How to get gran into a home against her will

[Faciadipasta]

My gran is 96. She has always said she'd rather be dead than in a home but I think she does really need to be in one.
She lives alone, she is almost blind from macula degeneration, she is almost deaf and she is showing pretty bad cognitive decline. The last 2 days she has rung me in the middle of the day, crying, saying she's so lonely. She repeats herself constantly. Today she rang me saying she had fallen over, thought she had been unconscious but couldn't hear my to answer my questions on how she is. (This is not only worrying big it also is disruptive. I'm working. I miss meetings)
She can't hear the doorbell or the phone, although my dad has keys she usually seems to.leave her keys in the lock.inside so we can't unlock the door anyway.
I called my MIL to ask her to go round with keys to check on her. She did manage to get in (this time) and said she didn't seem injured but just kept repeating the same thing about calling the hairdressers??
Her house is pretty dirty too because she refuses cleaners and cant see the dirt.
The thing is she goes absolutely crazy if we say she needs ANY help. Literally screaming at everyone.
Even specsavers have said they won't see her anymore unless she has a chaperone because she is abusive.
WTH can we do?
My dad goes round a couple of times a week but we can't just turn up because we can't get in.
I go round a bit but really only if we can go out in her garden because I have young kids and her house is NOT a suitable.place for them to be.
Any advice would be really gratefully received. She is causing so much stress for everyone.
Thanks

Its not ok. its just not an excuse to take away someone's legal right to agency.

This is a simplistic picture, capacity is a complex issue and comes down to the judgment and interpretation of doctors and the situation. Until people lose capacity completely, they can retain capacity to make decisions about some things and not others.

The two key questions wrt to capacity are - does this person have a mental impairment, and does the impairment mean they can’t make a particular decision. They have to be able to - understand, retain, weigh up and communicate information relating to this decision. If they can’t do one or more of those things they would be found not to be able to make their own decision.

It is by no means clear that the GM has capacity in this case.

By the time we put my elderly relative into a home, they lacked the capacity to make that decision. However we did still insist that they were onboard, and collectively persuaded them.

I am saying that when you are late 80’s you might not even remember what you wanted and refuse to do anything at all. You could well believe you didn’t say any such thing.

My DF was living in such squalor but refused to admit it. Think of trashing every room in his house and refusing to let anyone in. He was sleeping on a small camp bed in the end soaked through with urine but was insisting it was ok- he just lived a little messily.

Think how you'd feel if someone suggested to you tomorrow that you weren't capable of looking after yourself to a standard specified by them, and because of this you must leave everything you know behind, and be incarcerated with a bunch of strangers. That's how she feels, and what she fears, whether or not you think she'd be better off. Nothing to do with being 'selfish'.

God that sounds awful @stratforduponavon. I'm sorry

My Mum cannot often remember simple things. It’s called getting very old. Memory loss is rife in old people.

Imagine you tell your kids you want this and that when you are comptis mentis and then when you are 96 denying you said anything like that. Do we just leave you to fend yourself - after all it’s your choice. What could possibly go wrong

The thing is though @watcherintherye it's not just about not wanting to.move out of her home. I really REALLY don't want to make her do that if she doesn't want to. But she can't get out and about her home is dirty meaning she doesn't really get visitors, she is lonely, she falls but we don't know because she doesn't wear a fall alarm and won't allow us to put in a camera so we can check on her. She won't allow carers in and she can't hear the phone or door but even though she allows my dad to.have a key he can't use it to check on her because she leaves her key in the lock on the other side.
So what else is there?

Can you change the lock on the door so you can't leave the keys in?

Yes thanks. A pp did suggest that. We will.

He also said when my sister went mad at him that it was for someone else to sort out when he passed. Fire brigade was called out and ss but he was deemed to have capacity so they ‘left him to it’.

Lucky family to mange the situation. It was literally a death trap but his death trap and for some on this thread that is just fine with them.

Eventually even he recognised it couldn’t continue but it took us weeks to sort our his house, sell it and he moved into a care home where he is just existing.

We went through this with my father. He had several falls and the hospital just sent him home even though he couldn't walk. My mum, who has severe mobility restrictions, was his career. Eventually, they both ended up in hospital, my Dad got Covid and died. Because my Mum was in hospital first, my Dad fell and had to wait over 3 hours for an ambulance.

The thing is, if he'd been asked, when he still had capacity, if he'd rather die than go into a nursing home, he'd have said he'd rather die. He was adamant about it. So, although I feel horrible about losing him, I do know he got what he always said he wanted, to be in his home until the very end.

Is your Dad able to have a conversation like that with her? Would she contemplate going to look around a place just to see? It may be safer for her to be in a home, but it could be the wrong decision for her, if she genuinely would rather die than be in one. I know that is hard to accept, but maybe she would rather take the risks of living alone.

When the house was cleared we did find the remains of a care pendant. Funnily enough after a year the care line did call me wondering why it hadn’t EVER been used. As he fell out with most people he could have easily fallen and been there for days.

She would take rather take the risk of dying alone. For sure. But it's based on her perception of what a care home.is rather than the actual reality. So does that count? I don't really think it does.
And she isn't happy. She has told me 3 or 4 times this week she might as well 'put her head in the oven'

My mum wouldn’t go into a care home but when she fell she was screaming for me as the only child in the country. She didn’t have her care pendant on. It’s how one older persons decision affects others. That is what I am querying.

I don't understand the attitude that we should just leave someone in her position to live the way they say they want to even when they are at risk, almost blind and deaf and clearly miserable. We wouldn't do.that to a 14 year old, even one that is fully healthy. And really the average 14 year old is eminently more capable of living safely and making decisions than she is at 96 (not saying this would be the case for all 96 year olds obviously) so what is the difference. Is it reverence of elders? If so shouldn't they be awarded dignity to live a happy (hopefully - at least a chance anyway) clean and safe life?

Our lock has a safety feature where even if there is a key in the inside, you can still put a key from the outside and get in.

the points you are missing is that the person's right to make unwise decisions is enshrined in law and if a decision does have to be made on the persons behalf, then evidence about previously expressed opinions must be taken into account. So if someone has said that they won't go into residential care under any circumstances when they had capacity to decide, then this strongly expressed opinion must be taken into account when taking decisions if capacity is lost....so eg presuading them to try residential care, as you did, fine.....saying "mum you are going and that's that" not fine.
You are right though....the legal principles are simplistic and clear cut...as simple and clear cut as "You must not murder people" Its down to case law and real world application to interpret the nuances.

This is all personal experiences told to me or I know. Every recalcitrant elderly person finally gets into a home (a good one) and loves it, they actually bang on about it til its boring. Most were resistant but ended up in one anyway

A potential in with yours is that she gets to choose now which home she goes in. Once she has lost capacity she has no more choices. So let's go see a home today gran see if you like it, it's close to ?? Its lovely, it's like a sheltered home, look at the flat you could have, no heating bills, Christmas parties, movie nights etc etc. Play up all the good points whatever they are and whatever she likes.

Make it clear its this or you will bow out.
It sounds really mean but a good care home can be wonderful and the best thing ever , maybe she is scared no one will visit but she obviously doesn't know how brilliant homes can be. Frankly visitors will get in her way of a good time.

Try contacting her local Community Mental Health Team and explain the GP won’t visit. That should include Older People Mental Health Services.

The GP might refer to her local Crisis team if she tick the right boxes.
Arguably she’s showing signs of cognitive impairment and also paranoia (chiropodist) and also suicidal thoughts. Flag also that she may have had a head injury when she fell.

To get action you make an appt with her GP and insist they don’t wash their hands of her - and to refer on out of the area if necessary.

a 14 YO is a child .....you would leave an adult..say a 20 year old....to live how they choose assuming they have the mental capacity to decide. Your grandmother is not a child.
Its not about what you should do; its about what you should not do which is deprive an adult of their right to make their own decisions and if they do need decisions making for them, them making those decisions with due regard for the choices that they would have made in the past and would make now if they could.

oh believe me...its not "just fine"

I haven’t missed this point it’s just not really relevant as GM in this case may well not have capacity, and it’s not the case that someone who didn’t want to go into a care home then can’t be put into one once their capacity has gone. Their wishes may be taken into consideration, but their condition and needs have changed and their safety and well-being is paramount.

I didn’t say the legal principles were simplistic I said your presentation of the issue was - it’s a complex medical decision.

Actually its not a medical decision, although a doctor may need to make a capacity decision, as may a nurse, a relative, a carer and so on. Even when people do lack capacity, previously expressed wishes must be taken into account...they don't automatically trump current need but current need doesn't automatically trump them and neither does safety or well being.

Don't worry, you'll find out when you get old and your children are saying the same thing about you.

At first I sympathised with your situation but found it strange that your post only mentions GM in negative terms. No recognition of the fact that being 96yo is a blessing bestowed on very few people but which has its challenges which you go into. Have you tried thinking what life is like for her and trying to speak to her in a manner in which she can believe you have her best interests at heart other than she's a burden and trapping all of you with her daring to be alive for so long??