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?

As above, ask to see the capacity assessment. Request a meeting with the social worker and their manager outlining your concerns from a safety and risk point of view. Request an advocate for your mum.

Also keep detailed notes of dates, times and who you spoke to. All calls are recorded so if you quote back to them dates and outcomes you are more likely to be listened to.

I come into contact with SWs in a different capacity. I think hopeful might be replaced with doubtful?

I have POA for both financial and health as does my Dad
@Secondtonaan is is definitely the case that you have joint POA with your father? For both my parents and DHs they set it up as spouse being primary POA, falling to children only if the spouse failed - which I understood to be the most common set up. How is the POA worded?

We all have equal say and can act independently. DH also has it for my parents.

Thanks to those who have suggested this - I requested yesterday. There seems to be conjecture as to whether or not DM acually has a DoLs in place so am determined to unravel it. Think there has been an error somewhere down the line so am trying to unravel.

I would actually get a solicitor (funds allowing) to write to the Social Worker and say that in your opinion this is a bad idea for the following reasons and ask if they are prepared to take responsibility for anything that happens due to them not listening to your concerns and suggest that IF they act against your advice and it does go wrong you will look into legal action against them.
The idea that they could be in the firing line might make them take notice

OP I had something similar over a decade ago. In my case there was no POA in place. I got the most help from the weekly dementia group DM used to attend. They told us to get a list of all the falls she had previously as this is apparently a trigger for social work that they can’t ignore. I also went along to a dementia support group who were also very helpful and told me to quote some legislation to the social workers, care home, hospital etc. I can’t remember what it was; section 6JZ or something (I’m in Scotland though). It was something to do with preventing a move of a person with dementia out of a place of safety. I’m sorry I can’t remember the details but I would suggest you contact the previous day care staff and a dementia support group if there are any running near you. They were much more helpful than the care homes, medical staff or social workers. I know it’s not the same situation but the advice I received from these two sources was invaluable.

So your father, you and your husband all have joint and several POA for your mum? That makes it complicated indeed.

Yes - that's it.

I get that it's more difficult if there's not one person in charge of decision making but thought the joint and several was standard?

I think that the whole issue of capacity can be very difficult to detangle. Capacity is not an all-or-nothing scenario, but linked to the proposition for which capacity is being tested. So someone can clearly have capacity to decide that they don't want to (eg) eat a meal, whilst lacking capacity for bigger decisions with more lasting effects.

I suspect that many of the more junior people in SA, care professions etc etc aren't really aware of the nuances of this.

It's not enough to ask someone if they want to go home (or a better question would be to ask where they want to live, as it's not a leading question). You have to be sure that they have received all relevant info, taken in it, comprehend it AND comprehend the possible consequences of their actions. And if someone has capacity, they are legally allowed to make what appear to be poor decisions.

But in this sort of case, a single chat about home isn't going to cut the mustard. @Secondtonaan, your mum needs to have that chat without your dad there (so no undue pressure from him) and to check what her understanding of "going home" is - Vis a vis those others who've said that it transpired that their relative was thinking of a home from 60 years earlier! Then there needs to be a long chat about risks and how she understands them, and what would happen if (insert catastrophe of your choice).

Then that same formal structured discussion with your mum needs to had again at least one more time on a second occasion - and it may become very clear that she doesn't recall the issues previously discussed. And in this case you can well argue that as she cannot retain information and doesn't have understanding of the consequences of her decision, she does not have capacity to make that decision.

So often, these capacity decisions are made on the basis of a single fairly superficial conversation with a relatively inexperienced professional, and that's just not enough for big life-altering decisions.

It is, but I think ´POA to spouse then failing them it passes to children’ is more common. I might be wrong though.

That is so well explained and I totally agree.