Mental Health Assessment at Home

[timeistight]

Finally, after three years, MIL has agreed to this, but it's taken so long to get her to this point that we don't want to blow what might be our one chance to get her in the system and properly supported.

MIL is in v poor state physically and mentally. She does not know me and, although she is consistent with DH, she clearly thinks he is someone else. She can chat away for hours in a social setting, but sadly, none of what she says is true.

Can anyone advise me what form the assessment is likely to take and what we should do to optimise our chances of getting a result that correctly represents her condition.

Thanks

No-one?

You really will have to leave the assessment up to the professional who carries out - has she/you received an appointment? It should say who will be coming out to assess her, or there should be a phone number so that you can ring and ask who will be doing the assessment and what form it will take.

It might help if you write to the team carrying out the assessment (there should be a postal address or an email address) with your concerns and your own experience of how she has deteriorated, how she presents etc. I used to work in mental health and this kind of input from family was always welcomed.

That's really useful - thanks. I can't write (complicated family dynamics) but DH could.

Hi, just wondering what the outcome here was? Did you have an assessment? I ask because I am expecting one for my PILs on Monday, but social services really does not want to engage. I don't know if I'm supposed to be present or what time it is. It's ridiculous how little SS actually helps us.

It's not for a couple of weeks, so no update yet, other than that DH is minimising furiously and saying his DM will be fine

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while also acknowledging that she has forgotten my birthday, and his and his late DF's.

Isn't the whole thing just soo stressful. My DH and FIL wouldn't even talk about dementia for about 5 years after MIL had it. Now they are both over 90, still living at home, which is filthy, despite our efforts with cleaning, etc. And SS are still saying to us 'if she doesn't want to go into a home we can't make her', and then leaving us to it. Of course she doesn't want to go into a home - she has DEMENTIA!!!! Sorry for rant!

I found if you google Mental Health Act, it tells you all about capacity to understand.

I have been present three times when the initial assessment has been carried out.

The Assessor introduces herself and asks if it OK to proceed with some questions. They ask thing like who is the Prime minister, when is your birthday, Do you know who this lady is. They get the person to talk about their life and prompt with questions, to check the grasp on reality.

The give them some words to remember and through the interview, ask if they can remember them. Usually they are shown a clock and asked to put the hands on a particular time.

The worse the person ‘performs’ the shorter the assessment. Sometimes it is easy to see the level quite quickly And It is cut short to avoid tiring or stressing the patient. They can get quite upset if they feel they are not answering the questions correctly.

I have found every assessor really kind and understanding.

I guess I need to ensure that someone can indicate to the assessor when she gets it wrong. She sounds so plausible, but it's all rubbish. She's by turns delusional and paranoid, afraid of things that aren't there. It's awful. She can no longer remember anyone's birthdays and she's even starting to forget her late DH who was the love of her life. She'll talk about him playing with his grandchildren and it sounds lovely, but the oldest grandchild was born three years after he died.

They are very good at seeing through the flannel and also aware that people always perform when being assessed. Some inner strength appears from somewhere. If you are going to be present during the interview, give a letter to the assessor at the start, outlining your concerns. Ask her to take it with her to read after the assessment.

During the assessment sit out of MiLs eyline. Position yourself behind her. Don’t contradict her, a good assessor will look at you throughout for nods or shakes for confirmation. You can occasionally join in conversations in a gentle way that will not put MiL on her guard. Again a good Assessor will leave openings for you to do so. The ones I have dealt with have made it seem like just a friendly chat. When the relatives has said how well they cope, the Assesor has replied, ‘that is really good’ , but not being taken In for a minute.

If you cannot be present, then do write a letter to the unit doing the assessment. The more background information they have, the easier the job is.

That's really helpful - thanks.

DH has just called me.

The assessment took two and a half hours in the end. MIL performed brilliantly at the start and then lost it completely. As a result she has been referred for a brain scan.

The assessor was very thorough and highlighted that MIL needs to see her GP urgently re her heart issues and also advised us to see a solicitor about PoA, although as a former practising lawyer myself I think it's too late for that. MIL, needless to say, has refused to do either.

My SIL, who will tell anyone who is prepared to listen that she has now given up work to care for her mother full time, wants no part in this process and stayed at home, as did my BIL, so DH had to deal with this alone and is now v upset.

Thank you for your support.