Since she's been in the home, the improvement in her has been remarkable, she's less confused and looks much better. She eats regularly and has company all day if she wants it, it's such a relief for us. I don't think Social Services can force your mum into a home, but the care my MIL was offered ay home (we aren't able to call in every day) although good, was only for a limited time. It's called "Enabling Care" where we live and after 6 weeks an assessment is carried out to see what the next step should be. Don't know what SS would do if they felt that your Mum needed more care ? Your best bet is to speak to SS about your concerns.

Just wanted to let you know that going into a care home can sometimes be a good thing.

monkeyspanner

I find this situation quite strange it is usually the other way round with families desparately worried and trying to get the social services to get involved. Unless your mum has been sectioned she can insist she goes home and neither the care home or social services can stop her.

clemmatis

I agree with monkeyspanner, this is strange. Hospital teams though do sometimes decide a patient should not return home on discharge. But you can contest that.

Have you talked to the hospital consultant and the ward manager?

I suggest you consult AgeUK.

http://www.ageuk.org.uk

Savvy_Sue

Have you asked the sheltered housing warden if there is a reason Mum can't go back home?

mamabuddah

thanks to all replies so far...after a lot of pushing on our part, mum has a team re-assess her today...basically came down to...she could have a fall at some stage....but she could have that fall wherever she was, but less likely in her own familiar surroundings as a fall is just part of life now for a 91 year old.

So mum is delighted she's going back to her own home with us providing the "care package", which will be more than the 3 X 15 min visits per day, they can perhaps be used for another more needy case, we will happily provide any assistance until 24hr care becomes a reality and a home is perhaps the only option.

Best Christmas present my mum could get, so Chistmas Wishes to all the hospital nursing staff who provide great care, all the OT and home visit staff who assessed her really quickly (assessment will now continue in her own home environment after Christmas) the lovely workers and nurses in the care home who kept her spirits up this last few days....lets see...have I forgotten anyone????

Social Worker...who we had to chase, who didn't keep us informed, who didn't know what was going to happen, what my mum was to be assessed for...as he said..."I'm not medically trained"...well neither are we...and when the hospital treated the infection and it got better, there was no evidence after scans of any brain injury...we knew a fortnight off her feet would make her unstable and the UTI would make her confused...no need to tin-plate your !!! if you know how to do your job....

meer53

Good that your Mum gets to go home, bet she's happy ! I hope she doesn't fall again, my MIL fell 3 times in 2 weeks which was what prompted us to look into care homes. Even in sheltered accomodation and you calling in regularly, sometimes 24 hour care is the best way forward. It has been for my MIL, mind you, she's an obstinate, argumentative woman, says that only old people use zimmer frames ! Merry Xmas

clemmatis

Good news, and thank goodness!

Savvy_Sue

Great news, hope she goes from strength to strength.

mamabuddah wrote: »

basically came down to...she could have a fall at some stage....but she could have that fall wherever she was,

:rotfl: don't I know it, tripped over my recycling box last year, smashed my shoulder to pieces, and THAT'S not something I'd recommend to anyone!!!

One of our neighbours was whisked off to hospital last weekend after a fall, one of my boys asked if she'd tripped over her recycling bin! No, DH went to visit her, and she thinks she fell asleep sitting in her kitchen and fell off her chair! Who knew how dangerous sitting in a chair could be!

lissadenton

when my 86year old aunt fell-and went to hospital-the social workers refused to let her go home. They weren't prepared to provide carers going in-so she had to go to a home.
She's been there 3 years and hates it-always asking to go home-but she wasn't looking after herself at home.

I don't know what the answer is-she looks so much better-but really her life isn't good. She cries every time she sees us and just wants to go back home.

Savvy_Sue

lissadenton wrote: »

when my 86year old aunt fell-and went to hospital-the social workers refused to let her go home. They weren't prepared to provide carers going in-so she had to go to a home.
She's been there 3 years and hates it-always asking to go home-but she wasn't looking after herself at home.

I can't help feeling that you've misrepresented the situation here. And this isn't particularly directed at you, it's to make a point which I feel is quite important for the OP.

AFAIK, a social worker cannot 'refuse' to let someone go home, not without getting the person sectioned, which is not a step taken lightly.

Obviously, a social worker CAN assess a situation and decide that the amount of care someone requires cannot be reasonably provided at home, by the local authority.

At that stage there is absolutely nothing to stop the person with resources from saying "I don't want any help from the local authority, I will organise the care I need and pay for it myself, including if necessary live-in carers." Clearly someone needing a good deal of care might struggle to organise it themselves, but family or friends might become involved in organising it.

Now, if the person concerned owns their own home then the 'resources' tied up in that can used to fund this. Even someone who rents their own home may have considerable savings which can be used. The point is, they have a choice about this.

If, however, all resources have been put 'into trust', given away, or are regarded as untouchable because they are supposed to be bequeathed to someone, then such choices are gone. If these resources never existed in the first place, then the choices were never there, but that's a different issue.

And you might like to think that those with whom you have prematurely shared your resources would rally round and support you in your dotage, should the need arise. But it's not reliable. It assumes a level of cordiality between the family which sadly doesn't always continue.

I don't know if lissa's aunt didn't have the necessary resources, or wasn't as well informed as she might have been. Sometimes professionals can be quite persuasive when they think they know what's best (for their budgets, if not for the individuals).

But as I and others have said before, I would like to have choices. If I could manage at home if I had appropriate care, I know that's where I'd rather be. If I have to pay for that care myself, then sorry boys, but your 'inheritance' is going on my care. If I absolutely have to have residential care, I'd like a choice.

And since it's a very small percentage of people who do in fact die in residential care, it's all a bit moot whether putting things into trust to avoid paying for it is worth doing!