Can Social workers get access to a carers medical records.

[Oldsu]

I am up at 5 in the morning talking to a friend on facebook who could be depressed and IMO needs support

Scenario is that she cares for her husband who is 61 with early onset dementia, she has a total mistrust of medical professionals and given some of the problems she has had to face because of them I cant say I blame her.

She was first visited by SS when the District Nurse who comes once a week reported her for having a 'dirty' house, now considering 2 days before the visit my friend broke 2 ribs and could hardly move let alone scrub the fucking kitchen floor that report was a tad out of order, especially coming from a nurse who knew my friend had broken ribs and presumably had enough medical training to know how having broken ribs would affect a persons mobility and day to day activities - but that's another story

Anyway Social services are involved now so she has to deal with them

I have been on facebook with her for most of the night as she is weepy and cant sleep, I think Christmas is the catalyst because she has no support from her family and she knows on Christmas day she will be just staring at 4 walls on and not being able to celebrate ( I would go to hers but her DH gets scared and anxious when strangers are in the house so it would just means more stress for her).

I have suggested she sees her GP, not necessarily for medication but just a chat to see how she can be helped, but my friend is petrified that if she seeks help her GP will inform SS or SS will be able to access her medical records and find out anyway and remove her husband from her care.

She is usually a coping upbeat person despite her difficult circumstances so her mood at the moment could be temporary but it also could the start of a bigger problem

Does anyone know the procedure, would her GP inform SS, can SS get her medical records and if they did would having depression mean that she would be declared unfit to care for her husband

[AnxiousCarer]

In answer to if SS can access mefical records, yes they can when appropriate, although I think it is more likely they would be accesseng her DHs records than her own as I susspect its him thats been refered to them not her. In any case her accessing help from her GP would be seen as a positive.

Social services role is to support people to remain in their own homes for as long as possible. They would only ever remove someone form their DWs care as a last resort,if there were extreme safeguarding concerns e.g. concerns that she was actively abusing her DH or neglecting him, not just for the house being a bit unkempt.

Was the referal for safeguarding concerns, or was it for an asessment of their needs to see what support is available for them both, which seems more likely. Even if it was arround safeguarding concerns, the first port of call would be to offer them support at home. Things that may be available will depend on her DHs needs but could include someone to help wash and dress him, a sitting service to give her time for herself, to go shopping etc, day care again to give her respite, (she is entitled to a carers assessment, seperately from her DH to look at how they can support her in her caring role) they may also look at advice regarding financial help they could be entitled to and give advice about other organisations in her area which could help e.g. age concern. I would also advise speaking to the Alzeimers society who were an amazing fupport to a friend of mine and her parents with her DFs dementia.

Social services can also look at assistive technology eg door sensors to let her know if he leaves the house, watches with inbuilt tracking devices if he is prone to wondering and getting lost.

I speak as a carer for my DH who has MH problems and also a healthcare proffesional who has a lot of involvement with people with dementia

[PoldarksBreeches]

I only know about child protection- answer being yes they can but only if it's a A formal child protection investigation which has to set certain criteria. I would be surprised if they could in the situation you describe. It doesn't seem proportional or necessary.

[AnxiousCarer]

Just to add I am currently under my GP for PTSD in relation to caring for my DH, I am on an antidepressant, I have support from a CPN (community psychiatric nurse) and councellor and am waiting to see a psychologist. I would not expect any of this to go 'against' me as without this support I would be a complete mess unable to care for DH and he would likely end up on the streets, in a police cell in hospital, very unwell himself.

[dangermouseisace]

I used to work for adult social services, for 3 different local authorities so I've experienced different teams.

The district nurse may have just referred your friend and her husband because it would be useful to see what help social services can offer. As you said, she knew your friend had broken ribs…it's common for carers to temporarily be incapacitated and families need a bit extra practical support at that time. It sounds like, and probably looks like she's struggling and could do with a hand. It is hard work looking after someone with dementia, more so if you are unwell yourself. I doubt that it would be a safeguarding referral…or even if it was due to uppity DN it would probably get downgraded to a standard assessment referral/carers assessment.

Adult social services usually do all they can to help people with dementia etc stay in their own homes for as long as possible, and have a duty not only to the person with dementia, they also have a duty towards the carer. They will probably ask for friend if she wants a carers assessment- there may be support available to her. Social services are meant to go in with an open mind…to be honest most social workers/assistants have a deep distrust of medical professionals too. There is a lot of antagonism between the two as some (not all, by any measure) medical professionals can be a bit prescriptive e.g. 'this person needs to go into a home!' whereas social services are a lot more about supporting people to live their lives as fully as possible, where they want to be, with who they want to be with, for as long as possible. I'd go out and meet people for the first time and they'd be petrified I had come to 'take people away' and that was definitely not the case at all. Your friend might even find that something positive comes out of this.

Social services cannot contact your friends GP without her written permission (they usually bring along a form to sign to contact others on the first visit). Even if they had that form signed, they should, and usually would still ask permission. They certainly do not have access to people's medical records, and would not be able to see them. I've phoned people I've assessed's GP's before (after asking) but only people who were receiving a care service, not carers. And usually it was only people with dementia who weren't able to give me accurate health information themselves, or they were unwell and I was concerned about them. It is common for carers, and indeed anyone, to have depression. I think probably most carers I assessed said they had depression/were on anti depressants and we didn't think any less of them (maybe because most people who worked in the office were on anti depressants as well…)

[Bloopbleep]

She could ask for social services to do a carers assessment where they look at her needs and how she can be supported to care for her husband. Unlike an assessment for her husband as a carer she probably wouldn't have to contribute towards any support she was entitled to. She might even get respite for herself. People need to stop thinking SS involvement is always a bad thing.

I'm not sure they can access her medical records without her consent but as carers are so often depressed and on medication it really wouldn't be held against her.

It sounds like she needs support and she needs to realise there's no shame in that

[hatgirl]

I'm a social worker for adults.

It wouldn't even cross my mind to attempt to access your friends medical records, and I would hope any GP who I asked in those circumstances would tell me to get lost! Massive breach of confidential information otherwise and I would have no business knowing.

My most likely course of action if it was me who rocked up yo your friends door (although I would always ting first!) would be to offer a carers assessment (completely up yo your friend if she accepts) and as much support as resources would allow and your friend would accept.

I echo the previous poster who said social services can get a bit fed up of some health professionals who make often extremely judgemental referrals to us without proper consent.

[CMOTDibbler]

I don't know about accessing medical records, but I do know that certainly in my experience none of those things would mean they would consider her incapable of caring.
My dad cares for my mum who has severe dementia - he is nearly 80, has heart failure, kidney failure, leg ulcers, heart rhythm problems and a whole host of other issues. He's had severe depression in the past and now has very early dementia himself. And SS are still happy that he makes the right decisions for mum, and with the help of carers they go on. But she has to ask for help, and see that the DN referred to SS before because she wasn't coping due to the injury and needed help, not in a judgy way, in a practical way. Dad found it hard to get his head round them being there to access help, and that when they told him that they could see he struggled with cleaning it wasn't to be rude, it was a statement of fact and that they wanted to help sort it.
Is there a carers centre locally? They can be very supportive. And someone I know whose wife had early onset dementia was telling me the other day that he was a member of an early onset support group which was really good - I can try and find out the details if it would help

[Oldsu]

Thank you all for your help CMOT that would be a massive help she is in Cleveland I am so far away from her I can only help remotely but am doing what I can

thank you l again

[CMOTDibbler]

Its Young Dementia UK - hopefully she can talk to others in the same situation

[myheadsamess]

From the GP Perspective, SS may well request her medical record but they would have to be assured of the reasons why before releasing it.

Disclaimer I'm not a GP but admin in a GP practice.
Hope things look up for your friend

[myheadsamess]

Sorry, I'll clarify - SS don't need to know if your friend is on medication/therapy. They may need to know the effect of the meds/therapy or lack therefore is having on her ability to care for her husband.

[averythinline]

The DN probably thought she needed some practical help as she had broken ribs - it maybe that she is down so didn't necessarily 'hear' that . To get any support in most areas she is entitled to an assessment of her needs as a carer as much as his needs.
I have seen packages go in for a short period of time for this very reason..she maybe able to access some direct payments to employ a cleaner... or other things

Why does she not want help? if you can talk to her about seeing her gp they may know of local support activities/groups for all of them...
the councils website should have information for carers so maybe you could have a look for her...

[Oldsu]

averythinline she thinks they will put her DH into a home if they think she is depressed or needs help, sadly its a lack of trust on her part, she would rather suffer in silence then seek help at the minute, I am the only person she trusts with her feelings and am doing what I can to help and support her.

CMOT thanks I have copied the link onto a facebook message, It look good so I hope she reads it