Mental capacity but making bad decisions - help

[breathcalmly]

A family member has cerebral palsy but has lived a long life and now in his 70s living in a bungalow by himself. His eyesight is poor and he has various ailments. Over the last year he has had a number of falls at home requiring my parents, who are also in their 70s, to come and rescue him, sort him out etc. They also do all his garden maintenance and doctor's appointments etc and visit him weekly. In the last month he has had two serious falls requiring ambulance and hospital stays requiring my parents to go around late at night until the ambulance arrives and caring for him. Everyone, the ambulance workers, the doctors at the hospital, my parents, think that he needs to be in supported housing, like a care home, warden controlled etc. BUT he is having none of it. He has full mental capacity and does not want to go into a home of any type. I'm worried for my parents as my dad in particular has health issues and is 78 and cannot continue like this. So my question is, if someone has mental capacity, but is causing them harm, can anything be done to intervene? Thanks

If he has been assessed and has capacity to make this decision, then no, nothing can be done. People are allowed to make bad decisions.

How long ago was the assessment?

No, the only thing your parents can do is step back. They can't stop him from making decisions they don't agree with.

He hasn’t been formally assessed but (to my untrained eye) he clearly had mental capacity on a day to day basis. His mother lived in a care home in the 80s after a stroke which was pretty grim back then so don’t know if that is what is worrying him

Mental capacity is decision-specific. Someone can have capacity to make certain decisions but not others.

That said, assuming they have capacity then everyone has the legal right to make decisions others may consider "unwise". You cannot compel him to do anything.

Has he had social care assessments or started looking at paid carers if family cannot meet his needs?

If you are asking how to deprive someone with capacity of their liberty, you can't unless you want to end up in prison.

Sorry, but no, there's little if anything that you can do other than attempt to persuade your parents to put in some boundaries.

For starters, his garden can go to pot. It's right at the bottom of the list of priorities.

What would he did if they said they aren't coming out to him any more? I know it's vanishingly unlikely that they could bring themselves to do that, but still...voicing it might be interesting.

I presume he had an alarm for these falls? Get your parents taken off the contact list at the alarm call centre.

Mental capacity is also assumed. Unless there's a disorder that might affect it, you're assumed to have it. I don't think cerebral palsy would fall under that category.

Ultimately what is under your parents' control is what they do, not what he does. It would be a good idea to let him know if they need to step back though.

Thank you for all of your comments, they are very helpful. Over the last week my parents has put in place carers which he will pay for - who will visit him twice a day and he has an alarm, but when he has a fall he rings my parents not the alarm provider even if very late. His last fall was nearly the end of him and he is a good man and I feel awful that he can’t see the wood from the trees and move somewhere where he has company, good food and people to keep an eye on him. He has very very poor eyesight and a hunchback and we think he might have given himself food poisoning recently as he can’t read the food packet instructions. I fear that he won’t last much longer living alone but, as you say, it’s ultimately his decision, even if it’s a bad one ☹️

The thing about falls is that they don't stop happening just because you are in a care home. As long as he had the ability to call for help he is no worse off at home. Your parents however have a choice to stop assisting him off the floor and should wait for the paramedics. Maybe the GP could recommend an exercise group or a falls team referral to make sure he is staying as strong as possible.

He is worse off are home. In a home, a fall won't go unnoticed (he might not be able to call for help next time) and they're less likely to happen in a care home because unlike your average house, floors are clear and there aren't any trip hazards.

My mum fell (due to a stroke) in the middle of the night. She was found, purely by chance, the next morning, hypothermic due to having lain on a stone floor overnight. Had her neighbor not gone rooms to all a favour, she'd have died.

Apologies for the typos above. Hopefully you can interpret them

I think of someone is adamant they do not want to be in a care home, that needs to be respected. As long as they are fully aware of the risks, which yes... could be as extreme as dying... but to be in a care home against your wishes.... you have to ask yourself what is the point?
I do meet some people in my line of work who are adamant they do not want to be in a care home, who I can tell would actually probably thrive in one as they are sociable and enjoying their time in hospital, however, I met many who just want to be at home and if they fall and die, so be it. I can respect that, but they have to accept that their family cannot come running at all times of day and night of they choose to remain at home.

I really do hope that you have some luck in persuading your DPs to take a step back. Right now they are enabling his behaviour and choices.

I'm in a similar situation but I'm I'm carer for a lady with bipolar and she makes terrible decisions that are physically detrimental to not only her but her husband. They are both in their 70s. She is the boss and I'm just there to make sure she doesn't hurt herself when I was hired to help rehabilitate.
Any advice?

He is worse off are home. In a home, a fall won't go unnoticed (he might not be able to call for help next time) and they're less likely to happen in a care home because unlike your average house, floors are clear and there aren't any trip hazards.

Another way of limiting falls in a care home is to have the residents bedridden. I’m sorry to be blunt, but most homes don’t have the staff to be helping unsteady residents, especially not to get up and about if they have had a fall in the home. My father-in-law wasted away in a home because they wouldn’t get him up and out of bed, and walking around, to the point where, of course it became impossible for him to do so. If he’s so keen to stay at home, could your relative afford a live-in carer?