Forcing care?

[rivalsbinge]

I’m asking on behalf of my DH, his dad has dementia diagnosed 15+ years, up until recently his mum 84 has been his carer but now she is frail, having ing some very strange symptoms like paranoia etc and becoming quite unstable.

My DH and his siblings want them both on a care home to relieve her stress and help them to have a better quality of life. But MILL is point blank refusing to accept she is struggling, won’t see a GP for what we suspect are TIAs and is also refusing the carers entry to their home.

As a result her husband is poorly cared for and suffering.

What are the rules? Can anyone force care? Would my DH have to prove neglect? How on earth to you move on from here?

They have money can afford care, she is just refusing any help at all.

If you have concerns that he is being neglected contact adult social care.

If she has capacity she can make decisions for herself, but not necessarily for him.

You'll need to start logging each concern and incident with adult social care (contact through their county council) ask each incident to be logged as a 'safeguarding concern'
You aren't able to 'force' anyone into care. A social worker can do a capacity assessment and if they are deemed to not have capacity over where they should live then arrangements could be put in place for going into care (providing they meet the threshold)
If she disagrees and has capacity then you simply have to let it play out until the risk.gets higher and eventually something either happens or the capacity assessment comes back as failed. It's a long journey and not an easy one.

Has she been checked for a UTI? They cause really weird symptoms in the elderly, usually uncharacteristic behavioural issues.

Has MIL much support from her adult children? It sounds like she is doing a lot herself.
Do they have home help or carers.
MIL probably has an infection. I would not like to see her forced into a care home, unless nobody has time to help.

Edit. Missed the part, refusing care support.
Contact adult SS is your only option.

Sorry your DH is facing this, it’s a very difficult situation.
Your DH needs to treat his parents separately here, not as one unit and they may need to be split up.

You need to refer FIL to adult social care as he is a vulnerable adult, lacks capacity to make own decisions and is not being properly cared for.

MIL needs to see GP for assessment of any treatable conditions. If there’s nothing else going on then she needs a capacity assessment. However even with that it’s very difficult to force care onto someone who doesn’t want it, or force her into a care home if they don’t want to go

Thank you all, yes he’s called the GP who’s said while they can’t do anything and make her go in they will call and ask her for a review potentially. We did think UTI but on visiting recently they drink lots and have gallons of tea, but we also have no way of testing.

They have been assessed and have over £2k of care avaible from the council and she refuses it, she will allow one lady in every so often to help. But essentially her husband is being neglected hygiene is a huge issue along with meals and eating properly.

yes adult children around trying to help and being told to leave alone “she’s fine” she has capacity so if making decisions that are directly impacting on her DHs quality of live and stressing everyone out.

Social care have provided a very generous to my mind care package but she’s refusing it, we are paying the major back monthly.

Also they have money so could afford a home or even a retirement village style place, but she won’t hear any of it at all.

As suspected we have to wait for this situation to get worse and worse before we can step in and help, it’s just hard on everyone as she’s now calling, emailing daily in panics about various things, all would be solved with a lovely setting where they are both looked after and fed.

You can (and should) also make a safeguarding referral regarding your FIL. If your MIL has capacity, she can absolutely decline care and intervention for herself, but the capacity threshold for making decisions for another person is higher (assuming MIL has POA for FIL?) I would approach this with the focus on your FIL, you are much less likely to get caught in the "capacity trap" and the priority has to be getting and keeping him safe, as he can't make decisions for himself.

Is the GP aware of your DF's condition and vulnerability when they said they can't do anything?

Who, if anyone, has LPA for your FIL? If your MIL has it but is not acting / is able to act in his best interest then social services can intervene. It’s not straightforward or easy. You can start by making a safeguarding referral and go from there.

Definitely Power of Attorney for them both. I was told it’s more important than a will to safeguard and support elderly parents.

It's too late for to get it for a FIL who's had dementia for 15 years.

That’s another issue nobody has POA over FIL as his decline was hidden by MIL, so there wasn’t the gap in him having any way of signing or agreeing to anything, she kept him hidden away and point blank refused visitors for years and then covid and it’s just a mess.

She stopped his emails, phone calls and essentially has him just to herself, they live very remotly btw.

She’s also refusing to sign any POA paperwork for herself. Thanks for the advice I’m passing it to my DH who is getting increasingly worried about her decline and mental capacity.

Nobody has any POA over FIL he declined quickly and the severity of his issues were hidden from the family.

Does your DH have access with consent to her financial affairs?

No nothing, they know she has money as they used to be wealthy but no clue what’s left but they are sitting on a substantial property, and land which is known to be mortgage free, but no access to banks.

Ideal world that would be sold to fund the care they both so desperately need.

This. My elderly MIL had them frequently and the symptoms were alarming.

Though paranoia was not one of them. Is it possible she is in the early stages of dementia too?

My mum has dementia, pretty bad now. It’s crystal clear to everyone but she absolutely will not acknowledge it (during increasingly more rare lucid periods).

Since POA unlikely for your DM the next best thing is for DH to become a named individual on her bank account, with her consent.
Take time to consider how to do this before asking in a rush as she may flat refuse first time around and opportunity is missed.

I'm sorry I do not have advice for you, but can understand how upsetting this must be. My mum has had dementia for 5 years, and in the early stages we managed to get lasting LPOA, which was encouraged by my Dad, who is fine but has disabilities and is deaf. Now we must get it for him, and he is happy for us to do so. Your post has reminded me how important this is, because without it, we will end up in a complete muddle. My friend had a mum who refused to sign the LPAO stuff until the last minute before she went into a care home, and I can remember how distressing it was for all - they just had to keep at it until eventually she admitted that she thought it was acceptable . It's a horrible time, my dad still cares for my mum, and she is just about OK, but he knows that the time is coming when he will not be able to do so anymore. Not everyone thinks like this, it's so hard ! xx

As there is no power of attorney, if Fil has no capacity then you can apply to the court of protection for deputyship. BUT this normally only covers financial affairs and can take months and be expensive to arrange as part of it is a 'bond' to the court of protection which is a yearly fee.
With no power of attorney (we've been through this with my parents, mum was moved into dementia care last year and dad is currently sadly end of life after a fall) your DH needs to contact adult social care, explain the circumstances, explain that there is neglect and log the issues as 'safeguarding' with adult social care and their gp. There is no 'quick fix' it took us a year to get things sorted out, which was initially triggered by a different hospital admission for my dad and paramedics raising massive concerns about my mums behaviour. Gp, adult social care etc have a 'duty of care' they can't just let things spiral out of control. If they have a package of care, someone in adult services needs to be following up the refusing, the carers won't be continually turning up and walking away, it needs to be reported. If you don't know the name of their social worker (someone must have set up the care package) ring adult social care at their county council and ask. Ask to speak to a senior social worker or a group manager and don't be fobbed off. Yes, Mil can refuse all she wants for herself, but the rest is now neglect and needs to be notified accordingly even if only to give a paper trail that they have been contacted.

In that case, you (or your DH) must make a safeguarding referral on your FIL/father's behalf. This isn't a safe situation for him, and it is essential for his wellbeing that his care needs are assessed, independently of hers. I know it's really difficult, I know it feels like a betrayal, I completely understand those feelings, but this is about a person's safety.

Thank you all again so much, I’ve passed all of this on the DH he is having to take a couple or weeks off work to try and stay with them and work out how on earth he keeps his dad safe and keeps his mum cared for , added stress is he’s in a new job role, they are being understanding but he can’t keep taking weeks off and away.

We work flat out and can’t take either of them in with us, as we are in a small home although it would be good to have them closer than 8 hours drive away.

This is good advice. I would however suggest it is a waste of time trying to get deputyship for DFil. From experience the social work team will do their best for him if it is a safe guarding issue and they will intervene.
For the financial affairs, DFil may not survive a deputyship application by the time it all comes through. Presumably, DMil is his next of kin? Do you know if they have wills? If he dies and leaves every thing to DM, your DH will still be powerless and in a bit of a mess trying to help unravel everything.
Often you have to let it all play out, even though you can see a train crash happening.
My DM was under section when DF died unexpectedly, both without POA. It’s an unenviable and difficult route for your DH and you. Sending virtual support.

The biggest issue we have is her refusing the care package she has been given, they have been assessed given daily carers and she’s refusing to book or engage, so it’s now falling on us. But none of the family live close and we can’t help, so she isn’t turning them away she’s simply not engaging.

Thanks to the poster who said about the UTI my DH was there recently and thinks it highly unlikely given the amount of tea and water they drink, but seems to think it’s more stoke related but we haven’t a clue and can’t get her seen.

I swear to my own kids I won’t do this to them, I’m checking myself into a retirement village, I even know which one I quite fancy as they have a bar.

@Mum5netno that’s another issue no access to wills, no clue what’s in the will at all so that will be a good awful mess as well.

Mind you my own DF who was perfect sound of mind wrote his own will with my mum, when he died we realised it wasn’t worth the paper it was written on and as he had 40k savings I had to pay for probate. He thought he was doing the right thing at least, but googling and writing your own “mirror wills” is not recommended