So, a sudden change in status with middle stage alzheimers mum

It must be really overwhelming, it is a big decision.

Bear in mind that hospital is a terrible place for people with dementia, it is noisy confusing and intimidating. And there is no one there to reassure and help you because the staff are all too busy. So it is not surprising your mum is tearful and scared when she sees family.

She will honestly feel much better in a care home, it is a completely different vibe, more homely, music or TV playing, carers who understand how to help her and have the time to do so. So she should be more settled and happier there.

My mother broke her hip and she was very withdrawn and scared while in the hospital, the staff were hopeless in terms of dealing with her dementia (I get it, they are too busy). But once she was back at her care home where they understood her, she was a different person.

Oh @FinallyMovingHouse it's so hard. It sounds so like that happened to my dad. He was at the same stage of dementia and I very much recognise the shouting in the night and keeping their spouse awake as the same thing happened to mum. He was very difficult to manage and quite nasty at time which was so not like him.

This is the stage we started having serious talks with mum about residential care. It sometimes takes a crisis like this to bring things into perspective. I hope your mum continues to be settled and calm in care. Dementia is the absolute pits and I wouldn't wish it on my worst enemy.

Your mum's 'half of the house' will never be used for care fees as long as your dad is living there. When her savings get down to £23k Social Services will take over paying for her care. When she has about 4 months of fee funding left you should contact Adult Social Services and ask for a financial assessment, you as her attorney will fill in the forms, they will visit your mother. It will take around 4 months for them to go through the process so don't leave it to the last moment.

I never encountered a COP3 form during the ten years of arranging my mother's care, both self-funded and LA funded. I mentioned earlier that Social Services will do a DoLS, and at that point they could raise an issue if they thought the care home was not the right place for her. But it may take quite some time for them to do the DoLS.

But capacity is decision specific.

COP3 is a court of protection form. This family have PoA and in my experience a formal capacity assessment won’t be required.

Those involved in process - home staff/ SW/ medical staff etc do their own assessment but it isn’t formal.

I imagine if they think a capacious person is being deposited against their will in care they would raise safeguarding concerns.

EPICF was initially unhappy mostly driven by talking with one of their friends who had no idea of the day to day chaos that was happening or the amount of support required.

We (other PoA and I) offered to arrange a formal assessment for them with a third party but ultimately EPICF decided they didn’t want to do that (think the thought of being told by a professional that things weren’t right was too much).

My fellow PoA snd I both assess capacity in our professional lives and outlined very clearly to EPICF why we didn’t think they had capacity to make the decision. As always in families EPICF will defer to anyone except us even in the areas of our professional expertise.

To the extent that in the past before their own cognitive difficulties they rejected my fellow PoAs legal advice about what they could do with the PoA for a family member with dementia and instead sought their own advice which cost £££. My fellow PoA is a solicitor.

I also politely updated the friend with exactly what was going on behind closed doors and asked them to check before encouraging PoA to oppose stuff we had put in place. I reminded friend that if still unhappy after speaking to me they can invoke safeguarding route and that I regard them as good protective measure for EPICF.

So has a formal capacity assessment occurred and you've been issued with the COP3 confirming that she no longer has capacity? Being an appointee for benefits doesn't confer a decision on capacity, as the DWP use a lower bar for allowing appointeeship.

It may seem "blindingly obvious" to people who support the elderly person day to day, but it is a legal status which is established by a legally defined process, and one which a great deal of significance is attached. So it is essential you start asking questions about capacity and ensure assessment and Best Interest planning is taking place with your voice included.

@FinallyMovingHouse
No one did an official capacity assessment of my mother before she moved to her care home either. As you say it was blindingly obvious she didn't have the capacity to make decisions beyond 'tea or coffee'. Social Services will do a DoLS (deprivation of liberty safeguarding) assessment after she has moved in but they generally aren't in a rush, in my mother's case she had been there for five years!

As a PP mentioned, all her clothes and other possessions will need to be labelled. I used iron-labels, so much quicker and easier than sewing and they did stay on through the laundry process.

Oh and EPICF is thriving in the home. Cognition is declining but enjoys the activities and chat (living alone before).

I still struggle a bit with making the decision but trying to keep them at home was killing me and was pretty precarious.

Care home are really used to dealing with reluctant residents.

i’ve found them to be helpful in settling the EPICF (elderly person I care for) in.

Various staff members have told me to stop stressing at times and just let it ride. They also manage EPICF’s obsession with having money/bank cards well meanwhile I tie myself in knots that her having loads of cash puts staff at risk of theft accusations when it inevitably gets misplaced.

Losing stuff is a big issue for us. I got accused this week of cutting up her favourite blouse and sewing a cushion cover with it as it was lost. To be fair I did make a Christmas cushion cover for EPICF and one of the fabrics was similar. But I live 400 miles away so cushion cover was posted and the blouse was hanging in her wardrobe!!

Sounds like your Ma might be beyond this stage though (sorry). I hope the move goes well and your Dad gets a bit of life back.

The advice we got on settling was not to visit for first few days and having watched a friend’s mum basically sacrifice her entire life to whole day visits each day I would encourage your Pa to only go a few days a week and try to pursue some social stuff for himself.

Will the home label clothing or do you have to do that? The one EPICF does all that which is ace but it is £££. The cheaper one my grandfather was in required us to do it all.

My mum had very bad delirium which did not fully resolve and which for a while obscured her developing Alzheimer's. It's tough, OP, and it will be very hard for your dad to manage. Your mum may well not want to go into a home but a good home will be very good at managing that and settling her in. I think you have to prioritise your dad not least because how your dad can cope has a very real impact on your mum's wellbeing too.

Hi OP, my mum was admitted with pneumonia in the mid stages of Alzheimer's and it utterly unmade her, she was delirious and way way from reality, she was discharged home in quite the state but, although it took approximately 3 months, she did come back to much more herself for another couple of years (she also has AF by the way). It's only now 3 years later that she has become very remote due to the disease.

I don't say this to discourage the care home suggestions though, wish we'd done that as it's ruining my father caring for her overnight but he is too stubborn to seek change at the moment.

The medical diagnosis and the capacity assessment are two different processes. Just because she has a diagnosis doesn't mean she has lost capacity. You will need to ask for an assessment of this before making any decisions about the future, because ultimately if she has capacity and doesn't want to go into a care home, then that's that - she can't be compelled. The capacity question will determine the way the whole situation will need to be managed.

At least you now know where the originals are, well done! I hope your mum gets a placement soon and settles in.

On a side note DNR need to be renewed yearly.

If it was done by a solicitor, the solicitor should have kept the original so you can get copies that way. You also need to check it has been registered with the OPG as it can't be used unless it has.

I'm glad to hear your mother is (hopefully) being accepted by a care home.

My LPA was pre 2016 too so I had to use paper version.

I am not sure what you actually have in your possession. I've just looked at my mother's LPA, it is 11 pages long and is signed by my mother, me and her solicitor. It has been registered at the Office of the Public Guardian.

There is only one original. It is often held by the solicitor who did it (or whichever relative was instrumental in doing it).

What you need to present to each institution is a certified copy of the original. My mother's solicitor kept the original and sent me certified copies when requested (he stamps and initials each page). I got half a dozen because they are not reliably returned by the institutions.

If you do have the original, never give it to any institution. You may never see it again. I sent a certified copy to one, asking for it be returned. They shredded it.

When you start viewing homes don’t take too much notice of fancy extras such as cinema rooms. Look at the staff to residents ratio and if the home has a homely feel. Also try and find out if the care home is also a nursing home so you won’t have to move her again. Like others have said you need one that caters for dementia.
It could be worth contacting social services and see if they can help with suggestions etc.

I have no idea about processes etc as I'm not in the UK. But just wanted to say that often, if a person with dementia develops delirium from an illness, the delirium doesn't always fully resolve, and they are left with a deterioration of their dementia symptoms.