Is this morally wrong?

[NotPicasso]

I have an elderly family member. He lives about four hours away and no family live near him. His mental health is drastically declining and he’s now at a point where we have doctors/social services/police involved but he is refusing to move into a home, or closer to us. The big problem we have is that he is a wanderer, and will go missing for days so when we call to check, we can’t find him. When we visit, he often forgets we are due, and we will spend hours trying to find him in his local area. Last month he was missing for 8 hours and when he got home, he said he’d been in the supermarket (we had checked several times and didn’t find him in there). I’ve said I’d like to put an AirTag on his keys, so when he goes missing we can find him. He has no idea what it is, doesn’t have a mobile and doesn’t understand technology. He might consent to the tracking one day, but won’t remember the next. Would it be acceptable for me to put it on his keys anyway? He always takes his keys when he leaves, so I think it would be a good way to find him if he goes missing again?
obviously we are working to get the situation sorted, this is just a short term solution to try and keep him safe.

YANBU- track him
YABU- it’s violating his privacy and shouldn’t be done without him fully understanding and remembering it’s happening

None of your 2 options because I don’t think it matters if he remembers. But if you ask and discuss it with him and he agrees then I think it’s ok even if he subsequently forgets the conversation. I’d ask the carers to be present when you discuss it with him.

So age dictates? What age is that?
Does he go missing? From whom? Or foes he go out and not tell everyone were he is going? As a young woman, who kept tabs on you?
Declining MH doesn't mean loss of autonomy. Yes safeguarding is important, but it has to happen at the right time, so we don't randomly decide who is kept under control. The OP asked for opinions, as someone who worked in SS, I was giving her points to consider. Right to privacy and liberty are human rights, before they are removed, we have to think about why we are doing that.

OP, is it his cognition that is declining? (just checking he's not walking for hours due to depression or mania etc).

I'd speak to social services and his GP. If he is at the stage that he lacks capacity to make a decision regarding going out with/ without being tracked I'd suggest that he should be reviewed by psychiatry/ memory clinic to get a formal diagnosis.

What are the police involved for? Does he always come home or has he got lost or in a risky situation?

I know a few PP have said about pushing to get in him in a home near the OP. Even if he lacks capacity to make that decision it has to be the least restrictive outcome. His current and past views need to be taken into account and risks need to be weighed up against his own wishes and what would cause him the most distress.

Cognitive problems could happen to any of us, and it isn't limited to old age. Think it something happened to you today whether you'd want someone to 'put you in a home' or work to keep you in your own home.

You don't know that.

My mum has dementia. She has fallen a number of times. She is still at home with carers and assistive technology as it's where she wants to be and the best place for her at present. She knows if things get risky (like leaving gas on, getting lost in the local area so she's at risk of being out all night, refusing to let carers in etc) AND she lacked capacity for those things we'd have to make some tricky decisions. It's not a given that someone falls and then gets moved to a nursing home. That's obviously not legal for many situations.

If is also a danger to others, what if he wanders in to a road.

Everyone could be a danger to others by walking into the road. Of course if that is happening and is a risk then it needs addressing but you can't stop someone from going out based on a what if.

If you got a cognitive issue at any point in your life at what point will you expect to be locked in somewhere just in case you walked out in a road?

Err, I mean people that wander in to a road. Not people that look both ways and cross sensibly.

@coldcallerbaiter but you have no idea if he looks both ways or not- that's my point. You can't deprive someone of their liberty on a what if.

As I said- if he's dangerous on roads then it needs addressing but as far as I can see the OP hasn't mentioned issues with roads at all.

You're imagining what his 'wandering' is like but we don't know how cognitively impaired he is, what he's doing when out and about and what risky behaviour he is or isn't engaging in.

I don't think that the NHS are allowed to recommend anything. (ex NHS manager) local staff might say that they know someone who has got one but recommending stuff goes a step too far.

You're keeping him safe, and it's only morally wrong if YOU have bad intentions.

You sound like a very caring person to do this. The only other option would be locked in a secure care home, which it may well come to at some point, but for now you are offering a few more weeks/months/years of freedom which is very precious.

You're keeping him safe, and it's only morally wrong if YOU have bad intentions.

No it's not. I'm sorry to keep banging on and everyone is very well-intentioned. But caring for people with capacity issues is one of those areas where the road to hell is paved with good intentions. Freedom and agency is messy and complicated. And getting rid of that mess is wrong, even if it's safer and neater.

It's morally wrong if it unnecessarily or disproportionately impacts the OP's relative's life and choices. Even if the OP has the very best intentions.

Sorry, loads of questions and really helpful suggestions here so I’ll try and respond quickly.
physically he seems ok, he’s 90 and walks comfortably without needing aid. It’s all mental and definitely declining.
with regards to food and drink, he doesn’t seem dehydrated but does turn his fridge off regularly resulting in rotten food. He doesn’t seem to eat it, just leaves it and buys more? His house is disgusting every time we go, we clean his fridge out most weeks to try and avoid rotten food

the police got involved because of his driving. He drove somewhere and got lost, then fell over and ended up in hospital. He no longer has a license luckily

would a sign on the fridge and on the electric socket saying "don't turn this off" help?

@Ponoka7

you would never say a toddler has the right to wander the streets alone.

I cared for my MIL for 10 years, she had Alzheimer’s. I needed to take DS to school and she was sleeping. I locked her in. Which isn’t something I thought I would do previously. I couldn’t allow an old lady who wouldn’t dress inappropriately , would get lost and freeze to death to do what she would’ve decided she wanted to do if she had capacity.
The problem is they don’t realise that they are being reckless. She said she’ll come back when she finds her Mum, could take a while.

Who is they? All people with memory problems?

Like all conditions everyone is different and presents differently. What was best for your family member does not mean it's the best for everyone. Also not nice comparing grown adults with toddlers.

@NerrSnerr

I didn’t say that what was right for my relative was right for others. I said you may have to do things you never thought you would.
you have a lot of opinions but have you had to care for anyone with reduced mental capacity.

I think the like a toddler analogy is spot on. They can argue and be sure they are right, they know what they want. They need an adult to guide and protect them.

The statement I had issue with is was 'The problem is they don’t realise that they are being reckless'. We have no idea of the OP's family member is being reckless. Some people with memory problems may not realise but not all.

My mum has Korsakoffs so yes, I have personal experience as well as professional.

But this person doesn't have a diagnosis, from what the OP said, isn't enough to take away their autonomy without further questions. I was pretty reckless as a young woman, just because I'm nearly 60 doesn't mean that I can't be reckless now. If you go by recklessness, people should be under control until 30+. The questions that our care charters etc ask are the ones I've posed to the OP. Why does just getting older mean that suddenly you can be put under another person's total control? Your situation might not be the OP's, without further probing, you couldn't rightfully say that she had the right to track his movements.

I doubt a social worker would condone this.

@NotPicasso what other tactics have you tried with your dad?

Can you add some things to his established routine? Like if he reads the paper every morning ask him to read his calendar for the day at the same time.

I was given a list of things that can work with memory loss/cognitive decline for day to day living when my mum had brain cancer. The big things I remember from it is to simplify things as much as possible and to write more things down. So maybe a weekly calendar in a prominent spot with upcoming visits. A visible daily checklist… Monday- check dates on food in fridge Tuesday - Shop Wednesday NotPicasso visit @ 5pm etc.

I’m sure a similar list could be found somewhere. I’ll be honest some of the suggestions are pretty stupid but I did find a few good nuggets.

It may be too late for this but I’ve been very successful in introducing Alexa into quite a few elderly people’s lives with varying cognitive abilities. I set up the account and device and enable the drop in option. One of these days I’ll write up a short how-to on successful integration. But am happy to give a few tips if you want to give it a go. It seems to work because you can can give them a list of commands that are relatively easy and things they might be interested in. For example, you teach your dad how to ask for the score of his favorite sports team. At the same time you can set up a routine that reads aloud his reminders in the morning automatically.

The biggest piece of advice (that you didn’t ask for) is that while you are trying to fix the current issue the next one is really just around the corner. It’s hard but you have to start thinking about ‘what’s next’.

Back to your original question… yeah add the air tag to his keys. I’m the most anti-tracking person out there but in this case I’d just do it and tell him you’re doing it. He might forget but you can’t help that.

Coming at this from a more practical perspective, I’d fit the air tag so that I didn’t have to waste hours of my time looking for him.

But I think he has the right to not want this. Loads of people have mental health problems and are at risk of suicide. I don’t think they should all be fitted with air tags. It’s not 1984 just yet. Almost but not quite.

You can’t just arrange a mental capacity assessment without consent. My mother has early dementia and there’s nothing I can do because she won’t agree to an assessment.

actually you can get an assessment if the person has passed the point where they have capacity to agree and either they would have agreed if they had capacity to do so OR its considered to be in their best interests to be assessed. This is a horrible way to express this and I am sorry, but its a common situation in that in your Mum's case its too early as she still has the capacity to refuse.

Honestly? I'd do it without a thought.

Alternatively, does he carry a bag that you could slip it into? Or as the colder months approach, sew it into the lining of his coat? He wouldn't even notice it.

Just to clarify mental capacity assessments are covered under the Mental Capacity Act not the Mental Health Act. Very different legislation. But yes to everything else you've said.
It's about being proportionate. I think an AirTag on his keys (if he doesn't remove it!) to be used when he's missing is a good way to manage the risk without impinging on his freedoms.

Safeguarding trumps everything! Get it on his keyring.