How do they force her into a home ?

[GoodnightGrandma]

My MIL is refusing to go into a home. She has dementia and is becoming unmanageable. It’s sad to see what this once proud woman has become. SS are going to court to get her forced into a home.
How will they physically get her there if she refuses to go ? The home won’t help, they are saying we have to get her there.

They will have to apply to the court of protection specifically to get an authorisation to transport/convey.

If the court agrees that it's in her best interests then the local authority will work through the kindest/least restrictive options first.

This may include things like asking the family to try 'taking her there for lunch' and them doing a disappearing act once she is tucked into tea and scones, or possibly sending patient transport to the house and telling her she's going to a hospital appointment right down to physically getting the police to come and assist with removal/restraint.

In my many years of a social worker I've only ever once had to resort to the police and they were really wonderful and kind. However, It's nearly always possible to cajole the person gently and kindly to going semi willingly with no force required, but sometimes it can take a couple of days.

Once they are at the care home a deprivation of Liberty order will be in place giving the staff there the permission to prevent them from leaving again.

She won’t get in the car, she doesn’t go out. We had to get her Covid jabs done at home, and the memory clinic nurse had to come to the house.
I can’t see us getting her out at all, and she’s doubly incontinent now.

They are applying for the court order to force her into care, but they never mentioned an authorisation to transport.

There's various pieces of law they can use once authorised to do so and there's is a good summary at this link

www.rbsab.org/UserFiles/Docs/MCA2%20Conveyance.pdf

But ultimately if they can't get her to leave willingly it may be one of the thankfully very rare situations where the police are asked to become involved and the ambulance service would assist with transport to the home whilst the patient is under restraint.

Thanks.

I'm not certain but I think if the SS are so concerned about her welfare to apply to the COP, it will probably mean she will be sectioned. And they will do the least they need to, to take her to a safe place. It's such a terrifying time for PWD and their exhausted families. Lots of people do so much better after the agony and indignity of the last few months/years at home. Sometimes it is the only option.

I'm not certain but I think if the SS are so concerned about her welfare to apply to the COP, it will probably mean she will be sectioned

Not necessarily.

Detention under the mental health act (sectioning) would suggest that someone is mentally unwell (e.g. delusions, hallucinations, violent or risky behaviours endangering self or others) and therefore they require assessment/and or treatment under the mental health act to see if medications etc can assist with reducing the condition.

This would mean they would be removed to a mental health hospital bed because it is considered at that time that they require a medical level of care to treat their condition. MH inpatient beds are a scarce resource and there's no guarantee that they will be local, people can be sent 100s of miles to the nearest available MH bed at that time.

If the person is otherwise medically stable from a MH point of view but their physical care needs can no longer be met at home and they lack insight/ mental capacity to understand this and they are therefore resistive to the plans being made then it would be more appropriate to deal with that in the first instance under the mental capacity act and the court of protection as it sounds like is happening here.

The Local Authority wouldn't/shouldn't be applying under the MCA to the COP if it would be appropriate to use the MHA instead. But it may be that some powers given to police/ambulance etc under the MHA could be used in an emergency to assist then Local Authority in carrying out the decision made by the COP.

As pp has said they will likely tell her she’s going for lunch with a friend.

I have heard it of one time where sedation was prepared due to a very high risk to all involved, but thankfully it wasn’t required.

Good luck, I hope it works out well for her.

She won’t go out of the house for lunch !!
Perhaps if we could get her into an ambulance chair with her arms tied down, as she tends to be a bit violent now.

Oh gosh. What a terrible situation for you. Sending best wishes… so heartbreaking.

We had to trick nanna, told her we were going to the park and McDonald's (I know but dementia does make you like different things!) at the home the staff were great and helped us and we had her favourite sweets as lures. Basically the same technique as you can use with children

Similar situation for DP and family. MIL is in a siege situation in her upstairs. Meals are brought to her. Care home had to give away her room after ten days of failed coaxing. Interesting to read Hatgirl's comments, thank you for posting. Understand the process can take six months.

If there is any level of restraint used- chemical or physical, then this will need to go through a lot of checks first- her capacity first & foremost. They will likely try to persuade her a few times. Only if she’s at high risk & won’t go other wise would restrictive methods be considered.
Wishing her the best.

It’s so sad OP - I feel for you. I’ll be dealing with this soon I think.

It’s so undignified. They’d not want it. They’d rather die peacefully.

As a paramedic I've had to take a few dementia patients from their homes under section.

When we use our carry chairs (lightweight liftable tilting wheel chairs) with the majority of patients we use a folded blanket to wrap the arms in as it is common for people to grab out when the chair is tipped or when they get scared being carried down stairs. The chair also has a leg strap which we use with patients who can't keep their feet on the metal foot rest.

With elderly sectioned patients (or ones we need to transport who have lack of capacity, which is much more common) we use these methods but maybe with additional blankets to make sure they don't free their arms.

Generally once they are secured in the chair they give up fighting.

On the ambulance we have multiple straps on the stretcher and once snugly secured a blanket tucked over the buckles is normally enough to keep a dementia patients safe on the stretcher.

I've never seen a dementia patient need the police to cuff and move them, which I assume is your concern OP.

What a very sad situation, I hope it gets sorted out, you must all be so worried

An update - the ambulance refused to attend and take her.
Eventually the police came, had a chat, and she got in BIL’s car and went to the home. The police would have forced her if necessary.
She has been very upset, and initially it sent her MH spiralling down, but she’s settled in now and is doing well with regular food and baths.
She still wants to go home, but she won’t be doing.

My mum was the same - she didn't have the same issues but she was very resistant to going into a home. My mum was terribly depressed for the first couple of weeks but is warming to the place now.

Well not a great way to have to do it, but it must be a big relief for you all.

Not a great way no, but a great relief to carers, neighbours and family.
And she is being cared for, not just existing.

Good news OP. Well done on no one getting hurt.

I'm glad to hear your update. My grandma fought against a care home for such a long time. We told her she needed to go to a hospital appointment and booked a private ambulance to take her. She was so resistant but once she got in the chair and wrapped up in a blanket she completely changed. She relaxed, it was weird like she'd been tucked up in bed or something.
But it still felt wrong, felt like we'd tricked her.
It's a horrible thing op, I'm glad it went reasonably smoothly.

Thanks for coming back and posting an update @GoodnightGrandma. Sounds like it went as good as it could have given how resistant she was being

OP, I’m glad to hear she’s safe and doing ok.