Mum in care home temporarily

[Metoo15]

Hi. Mum had a long stay in hospital after becoming confused and feeling ill. She’s 92 and has been in the care home 4 weeks. The social worker is going to see her next week to decide if she needs to stay,or if she could be moved to extra care housing, or go home.
Mum is so much better is putting on weight and walking much better. I’m afraid the SW is going to send her home, but the main problems are still there, she has postural drop which has
ended up in 3 very bad falls, she’s slightly confused and has occasional hallucinations. Apparently the LA can’t afford to put every one in a care home because of these problems and she’ll be looking for a cheaper solution !
I’m so worried. She wouldn’t be able to manage at home she had carers 4 times a day before her hospital stay. How can I navigate the meeting with the sw. I haven’t got POA so apparently it is her decision whether she stays or not.

No. The OP is the one on her knees. She gets to decide.

I know it sounds selfish but I’m late 60s and the thought of having to support her at home again are stuff nightmares are made of ! It’s keeping me awake already

@Oldermum84 this is a direct quote from the OP.

Not according to The Mental Capacity Act 2005.

The OP can decide how much she will do, but it's not her decision what happens to her mum.

If her Mum has capacity it's her decision, and if she doesn't it's the State's decision, although they will take the OP's views into account when they make their best interests decision.

Yes. But the OP thinks her mother is better off in the care home, is better cared for there, and she herself cannot cope any longer.
Her mother can decide at long as she knows that the OP won't be looking after her anymore.

Not if she refuses and is not around to do any of it. No visiting remember.
Put it in an email to the social worker and absolutely stand by it.

100% agree with this.

OP - all you have to say re withdrawing your help and support for her is something along the lines of 'I don't believe my mother can now live safely in either her own home or extra care housing. As a result, I will not be able to offer any assistance if social services decide that she should attempt to live outside of a residential care home setting,'

Hi. I don’t know if mum has capacity because she hasn’t got a dementia diagnosis. Apparently this can only be done via the memory clinic, the Dr in the home is arranging this but not done yet which is a shame seeing as the SW is coming on Tuesday.
Mum looked sad yesterday, there was only two ladies in the lounge and they both have dementia so she has no one to talk to really. I came home once again upset for her. She said she’s okay there and realises she needs the support but it’s not ideal.
She can’t go back to her flat it really is unsuitable, she fell down the whole length of the stairs last year and suffered a brain haemorrhage the women from carers said she should have not been allowed back there after that, but her SW at that time said she had capacity and mum wanted to go home.

I’ve had a quick Look at extra care living in our area, but I’m not sure it’ll be enough for her. Thank you all so much, the support is great even though I do deem to be going round in circles 😵‍💫

What she needs now outweighs what she wants. Today is the best she will ever be. Your aim is to facilitate her safety by whatever means. If that means being 100% uninvolved to force the issue then that's the way it is. You won't be visiting as far as the SW is concerned remember.
Most people in care homes would probably rather be at home. That's just unfortunate if we're all now living to 101 with all the physical and mental failings old age that brings.
Sometimes ideal is unobtainable and good enough has to do.

tokesqueen Yes your right, I need to think with my head not my heart. She is most definitely safe where she is, it won’t be the same with only wardens popping in. Better get my big girl pants out for Tuesday.

Hi. I don’t know if mum has capacity because she hasn’t got a dementia diagnosis. Capacity is not the same as a dementia diagnosis. You can lose capacity without a dementia diagnosis, a dementia diagnosis does not mean you have lost capacity.

Capacity should in any case be decided on a question by question basis. You may have lost capacity to manage your investments but still have capacity to decide whether you want fish or chicken for tea, or indeed to decide she wants to live at home with all the risks that involves.

Thora Hird in Alan Bennet’s Talking Heads: A cream cracker under the settee - another perspective on “being safe”.

MereDintofPandiculation Aah thank you for that that's interesting I hadn’t realised. Who would decide if she has capacity ? Ive said for a few years now she can’t join the dots. She doesn’t understand the need to live somewhere without steps even though she’s fallen down them she just thinks she needs to be careful .

Capacity is usually assessed by a psychogeritrician - a psychiatrist who specialises in treatment of mental health in older people

https://www.nhs.uk/conditions/social-care-and-support-guide/making-decisions-for-someone-else/mental-capacity-act/

@Metoo15 Even if your mother is deemed to have the capacity to decide where she would like to live, you still have the right to decide that you are not going to be the one caring for her at home and facilitating her wish.

You must make that very clear to any SW who tries to guilt you into the usual default position for women. We do not have to do this. It is all right to say "no".

Here's a link to that thread again:

https://www.mumsnet.com/talk/elderly_parents/4967638-so-bloody-exhausted-waiting-for-someone-to-die-2?page=1

Just a word of warning, lifeline pendants do not always work. A relative had a fall while getting undressed for bed. The alarm did not go off and the relative lay on the floor undressed and cold for many hours until a carer found them next morning. That fall had disastrous consequences for relative's health.

The social worker can complete the capacity assessment if they suspect your mum may lack capacity around the decision. It doesn't need to be a medical professional and (although I may be biased here) often social workers have a better grasp of the mental capacity act and completing capacity assessments than medical professionals do.

The 'joining the dots' stuff is known as 'executive functioning' when doing capacity assessments - the social worker should be assessing not just if mum can make a choice/give an answer about what her choice but also demonstrate she is able to retain the information, and weigh up the pros and cons of the decision to be made long enough to be able to make an informed decision.

Capacity isn’t all or nothing. It should always be assessed in the context of the decision to be made. You can be incapable of assessing an investment opportunity but still capable of deciding whether you want the pneumonia jab.

Hi. Just an update as you’ve all been so helpful. I saw the SW this morning, she asked mum lots of questions, to my surprise mum said she didn’t feel able to move back home, she said she didn’t feel safe and she was lonely.
The SW then asked me if there was anyone that could move in with mum, took me a bit by surprise ! Err no afraid not, I’m an only one and I’m not far off 70.
To cut a long story short. Mum, bless her said she wanted me and my DH to enjoy our retirement and she was happy to stay there.
The SW then said she would recommend mum stay in the care home, but it wasn’t her decision she would take all the info back to her manager and a decision would be made wether she’d be able to stay there, or wether we would have to consider moving her to an extra care living place , which I don’t think is enough for her now. So again we wait, hope it’s not too long. Thank you all again.

Well, that's looking positive, OP.

Why would you do that to your mother?!?!

Sorry I was trying to the reply about the OP withdrawing all help for her mother. Please love and care for her don’t just dump her on the local authority. They are on their knees already.

Why would her mother allow anything different? A decent parent wouldn't.
Her wants at the end of her life don't trump anyone else's in the prime of theirs.
That sounds promising OP and your mother sounds lovely, understanding and most importantly, realistic.
Stick to it.

Her mum cannot go home just because she wants to. Lots of elderly people think they can manage, and assume that family will be able to help. For many, that situation is totally untenable and the person doesn't have sufficient capacity to make that decision so no, the OP mum's wishes are not paramount.