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.

@Dymaxion interesting idea - and possibly an approach DF would have been more likely to respond to.

You're being really disingenuous here. Mental capacity is enshrined in law and those deemed to have capacity cannot have anything forced upon them, whether that be through social services or by the NHS.
Someone can refuse to seek medical advice, refuse to go to hospital, refuse treatment in hospital and self discharge.
Social services do not make capacity decisions based on finances. Saying things like this will scare people.

@pickledpaula I’m not accusing any one individual of making any of the decisions about my DF’s care for financial reasons - all parties were very pleasant people and I believe most were trying their best to help him within their remit.

But @Dymaxion is not being disingenuous. At least part of the cause of some of the traumatic stories being shared here is the split between central funding (NHS) and local authority funding and the current structure of the overwhelmed system. Overwhelmed individuals pass the confused person around (or don’t have the time to properly assess how confused they are).

Previous posters have also stated that family cannot win - we really can’t and must refer to SS - some of us have power of attorney, which brings a legal duty to advocate for the confused persons health and welfare.

I'm a carer for my dh. A support worker arranged a social care assessment for him, I hadn't a clue what it was all about but everyone involved was lovely. They did the assessment at home and he's now been awarded respite care. This means we have the funds to pay a person of our choice to come in and take over my carers role every so often. Without a social care assessment this would not have happened. I was at breaking point but now feel like I can cope again.

@Bedbugdilemma your post reminded me of my late fil, who was in hospital after breaking his hip. The first one was great and he was starting to get help and then he was moved to a rehab care home and was shut in his room for 2 weeks due to covid. He was an alcoholic and went from having the meds needed in hospital to help with withdrawal he went to none of that. He was then moved to another hospital, one with no good reviews from what we could tell, who after about a week, a nurse phoned me and said he was doing really well and could do all sorts of things that he couldn't even do before and discharged him! The ambulance driver who brought him home had to help my dh manhandle him over a two inch high door step to get in his house. This was when my dh was trying to get the help and fil was saying he didn't need it in my previous post above.
I was so angry the nurse lied on the phone. I think they just needed his bed, and I suspect he was being quite aggressive as well. I wish we'd known about saying it being an unsafe discharge, even though I did try to emphasise this to the nurse but she was having none of it.

Saying that social services refuse to get involved and that capacity is a get out of jail free card is disingenuous. You cannot provide services to someone who doesn't want them if they have the mental capability to understand the risks involved in their decisions. It's not about refusal, it's about autonomy. You can't force support into someone.

I do understand exactly why you posted this, OP. People advise calling SS as if that’s going to sort the matter out. But if the person is still deemed to have capacity, they can - and often do - refuse to engage - or even let them into the house.
But even if they do, ten to one they’ll say, ‘I don’t need any help - my daughter will do it.’ (Always the daughter, isn’t it?).

A carer's assessment is meaningless. I was around when this legislation was drafted by a colleague of mine. At that time it had teeth ... it was obligatory and unlocked help for the carer. Now it us bottom of the list and takes ages to happen, and when it does it unlocks zilch and is just another piece of paper to be filed away. I know.... the SW dealing with my late OH was quite open that it was pointless ... she listed the hell I was luving through, said how awful it was and then ... absolutely nowt happened.

Ss depts still have a legal duty to investigate the circumstances of "vulnerable adults." It does not depend on whether they request this. If someone reports the vulnerability of a parent then SS are obliged to look into it.

Do NOT stop approaching SSD. It may not result in much help ... or indeed any ... but they still have a duty to look into it. Relatives of those who cannot grasp their own needs ... or indeed the impact of those needs on others .... cannot and should not be left high and dry.

In our experience as attorneys, SS treated DF as having capacity, when NHS MDT had determined that he might appear to have capacity but he definitely no longer had the insight to make decisions about his safety (let alone grasp the impact of his wants on others). I really don’t blame any one individual, but for SS to treat DF as having capacity, when NHS was saying 24 hour supervision, was harmful to his health and wellbeing - and it’s me that would be judged for letting him die even if that’s what he wants/wanted.

In my efforts to be a good attorney, I’ve read everything I can find over the last year about capacity (from NHS website, charity websites, NICE guidelines to MCA itself).

The MCA should be rewritten with more weight given to medical advice.

In the bigger picture of the cost of social care, all the NHS and council services DF used in his last year living independently almost certainly cost more than funding for the nursing home we put him in. He is safe from himself now but also hasn’t needed an ambulance, MRI/CT scans or hospital admission and stays.

I think it’s important that people ask for help and share their stories about the challenges they’ve faced around capacity. Hopefully things will change for the better.

Well crisis point is usually a hospital admission, where they come to the attention of the hospital social worker.

Not quite! I work in ASC and it's true that we need consent from the individual, however we have a legal duties around completing assessments and if someone refuses we then need to consider risk.

For people who said they wouldn't have a carers assessment because they don't want to take more on/continue caring- I would absolutely recommend having a carers assessment as this helps evidence the need for support for the person you care for. One of the questions in our carers assessment forms is are you are able to carry on caring? In some cases it's a case of just because you are being a carer, it doesn't mean you should be one (especially if it's impacting on your wellbeing and there isn't any other support that can alleviate this)

A carers assessment is a sticking plaster at best. I look after my adult daughter. I was given £200 for well being activities and 70 hours PA sitting time, which is not to be sniffed at, but a solution to the issues it is not.

This is dangerous advice, unfortunately- As kind as you're trying to be. I work on a specialist team in this area. If a family member feels there is a safeguarding issue and their loved ones need a carers assessment, then they should 100% call and have this done. They don't need their permission because they can be declared medically incapable of making decisions; this will then trigger the mental health services to come out and make an assessment.

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

I don't understand what you mean by "and their loved ones need a carers assessment". I thought a carers assessment was for the person doing the care, not the unwell person.

OP also says "You should not do this if they have capacity and don't want Social Services involvement." You could argue that the family member can't really know if they have capacity, but SS can't assess capacity. It was only when my family member hit crisis that MH services did the capacity assessment we had been asking for for weeks.

I do think OP was misplaced is advising people not to call SS, but I think her intention was to inform people what SS can (and can't do).

'sometimes there is a lot of pressure' is the understatement of the year. Family members are often treated appallingly and near on forced to take on caring roles they do not want. Its regularly implied to them that they have no choice, that it will be their fault if their beloved relative has a fall or suffers because they have not stepped up and provided unpaid care.
Its absolutely appalling.

My step daughter put me and my husband forward as carers for her baby before he was even born. I come from a legal background in child care and had anticipated what was going to happen before the social worker did. At the start of social services involvement I flat out refused to take the baby if he was removed from her as I was not prepared to raise someone else’s child again. This changed once we went to her 20’week scan and saw him, I fell in love with him and said if absolutely necessary we’d take him. We specifically told her to put us forward at a pre proceedings meeting. We’ve now had him since he was three weeks old. We passed the fostering and special guardianship assessment and now have the court order to keep him. I would however say that you should always ask someone if they’d have the child/children before putting them forward for assessment as they might not be in a position financially or physically to look after them long term

Please don’t try to put people off asking for help, it’s really dangerous. You may be asked when calling if the person has given consent but consent is not needed for a referral. People do need to consent to support if they are able but there are so many services available that most people don’t know about before they call. Many people don’t particularly want carers but will agree to loads of preventative services that make life easier and safer.

I could write a book on my late DM’s Alzheimers and problems from that, her diabetes and frailty.
What helped in dealing with her condition was the concept of ‘insight’ and not just capacity.
I had a row with her social worker who insisted that because DM was adamant she should go home after a hospital stay then she did indeed have that right. She was lucid and persuasive so he thought she had capacity. (She wouldn’t consent to carers either.)
Luckily I found a letter from her GP on her file which explicitly stated that she had no insight into her condition, or consequences of her actions. She would be highly unsafe - luckily SW then agreed and she went into residential care.
(Little did we know exactly how unsafe she was. When we were getting stuff from her house for her we saw an enormous burn on the carpet next to her bed — yes, she was a smoker — and on changing the bed we saw another huge hole in the mattress which had burned right through to the bed base.)
How she survived that I will never know. And of course she never breathed a word about it. There were other incidents but that was the worst.

This is exactly what I was told when I contacted the council for help with my mother. They needed to get her permission to talk to them on her behalf even thought I had a health LPA, which she gave even. They couldn’t do anything without her agreement and rightly so.

I think when people say contact SS on here they aren’t automatically suggesting going over their parent’s head but setting things in motion, i.e. talking to their parent and rest of family, to get a care assessment or other help.

I won’t be caring for my parents. I don’t want to and even if I did/could, I live at the opposite end of the UK.

If I think they’re struggling, but won’t agree, do I just leave them to get on with it?

My problem is my mum is round the corner. Yesterday I got a phone call because she'd been a victim of fraud (while in hospital ffs.) and it took several hours of talking her down t contact the bank.

Today it's sorting out a solicitor issue.

Each time it's "just xyz" but I don't want to keep doing it. She blatantly can't manage herself.

@Bedbugdilemma you posted before about your situation sounding similar to ours with our DF. I’m sorry to hear about the scam - such a nightmare to unpick. Internet shopping is outside the range of DFs abilities, but I fear the phone calls.

There’s a whole fraud industry targeting these vulnerable people, I don’t know how they live with themselves - but I’ve also seen genuine companies take advantage of elderly people with their upselling.

I also don’t know why society allows these vulnerable people (in DFs case no longer able to physically or mentally manage) to be deemed to have capacity.

They are vulnerable, do not understand the consequences of their decisions beyond that moment (or on other people). Something has to change in how ‘capacity’ is determined - especially when medical advice is that they cannot manage.