88yr old DM with Dememtia wanting to leave carehome to go home as being pushed by my Dad - what can I do?

[Secondtonaan]

DM is 88, has vascular dementia, I'd say middle stage. V bad osteoporosis and mobility, incontinent and very confused. My Dad was looking after her at home for 3 years with one carer visit a day but it was going terribly, she had a lot of falls and A&E dashes... his health was declining too as getting no sleep and struggled with household tasks he'd never had to do before. He clearly couldn't cope but refused any more help from carers or anything I set up - day care / lunch clubs / meals on wheels etc etc.

Start of 2025 she went into a lovely care home for respite care - although I thought this would be long term as it was clear she needed this level of care. She is very happy there, well looked after and thriving doiing the activities compared with being stuck in one room all day at home. My Dad had some health crisis and ended up in hospital for a few months so DM has stayed until now.

However my Dad is now home and "better" and is desperate to get DM home. He could not cope in any way and she is so much better off where she is. I'm terrified what would happen if she went home. It's all about what Dad wants - he is lonely and feels abandoned by DM and as she hasn't lived at home for a year is totally ignorant of her care needs and seemd to have totally forgotton the state they were both in when she lived at home.

My Dad is about to give notice to the home for DM to leave. She has been appointed a social worker but is telling her she wants to go home so the social worker is supporting this. DM has no idea what's involved or any concept of how to cope at home... I don't even think it's what she actually wants. My Dad goes into the care home 3 times a day and tells her she's coming home so this is what she's telling people. I'm at my wits end, trying to explain to social worker the disatster that would unfold but they are saying they have to support DMs choice.

I'm trying not to drip feed but also not make this too long! I have POA for both financial and health as does my Dad. DM had a DoLs assesment recently when they said she lacked capacity (the care home say she lacks capacity) but then it was reveiwed at the last minute and they changed their mind and didn't sign it so there is no DoLs in place which I cannot understand as she clearly has no idea what is going on.

What can I do to keep DM safe / in the home?

DM is funding care from her savings

How about she visits her old home for, say, three days? So you don't give up her care home room, and she and your DF have to face the care issues and how she feels actually being there.

My Dad is lonely at home - he has no "audience" - my DM was that for him, she never had a job, hobbies, friends, a driving licence or mobile phone so was just at his beck and call. He is also in denial about getting older in general (he's 86 but financial planning for next 20 years type thing) so refuses to accept the dementia diagnosis, speaks to Drs who can "reverse" dememtia and that's what he's going to do. None of which actually helps DM

This is v useful - didn't know how it was decided. She doesn't have a memory of what life was like before or how much help she actually needs - eg they would eat lunch at 5pm as it took her that long to prepare it.

No, he does none of these. Does eat lunch there, mind!

Yes, have considered this but think he could put on a good act for 3 days... have food in, no medical appts, lack of sleep don't have hit. Then the actual long term reality v different. But appreciate as a last resort it could knock a bit of reality into him.

As you know, a DOLS would only be appropriate if your DM does not have mental capacity to decide where to live, hence why I would say that establishing her current capacity for that question is the first step.

Does she have periods where she’s up and attempting to leave the home/trying doors etc, or is this more about what she says and in fact she doesn’t attempt to leave?

It could still be in her best interests to be at home even if she doesn’t have capacity to make that decision. (Obviously I don’t think that sounds at all likely, but mentally it’s good to remain open to all the possibilities at each stage as it helps to work through them in order).

Asking to go home is also pretty normal for anyone with Dementia in a Care Home. My own DMIL asked regularly and spoke with conviction about wheb she was going and how she woukd get there.

A bit of time talking with her revealed though tgat she had forgotten her home of the last 50 years and she thought she lived at home with her own DPs who had both been dead for over 30 years.

Usually it’s the sense of comfort that most people have at home that they are searching for.

If your F is planning for the future financially, do you think that part of wanting her home is so that they no longer pay for care?

My DFIL was alao upset that his fulltime maid and cook was mo longer available. He wanted her back at home but not as she was, what he wanted was the wife who had done everything for him every day of their married life.

She never attempts to leave and is very happy there, talking about the crafts she's doing, her fave nurse etc etc. she loves getting fussed over, having her hair and nails done etc. But my Dad says she will be coming home and when asked she says she will be going home. Think she still feels she has to do what dad says and support him which is so sad

Yes at 87 my mum was desperate to go home from her first care home (which was totally unsuitable for her). When I asked about it she described her home in Glasgow. She left Glasgow in 1946.

Is there any option for your dad to move into the care home with her?

This exactly. He wants his 58 year old wife not the demented 88 year old version and he regularly tells her she's not up to scratch

He's never go into a care home, he's convinced he's still in his 50s

Imo, if DM is found not to have capacity, then the ultimate decision maker would be the judge in the Court of Protection. DM would have the Official Solicitor acting for her (in reality a local firm of solicitors acts for DM, in consultation with the Official Solicitor) the LA would be another party to the case, DF another and OP - ie 4 parties. The care home might be asked if they want to join in the action. They can refuse. However, the care records would be required for the case.

OP could represent herself, she doesn’t have to have a lawyer. She can present her views, as expressed on here, as to what she considers to be DM’s best interests.

So useful to understand this so thanks x

Is there any way that you DF could go to the care home too? What is the classification of the care home? Would he meet it? We have a lovely elderly couple from church, both in their 80s. Wife (W) has several health problems to do with her heart and breathing and needs a lot of support with daily living tasks. Husband (H) is basically pretty fit and active and can do everything independently, but was finding being independent for himself, plus all the housework, plus seeing to W's needs between carers' visits, way too much.

They ended up both moving into a care home where they have rooms next to each other. In W's room they have a double bed, wardrobe, chest of drawers, and W's medical stuff + adaptations to the ensuite bathroom. In H's room they have a some comfy chairs, a desk and upright chairs, and some other home comforts. They spend their days together in their sitting room, or in the care home lounge, going for walks etc. While W sleeps, H can go off for a longish walk or help with gardening in the place, knowing that other people will look out for W. Or he can be in their sitting room and read etc. When she's awake, they do stuff together and the staff will help with pushing W into the grounds etc if H is tired.

Op it's always worth consulting a solicitor who is fully conversant with capacity and community care issues. They are very good at cutting through the 'crap'.

This would be lovely and makes sense. I've suggested similar many times but he wouldn't have it on any level. Will never leave his house or accept he's in his late 80s.

My mums husband was also abusive and plausible, She had a fall and instead of getting an ambulance he got the neighbour to carry her up to bed. Then he was boasting about lifting her on a saucepan to go to the toilet. Moving into a care home literally saved her life. Your mum only has you to advocate for her. I know it is hard to go against your dad and social services but you will be avoiding a disaster for your mum.

Very true. She broke her neck last year as my Dad was rushing her to go out (she didn't want to go out as finds it too much now). Lots of other stuff. It's horrible.

Yes my mums husband is like this, abusive awful.
Some great information here. Hope she can stay. Home would be completely unsuitable,

This is a dispute between two LPOAs, the local authority and the person who's capacity is disputed, and therefore should be referred to the Court of Protection for a decision.

You can make a section 16 welfare application to the COP- information about how to do that:

https://assets.publishing.service.gov.uk/media/5b17ef4be5274a18e5ea851b/cop-gn4-eng.pdf

I’m really not sure that the ultimate decision maker would be the Court of Protection @BlueandWhitePorcelain? I thought that would be the case only where LPoA wasnt in place and deputy ship was therefore needed, or perhaps where the different attorneys couldn’t agree, or am I wrong about that? Of course that might happen here, but I wouldnt underestimate the benefit of a true best interests meeting - it is amazing how getting into a room together can help thrash things out. I wonder about including the GP in that meeting - my experience is that GPs are nearly always helpful in these situations though I’m sure it isn’t always the case.

Keep fighting for what’s right for your mum and dad. The SW are keep to save money if people are cared for at home.

you know better than anyone how your dad will or will not cope.

it’s even harder when you are the only child and the only one to make these decisions. Im also an only one and have to make these decisions for my parent. It’s tough. The hospital have tried to send my parent home knowing I live nearby. I have fought this as they need more care than I can give and do not trust SW to provide a package of care that they need.

It sounds like they have already exhausted the normal Best Interests process though from what the OP has posted.

Ultimately the two LPOAs disagree, the OP feels the capacity assessments are flawed (perhaps on the informed decision part of the decision) and there also appears to be a dispute/disagreement about P's capacity relating to the decision.

'Off to court we should go' in the words of my most favourite local authority lawyer.