Alzheimer's - Live alone or 'forced' into care home?

[AnyName1]

Which do you think is morally right, and best for the patient?

This man has no family living within two hours away. He has an adult child who will not make any decisions regarding his care, and won't allow anyone else to do it either.

A family member two hours away could go to court and try to get the power to have him go to an appropriate home.

Patient absolutely does not want to go to a care home. By going home he will be alone in a very isolated area, if he wanders (which he does) he could very easily die. Home help is the only visitor.

Should I stop fighting and let him go home, to die.

He's only going to get worse and dying would honestly be a blessing, but obviously it feels like I'm wrong in allowing this to happen.

Does anyone have any thoughts? What would you do?

AnyName1 I've done a bit of googling about capacity in the ROI and it seems they have a Mental Capacity Act that is v similar to the England & Wales one.

The principles on how you assess capacity to make a decision are the same as the 4 I posted above. You do still have the right to make a bad decision (if you have capacity) and the person's wishes should be considered - this is the same as I am familiar with - but it doesn't mean that people who lack capacity get to make bonkers decisions.

So in the situation you are describing I would expect a proper assessment to include him describing how he can manage at home, including keeping himself safe and yourself corroborating if what he is saying is true. If he won't believe it is true, then he can't retain the information and lacks capacity.

You then go on to making a Best Interests decision. This would put a lot of weight on his wish to be at home so would think about what care is needed to support him - has he adequate mental health support, does he need more carer input, is he safe at night. If this absolutely can't be provided then perhaps his wishes can't be met and in his best interests he should go to a dementia unit.

This is fantastic, Anna, I can't thank you enough for making sense of it for me. I don't relish the conversation with him but it has to be done.

Thank you again.

I would phone adult safeguarding, ask for an email and put your concerns in writing - very clearly putting the duty of care onto them and telling them that he is vulnerable and will be unsafe and is at constant risk
AnyName1

Very few people would 'choose' to go into a care home, but there comes a point where their needs outweigh their wants and ultimately they have to be safe. So many people only end up in care when a crisis occurs which often comes about when family take a big step back. Very difficult and another result of us all living longer and longer.