Please please stop giving this advice

[wheretoyougonow]

I see so many responses on here telling family members to call Social Services to ask for an assessment for their parents as they are struggling with their caring role. You should not do this if they have capacity and don't want Social Services involvement.

One of the first things you should be asked is do they know you are contacting them? Even if they do call your parents ( they may call to offer an assessment) it is extremely likely your parents will refuse.

You really need their agreement first.

If you are struggling as a carer it would be worth contacting Social Services to ask for a Carers Assessment for yourself. This means you can talk about your carers role without consent of the person you are caring for.

If there are safeguarding concerns then of course report them but state that it is Safeguarding to get (hopefully) the correct response.

I'm writing this out of kindness and to hopefully avoid some frustration. Caring is hard so it's important that you are not waiting for support only to be disappointed in the actions (not!) taken.

Well said. Not everyone is physically able to drop everything to look after their parents. I wasn’t. I had a full time job and two young kids.

If I had stopped working to care for my parents I would have lost my house. You’re damn right I contacted social care and I would do it again.

@since1986

I think I've written very similar to you in my latest post but not going through a care needs assessment but raising a safeguarding ( if the person has capacity).

The safeguarding should require more investigation into the circumstances and assess how the risk will be managed without the current support.

I've written it like this as sometimes carers (quite rightly) become very frustrated at the lack of support - Social workers don't have the powers to override capacity. However if family/carers are aware of Safeguarding and how to report concerns that may well help.

@since1986 thank you. Our mother is unmanageable. Three of us have tried everything-she is deemed to have full capacity she just has decided to become selectively incompetent-which means when we go we end up doing everything for her - she refuses to have a cleaner, deliveries of groceries- she wont use her freezer - she is essentially doing what she has done all our lives - exerting CONTROL so she gets everything on her terms, even though she knows the stress we are feeling. Selfish behaviour.

I'm in a bind at the moment as my mum ended up in hospital due to self neglect (broken hip, mental health issues and bed bugs in the flat) I'd raised a safeguarding concern for 2 weeks before anything happened. She'd stopped eating, was on a drip for over a week and was very confused. She'd had a bipolar episode. She was not coping at home

I thought finally she would be assessed as needing carers or supported living or even a care home as she was not coping.

Now she's been in hopital for a month the council are finally looking at her flat. As it has bedbugs noone could go in (at the time I thought carers) so she can't be discharged.

They have today said they want to discharge her to a B and b the other side of town. She couldn't look after herself in her own flat. She won't cope in a b and b. She's rung me in tears but I don't know what to do.

She's told them she doesn't have care needs (?!) even with her broken hip and told them she could cook so she'd be discharged. (she thinks she'll lose her flat if she can't cope)

So presumably she's caught in the middle of it all

It will be an unsafe discharge but I'm at a loss now what to do.

I can't see how it was a safeguarding issue her being at home but they'll discharge her to a b and b. Or who I need to contact.

The hospital social worker is next to useless as has deemed her having no care needs.

I'm losing the plot and have taken time off work and now caught covid on top of it all so really not sure where to turn next.

I was about to update my own thread I started (and will do so) but saw this thread timely. I had waited until mum had really deteriates because I know from bitter experience people don't intervene until she's lost capacity (in this case sat in 2 weeks worth of poo and urine and not eaten enough for need for a drip)

I'm so cross she was discharged from cmht and social services in hospital don't think she has needs.

@Bedbugdilemma
I'm so sorry to read your post. One suggestion I have is ask the ward what physical care they are providing your mother. Are they helping her to the toilet/washing/dressing etc.
If she needs help then ask the social worker how she will manage on her own?
It sounds like a lot for you- if you are unwell or for any reason not able to advocate for her then maybe ask PALS to get involved.

In my county they can provide temporary care home stays (a bit like respite) to go to whilst they sort out how to get home. Might be worth asking whether they have anything like this.

Yes I was under the impression she would be going to a care home that does rehab type care.

The problem is she was assessed as "living on her own independently" even though she wasn't coping and that's why she ended up in hospital.

With a stick she can walk to the toilet. She has been in a nightie for a month but probably could dress herself. But that's her limit. She couldn't cook a meal or get food to cook a meal. She hasn't got mental capacity to cope on a strange place or work out how to get food or anything. She hasn't got access to any of her things as they're in her flat which the council will be debugging.

And yes I feel so unwell today I don't know how to keep fighting for her. I'm off work and wanted to switch off from it all and now I'm so worried as she has such fragile mental health and lots of previous involvement with psych units etc she won't cope.

I completely disagree with you OP.

Lay people have no idea about the intricasies of this service v. that service. Which one is appropriate in x circumstance, and which in y.

And despite having several years experience now dealing with various services myself, I still do not have a full idea of what exactly each one does.

It's very easy when you're part of these services to have knowledge of which is appropriate because you're working day in and day out with each of them.

If someone is worried about their mum (or whoever), because mum is no longer coping, then go ahead, phone social services. If they're the wrong people then I'm sure the worried person will be directed to the right service.

I think it's unreasonable and unfeasible to expect people who are probably at the end of being able to cope themselves, to have the knowledge required to get it "right".

That was my situation too.
Unfortunately I got to such a low point that I stopped taking any calls from my late father because I couldn't cope any more and many referrals to social care and nhs older adults mental health services proved pointless because he refused to believe he had any problems, and he wasnt 'bad' enough to be placed in a care home if he refused (and he did, often just telling me and everyone else to fuck off)..
He died from a heart attack at home and was found by one of his carers. To be honest as well as feeling upset at losing my Dad I was just so relieved it had stopped .
So I have mixed feelings about the 'call/don't call' Social Care dilemma. And I have already made LPAs for health and finances to protect my DC if and when.

That's so sad Mauve and I can imagine it will end for my mum once home in a similar way.. Turning your back on them is so hard and I thought I'd done that earlier and keep getting dragged back in.

Its a broken system.

I think this is such a hard situation.

I briefly worked in a service that carried out dementia assessments. The first thing that happened was that the person was asked for consent to do the assessment. Quite a few people said no - they thought they were fine or would rather not know if they had dementia.

Which left everyone around them in a real bind, because it can be getting a dementia diagnosis that opens the door for capacity assessment and getting more support.

We have a similar situation with a family member at the moment. Not at crisis point yet, but they aren't really managing without extensive support from other family members (who are getting stressed and overwhelmed), have declined interventions like an adapted bathroom that would help them to be more independent, and think that they are managing fine but not really aware of how much they are not fine.

Unfortunately, they have very good chat, so sound fine when in front of professionals for short periods - but then get everything hopelessly muddled and confused immediately afterwards, aren't able to take anything in, or kind of confabulate stuff to go along with a narrative suggested by someone else. I really don't want it to get to crisis point (again) for them to get some support (or die horribly) but I'm not sure if there's anything we can do to get things in place earlier.

I am afraid I also disagree. My MIL was assessed by first her GP and then the hospital as having capacity when it was utterly clear she was failing. We were told she was capable of showering and dressing - but they assessed that by asking her, not testing it while in hospital.

She could not shop, heat food or reliably make a cup of tea for herself. I could go on.

I personally called the hospital social team and told them what I observed- the double incontinence; out of date food; inch deep dust in the shower. And I told them I was done and there was no-one but DH & I .

Very sensible social worker visited MIL, halted discharge to home, and had her placed in respite for assessment. She never went home.

As pp have said, when you have tried , banged your head against a wall, have no agency in the situation, you sometimes have to yell for help.

It would be nice if there was a clear , available flow chart Q&A as to when to pull which trigger, but there’s so little joined up thinking and a lot of buck passing, that , ime, we each just cling on to whomever will actually listen.

@wheretoyougonow I don’t understand the point of your post.

People may want to get social services involved because even if the parent refuses, then at least you know you have taken the steps to flag up a problem.

I don’t understand why you would discourage anyone from doing that. Why have you posted this?

You have opened a can of worms here OP! Can I ask who you in relation to all of this? Are you looking after a family member, a carer or a SW?

Its all very well trying to make it YET AGAIN all about the elderly person. Its almost always about them.

My experience with two elderly parents living seperately is that its a minefield and as SOON as a social worker knew there was a daughter (yes, always a woman) you were bombarded with calls, letters, queries etc. I was estranged from one parent for many years. Didnt stop them contacting me and trying to get me to get involved which I did in the end.

I am honestly sick and tired of us ignoring the elephant in the room which is we arre lviing much much longer than before often with a very low quality of life. DF was in a care home for a number of years. Had a bad accident there. Incontinent, in a wheelchair and generally an all round bugger to be around. The care home made a lot of money out of him

DM was different. Just wanted a pill to make her 30 years younger and got more and more needy and anxious. Causing issues for all of us. She didnt want to be here. Was ready to go but she was just patched up time and time again until we had a robust coversation about treating medical issues and literally putting her back on a stretcher to her care home where she was bed bound, cried every day and begged to die.

Rant over!

I called social services to make a referral for an elderly friend who wasn't coping. The first thing they asked me was did I have his consent to call them. As I hadn't, they wouldn't help.
He ended up in hospital a few days later and the fact that I'd made a referral for him was flagged up as part of the bigger picture. He was discharged to a care home in the end. But it was a battle convincing the hospital social worker that going home with a care package would t work.

I couldn't give a monkeys whether or not they 'want' SS involvement if I think that a child is at risk of neglect or cruelty due to their poor parenting.
Elderly people are a completely different field. Elderly care is so delicate and complex and there is so little help out there

Exactly! If you have rung SS and they have done nothing and refuse to help or say the person can make their own decision and then the person dies at home due to their own neglect then of course its upsetting, but at least you will feel you did everything humanly possible to prevent it.

If you do nothing and the same thing happens then you'll be eaten up with guilt thinking "if only I had expressed my concerns...."

I know which one I would rather live with and it isnt the second one.

@Bedbugdilemma I am so sorry this is going on. You need to tell the Hospital SW that if they discharge her either to a B & B or to her home it will be ' An Unsafe Discharge'. Use those words and tell them that even although she has said she can cope fine, tell them what you know and what you have said here, about the things she cannot do. Ask them what exactly they have done to actually observe what she can and can't do other than asking HER what she can do. Also say that you are not in a position to do all the things she can't do herself and she will be unsafe if she leaves hospital for anywhere that doesn't have some measure of care

They WILL put pressure (lots of pressure) on you to say you will look after her and it requires being very tough to stick to your guns - but you can only do what you can do and if you can't meet all her needs or anything like all of them, then you have to keep saying no

Many elderly people don't want to admit they can't do certain things and will make the best of things/lie when asked. I remember filling out a claim for Attendance Allowance for my Mother. Absolutely NOT a word of a lie, or bending the truth anywhere on the form. She wanted to read it after I had discussed things with her and then written down the answers as I saw them. Her comment was 'You've made me sound like a poor old soul'. She had to agree that it was all true though, but wasn't keen to admit to it. She got the AA!

@guccibag well said. I have made contact with my mother’s GP and aired the situation we find ourselves in. My brother is her named representative so my sister and I leave it to him to take her. She is just defiantly resistant to implementing anything sensible both for herself and for us who genuinely do not have the spare capacity to do what needs doing. I’ve resigned myself to a crisis but at least the GP has a well thought out email outlining our situation. There is only so many times she can say ‘but I’ve got these 3 - why do I need external support?’ Well the answer is she criticises everything we do, throws food away we buy making excuses it’s “off”. Deliberately breaks household items so we are running round fixing things. External support would simply not accept this. I need her GP to know what we have to tolerate. Now amount of sertraline can medicate a mean controlling personality.

Thankyou. I've emailed the SW and just emailed PALS who have said they will forward to the ward.

I've said unsafe discharge and concerned she wasn't coping before which led to hospital admission so certainly wotn manage in a B and B

I hadn't said about seeing her manage. I will do that if they respond to me

The social worker had previously said the ward have said she can go to the loo herself so that's enough 🙄 And mum told the social worker she was cooking before she came in. But that's mum remembering before she deteriorated, and also mum saying what she thinks people need to hear. She's managing in hospital because everything is being done for her..

Im so exhausted.

Yes, in my experience SS won't do anything if the person has capacity and won't engage. My elderly Aunt was referred to them by emergency services after a fall. They visited and had a long conversation with my relative, she had capacity, she was stubborn and refused all recommended help and aids. They called me as NOK and told me there was nothing they could do.

My sister and I were not in a position or location to offer much care or support. And my relative died alone in her flat as a result of refusing all support, which she could have easily afforded. Very sad but that's the way it ended up.

I have an elderly mother that has capacity but does not have insight into her own care needs. She can’t manage, won’t accept help unless it’s me, DSis or the neighbours, and has frequent falls (has a care line pendant but doesn’t always wear it or activate it). We both live several hours away so can’t drop everything every time there’s a crisis, and the neighbours have got their own lives.

Currently being assessed by SS during the care package provided after a hospital stay. We had to be insistent that she would be unsafe to be discharged without a care package, and SS were helpful with both phone advice and putting the package in place.

No idea what is going to happen at the end of the care package. She needs residential care but she isn’t going to want to do that, or employ carers herself.

Our elderly relative was assessed and we were told ‘he has capacity and he’s decided that his sons will continue to take turns living with him to provide his 24/7 care needs’.

no acknowledgement that all sons had families, jobs, responsibilities and children of their own to look after.

This, with bells on.

The huge hole in your post, OP, is the contrariness, stubbornness, and frankly the delusion of some older people who take it as a personal insult and rank betrayal on the part of family members who have reached the point where they can do no more.

Ss need to be madeaware.they are gate keepers to range of referrals.
Making sure the family member phone number is listed is crucial

Eg trying to organize OT referral for chair or rail and elderly person does not answer voice messages etc it won't happen unless a family member or trusted person is getting the call

To say dont call ss is naive

Also feel compelled to weigh in - accepting @wheretoyougonow means well. I don’t mean to pile on.

We still have nothing formal saying ‘no capacity’ and DF will tell you or me every visit his wishes are to go back to his crumbling house, cook all his meals from scratch and he doesn’t need any care - then he presses the call bell in the nursing home under a DoLS for help doing basic ADLs (I do all higher ADLs and am LPA).

Many of the posters I’ve seen where it was recommended to call Adult Social Care are way past being able to wait for the person to agree, they’re already in a pretty desperate situation with an unreasonable vulnerable person with no insight into what it takes to keep them safe.

Some are geographically too far away for the same Local Authority to do a carers assessment.

I also think that the funding split between health services (NHS) and social care services (local authority) is really unhelpful.

How can the drain of resources to provide daily nurse visits, paramedics every other day (to pick up off the floor), numerous MRI/CT scans, hospital admissions, repeated 6 week reablement periods and broken bones/being sectioned be the best use of public resources.