Advice on adult social care referral for neglect.

[summerlovingvibes]

Please no harsh or unhelpful comments, I am posting for genuine advice and all opinions will be considered.

FIL has dementia and early on-set Alzheimer's. Diagnosed about 5 years ago but we noticed things for a while before. Currently aged 61. Lives alone in a town about 30 mins from us as 40 mins from my husband's sister.

My husband and his sister have both POA's. They both visit weekly. FIL has a carer which is paid for privately and they visit daily in the week. Previous social care assessment FIL didn't meet criteria so husband and SIL found this carer. No idea if any qualifications, more a cleaner / helper / helps with shopping and walks etc.

FIL wants to remain in his house as long as possible. Needs help with pretty much everything now - can't get dressed himself, can't cook, can't effectively wash himself. Has burnt himself before - not sure how as no-one was here. Cooker maybe? Has been found wandering several times. Been pickled up by police a few times as lost. Knows who we are --- I think.

Basically I am concerned that FIL
isn't getting enough care and support. Lady that visits is nice, in regular contact etc but I have approached the idea of getting additional care a few times - perhaps weekend cover (currently it is one of us that visit to make a meal & give medication). When carer is off (at weekends or for week or two holiday) FIL won't wash with us. Sometimes smells, not sure if continence is starting to be an issue. Sleeps in clothes, sleeps on sofa as can't work out bed sheets. All meals now ready meals as that is what husband and SIL buy. Lots of things that concern me but perhaps too long to list here. I am in care profession myself.

Husband won't listen to my suggestions, thinks "they are handling things fine". Would I be totally out of order to raise a safeguarding concern to S.S. myself (without giving details) in the hopes it is followed up and prompts SIL and husband to sort out more care?

Tonight's post is coming off the back of a call from a neighbour about FIL wondering again and nearly getting knocked down by a bike outside his home.

Just not sure where to turn really.

Op do what you need to and decide what to tell your husband. He is in denial as he likely doesn't want to acknowledge reality

Has the carer had a dbs check? A your DP had references for her? It sound more like your DH is guilty of neglect if he has POA

Thanks both.

My husband and his sister are both very caring and loving people but I think they both are out of their depth without realising. Definitely a lot of denial going on, and definitely a lot of thinking they are managing ok, doing everything ok. But I've seen this disease before, I just don't think that FIL is receiving the level of care he should. And husband has his head buried. I've made lots of helpful suggestions and I think it's at a point where he just doesn't like hearing what I have to say because it's "his dad and I'll deal with it".

But if it was my parent I'd want more for them.

So thank you for your support, at least I know I'm not totally crazy considering this move now.

As for carer - no idea if DBS checked. It wasn't a decision I was involved in, if I had been I would have asked. SIL is a police officer and in a relationship with someone also in healthcare so I would like to hope one of them considered this.

No specific concerns about the carer but I don't think the hours / level of care is enough and I don't want FIL to be un-cared for.

No references that I am aware of.

Has anyone made an adult social care call before to raise concerns? What do they asks? Will I be able to raise concerns without giving my details?

Tell your partner you have concerns….tell him he is failing to safeguard his father…ask about dbs and references…..what sort of relationship do you have where you are going to anonymously report him for neglect ? Because it’s not the carer thats at fault here in my eyes

He needs more care, failing him without more, maybe denial from husband, he won’t recover
You don’t want an accidental death, which could have been prevented.

No it's not the carer at fault at all. I think she does a great job,, that's not why I'm reporting. She can't offer any more than she does.

I think FIL needs more care - more hours / weekend care / support when carer is off etc.

I have suggested this to husband a few times, and it falls on deaf ears. We have an OK relationship, but busy. 3 young children under 5, he works away half the week. Weekends are busy with family and fitting in time for FIL every weekend. So I would say our relationship is OK but my husband is a terrible procrastinator. I have said before that I think FIL needs more help etc but my husband just says that he and his sister are managing just fine.

I just think they don't think about the finer details etc.

We do argue over it sometimes but it usually when we are strained because of tired / busy week / not having seen each other much etc. and he feels like I'm getting involved in something that isn't my business.

You're considering doing the right thing for your FIL.

We had a similar thing in our family when MIL children couldn't see how ill she was and I stepped in. Separately, my own parent has dementia and I know ours not easy to handle.

It is the right move. I wouldn't let your DH know though.

@Nsky62 this is my thoughts.

More so I don't want him to have an accident and end up in hospital and then stuck in "the system" suddenly without any control. I think if FIL wants to stay at home then he simply needs more help to do so.

But my husband just doesn't see this, and therefore hence my thought process of putting in a safe guarding referral.

Obviously if I told my husband that I was going to do this it would not go down well. He is very sensitive, gets upset, is finding it hard to deal with. But by not dealing with it I fear it will be more problematic.

And in someways I feel like if he was made aware that someone had concerns (I.e. not just me who he thinks is making a mountain out of a mole hill) then he may take it more seriously.

Thanks @AllThatEverWas . I appreciate the validation here.

I don't want to make issues in my relationship ship where ultimately there is an option not to. It's not about our relationship, it's about what is best for FIL and if S.S. step in and make suggestions then they will be listened to.

I just want to get there in the least problematic way.

Did you ever make a referral?

Hi,

Really sorry to read about your FIL. It sounds like he would meet the Care Act criteria for care and support now but I wouldn't raise a safeguarding. If he still has capacity specifically around his care and support needs have a chat with him and see if he would be happy for you to re refer him to social care. If there's any health professionals involved they can make a referral too. Have a look for unpaid carers support services in your area and if he does get reassessed ask for a carers assessment for your DH/sil to make sure they are being supported and to prevent carer breakdown.

OP I'm just place marking but will read through the thread abs come back tomorrow.

Without having read everything though I would say absolutely put on that referral. My DH and his DSIL were both in denial and if I hadn't have stepped in DMIL would never have got the care she deserves

And I'm so sorry about your DFIL. That's so young to be so advanced. He must have had his diagnosis at around the age I am now. Do you think that his young age is having an affect on your DFIL and his Sibling? Thru may not want to think of what it nigh mean for their futures

My dad had to make a referral for his sister in law who was living alone and struggling. She initially refused them entry but has since and has a much better level of care. The anonymity thing wasn't really an issue for us though so not sure how that aspect would work.

I’m of the impression calls to adult social services is confidential, and if he’s wandering neighbors calling etc the reality is anyone might make the call.
I’d call more in hopes that 1) your FIL would be on their radar for further needs 2) do your dh and SIL become familiar with contacts and available programs.

It might be worth discussing this with DH first but ring Adult Social Services for your area and explain just how FIL is and ask for a 6 week assessment where the care company (arranged by SS) assess FIL’s needs by calling to see him 4 times a day everyday. This costs nothing during this 6 week period (or less as they’ll be able to see just how much help he needs very quickly). The Senior Assessor will then make recommendations for further care/care home but family can insist he stays at home (not always the best decision and it does sound like he needs 24/7 care now). Obviously after the assessment period it would cost for the regular care he will require.

I'm surprised the police haven't raised one tbh.

He sounds extremely vulnerable and unsafe, is he under an elderly mental health team? Have they reviewed him recently?

I'm a nurse and unfortunately in this situations it normally becomes a crisis situation when someone falls over or picks up an infection 😕

Yes to reporting a safeguarding referral.

OP Safeguarding is everyone’s business and you can absolutely make an anonymous safeguarding referral to the local authority. Go onto the LA website and go to Adult Social Care where there should be a Safeguarding referral link. Please explain that FIL has early onset Alzheimer’s and he has significantly deteriorated, all the info you gave above re burning himself, not washing, changing clothes, getting lost and picked up by Police. Tell them family are in denial and he does not have enough support to keep him safe and family won’t put more in/ can’t afford to put more in.
The criteria for Safeguarding under the Care Act 2014
1- In need of care and support
2-At risk of abuse or neglect and
3- as a result of those needs is unable to protect themselves from the abuse or neglect.
The LA will then contact family to have a discussion and may open a Safeguarding Enquiry.

As I said previously, I've been in a very similar situation although DMIL was much less older. You have my total sympathy @summerlovingvibes.

In our case we phoned 111 on a Saturday when we were all with DMIL and she's gone missing 3 times in the week. Does your DFIL show any signs of Delirium?

As well as making the safeguarding call I'd also email DFIL's GP and say that you don't want any information you are just concerned about how much he has deteriorated and you, like them, want to avoid a Hospital admission. This is the phrase I've used with several Oldies in the family and it's worked each time. Definitely use email as there will be a traceable record.

Does DFIL have a SW and does your DH have their contact details? They should be made aware that DFIL is wondering.

Has your DH or your DSIL filled in the Herbert Protocol? It's a document that collates all of the information the Police will need once DFIL goes missing and can't be found, and that possibility sounds pretty imminent.

Have they filled in the This Is Me booklet? It's a very useful picture of DFIL's likes and preferences that should be given to any Carers, Hospital Wards and Care Homes.

Is DFIL getting PIP? That will help to pay for additional care.

There a lot of admin to do but it sounds as though it needs doing urgently if your DH wants to avoid a sudden Hospital admission

Just thought I'd two other things. DH and DSIL need to discuss which area they'd like DFIL to be in once he deteriorates enough for a Care Home although if he's wondering that does sound like that tune is now.

You can read reviews from family and residents online and the CQC reports on Care Homes in that area before reaching a decision.

And check out the Elderly Parents Section. It's a bit busier than this board and very supportive

I'd let SS know and his district nurse.
If he's wandering in the street he's not safe at home , they would really need to think about residential care.
I know he wants to stay at home but it sounds like he would need 24 hour care for that. Does he have the finances ?

*time is now 🤦‍♀️

Thank you everyone, and for your sympathy. It is young, and it's been a terrible few years.

Yes FIL is on PIP - I believe maximum PIP. Has been seen by S.S. before for a care assessment but this was a while ago and he didn't meet criteria which is when they got the private carer in.

The 6 week care assessment sounds good. Have never heard of this before and will certainly ask about it.

I'm very surprised that the police haven't done anything to be honest as I think it's happened 4-5x now that they have been contacted due to wondering over the last 6 months or so.

Further discussion about care homes is an absolute NO from DH & DSIL, but I have done some secret research to work out where is good / not so good and will hopefully be able to have some input on this when the time comes.

Haven't heard about the Herbert Protocol, will look at this but I'm pretty certain not. I know the This Is Me booklet from another family member but I don't think so either - this is something that is done when they are actually receiving official care?

FIL is under the mental health nurses / was under the memory clinic as has some medication that they organise specifically , but I'm not sure how often they visit now - maybe every 6 months or so?

FIL GP surgery totally and utterly useless. They had a "follow up" a few months ago which DH took FIL to and it was cancelled on the day & changed to a phone call which was just a simple tick box. DH did tell the GP things but nothing came of it.

Don't think the burn has ever been mentioned to anyone in an official capacity.

I will be making the call on Monday. Unfortunately I have all 3 children with me today and I don't want to make a call when there will be background noise & I can't concentrate. Will make some notes over the weekend from comments on this post and most relevant information I need to tell them.

Thank you all, will update on Monday.

If there's anything else specific that hasn't been mentioned above re: indie for the referral please let me know and I'll a did.

It doesn’t sound safe at all. Likely he needs to be in a specialist dementia facility which is expensive. Where it’s a medical condition and not old age there are ways of applying for it to be funded. Most areas have a local carers charity who will be able to advise.

I know the This Is Me booklet from another family member but I don't think so either - this is something that is done when they are actually receiving official care?

No it can be filled in now and kept for if and when he has a Hospital Admission or is placed in a Care Home. It's best if it's kept somewhere really accessible so it can be emailed to them even if you're away.

Same for the Herbert Protocol.

As for the Safeguarding report I really would email so that there is a trace. I think it's worth emailing his GP and using the phrase about wanting to avoid an unnecessary Hospital admission, even if they been useless before. Do mention the burn and the wondering as well