What happens if you can't prove mental capacity

[AFriendlyVouce]

Caught in a difficult situation at the moment.

Parent is not especially elderly but does have lifetime MH issues (bipolar and also compulsive lying/ attention seeking and narcissistic traits).

As getting older they are showing increasing traits of confusion and memory lapse which align to mental issues or early dementia although it would be very young for early dementia. The trouble is, sometimes they can be very coherent - particularly if anyone suggests a health assessment or going to hospital.

So long as parent is "coherent" it seems nobody can enforce healthcare help, hospital, taking medications or help with the home.

But meanwhile, I'm getting regular calls that they're suicidal or hearing dead relatives talking to them. Their house is frankly disgusting in terms of cleanliness. They aren't taking meds consistently, if at all. They forget day / times / who relatives are and often talk utter gibberish mid conversation although the fact they CAN answer questions like "what's your name and DOB" apparently means they have full coherence so cannot be enforced to do anything.

Does anybody have similar experience and what did you do?

There's a lot to unpick here... In your shoes, I'd start by contacting your parent's GP and the local Social Services Adults' referral team and tell them what you have written here.

A person does not need to 'prove' their mental capacity (which will always relate to a specific decision at a specific time i.e. it is not 'blanket') - capacity is assumed unless an assessment demonstrates otherwise. There is some good information online about mental capacity, including on the Alzheimer's Society and Age UK websites, including this 1 minute guide. Knowing one's name and DOB are irrelevant to whether a person has mental capacity for decisions about care, although not knowing them could be indicative of a cognitive impairment.

What would you say they lacked capacity for and when? Capacity isn't a has it or doesn't have it thing.

If THEY wish to take meds more consistently and it improves their symptoms and they would benefit from some support measures perhaps that could be explored. There are apps that can remind you.

Living in a cluttered, unclean home doesn't mean someone lacks capacity but their working memory or executive function might need some accomodations.

The law protects people from pressure to confirm to others views of behaviour including their right to make unwise decisions.

As PP said you can contact some people but if your relative chooses not to engage then that is their right even if they have mental health diagnoses.

It is really challenging so perhaps making sure that you are ok and not filling gaps that make you distressed would benefit the whole situation?

Thank you. Yes maybe but obviously when I'm getting messages saying they want to kill themselves or can't care for themselves it gives me some sort of sense of obligation. Any interaction I've had with the GP, they also suggest it is my responsibility as next of kin. But in reality if they've got capacity, I can't force them to be happy, or take meds, or look after themselves- and if they won't, the self-inflicted distress that causes then has a profound knock on impact on me and my family.

In general the bar for capacity is set so as to preserve autonomy for as long as possible.

So people with mental health issues are absolutely permitted to choose whether to take their meds.

There can be intervention if they are deemed likely to be harmful to themselves or others but in practice many many people have thoughts of suicide and much fewer attempt. If she is not actively attempting there is little help out there.

So.... you can't make her do anything.

I'd suggest in the circumstances looking to your own self care. Put your own oxygen mask on first. Only support her as much as you can.

You might give her the Samaritans number to call when she is feeling suicidal.

Thank you. It feels so brutal accepting this but it's very helpful advice. We may have many many years ahead of this.