Care Home Issues
Discussion
I'll try and keep this brief.
Elderly relative is in a care home, suffers with Alzheimer's and part of his dementia is that he is turned into the archetypal 'dirty old man'. Think Carry On level.
Recently found in his room with another resident without their clothes. Both consenting, he was blamed. Family not told for three weeks.
He has not been in the home long having been moved to be nearer to family who will actually visit.
On moving he was assessed and this part of his character was disclosed, discussed and a care plan put in place.
He has had another psychiatric assessment and was out onto constant care whilst up and about - he loved this as he had someone to chat with constantly and there are no issues with paying for this.
Fast forward to now and the care home want to evict him and have him sectioned, as the constant care contravenes his human rights and say he poses too much risk. I laughed at the human rights angle and as for risk, he is smooth tongued lothario who walks with two sticks and weighs 5 stone wet through, the staff can manage that.
The psychiatric team agree that he in no way needs sectioning and that supervised care is appropriate.
We have a meeting coming up at the home to discuss his care, the contract they entered into (pre-paid for 12 months) and our expectations of the care home in regards to reporting incidents and changes in care programmes.
Thoughts?
We don't want to move him as he likes this place.
As all this was disclosed and assessed when he moved in where do we stand with regards to the contract? He hasn't got worse according to the assessments.
If we have to move him can we recoup costs?
Elderly relative is in a care home, suffers with Alzheimer's and part of his dementia is that he is turned into the archetypal 'dirty old man'. Think Carry On level.
Recently found in his room with another resident without their clothes. Both consenting, he was blamed. Family not told for three weeks.
He has not been in the home long having been moved to be nearer to family who will actually visit.
On moving he was assessed and this part of his character was disclosed, discussed and a care plan put in place.
He has had another psychiatric assessment and was out onto constant care whilst up and about - he loved this as he had someone to chat with constantly and there are no issues with paying for this.
Fast forward to now and the care home want to evict him and have him sectioned, as the constant care contravenes his human rights and say he poses too much risk. I laughed at the human rights angle and as for risk, he is smooth tongued lothario who walks with two sticks and weighs 5 stone wet through, the staff can manage that.
The psychiatric team agree that he in no way needs sectioning and that supervised care is appropriate.
We have a meeting coming up at the home to discuss his care, the contract they entered into (pre-paid for 12 months) and our expectations of the care home in regards to reporting incidents and changes in care programmes.
Thoughts?
We don't want to move him as he likes this place.
As all this was disclosed and assessed when he moved in where do we stand with regards to the contract? He hasn't got worse according to the assessments.
If we have to move him can we recoup costs?
First up - you have my sympathy for what sounds like a horrible situation.
I can't offer any useful advice - we had a similar problem with my mother in law on respite. We disclosed all her behaviours (hers are "toilet" related) to the home who assured us they were able to handle this and any other issues.
Two days later they phone and say we have to come and collect her. Holidays cancelled, early home, money down the drain.
I get the feeling some homes will accept residents on the basis they want the money but then later realise they are not able to handle certain types of behaviour.
I can't offer any useful advice - we had a similar problem with my mother in law on respite. We disclosed all her behaviours (hers are "toilet" related) to the home who assured us they were able to handle this and any other issues.
Two days later they phone and say we have to come and collect her. Holidays cancelled, early home, money down the drain.
I get the feeling some homes will accept residents on the basis they want the money but then later realise they are not able to handle certain types of behaviour.
Do you know if this change of heart is coming from the staff, or the management of the care home?
And have any family members of other residents complained to cause difficulties?
I ask, because I have a relative in a home, where they are one of the few without mental issues, and they are paying over £2000 a month - but in the time they have been there, the staff have all changed including the manager, and the quality of care changed too.
My relative's difficulties arose from complaints by other family VISITORS to residents, who believed what their family member was telling them had happened, and made accusations directly to them, instead of the staff. When the staff found out, it was the other resident's family who were warned off taking matters into their own hands.
If the day to day staff are onside, it is a great help, but if they are against you, it could well be in your loved ones best interests to start looking elsewhere.
And have any family members of other residents complained to cause difficulties?
I ask, because I have a relative in a home, where they are one of the few without mental issues, and they are paying over £2000 a month - but in the time they have been there, the staff have all changed including the manager, and the quality of care changed too.
My relative's difficulties arose from complaints by other family VISITORS to residents, who believed what their family member was telling them had happened, and made accusations directly to them, instead of the staff. When the staff found out, it was the other resident's family who were warned off taking matters into their own hands.
If the day to day staff are onside, it is a great help, but if they are against you, it could well be in your loved ones best interests to start looking elsewhere.
This must be very distressing for you - you have my sympathy. Who is going to be at your meeting? What other agencies are involved? Remember the home have a "duty of care" to your relative so can't just "evict" him. Is the home registered to look after people with dementia - if so this should really be within their remit. Is there anybody else you can discuss this with - a GP or a social worker for example? If there is to be a meeting you should certainly not go in unprepared and without support - i.e. don't go by yourself for a one-to-one with the manager!
In this instance I don't hold power of attorney and I am the one going as the back up. I wanted to bounce this around for some ideas/experiences. I am fully, fully aware that this care home is a business and is operating as such, I do feel that the balance between care and business is a bit off.
I've a fair bit of knowledge of dealing with sectioning and the mental health system, which is why I'm going along as he does not need sectioning, he needs the level of care that was agreed at the start, and that his estate is funding. When he first became unwell he was sectioned as he was a risk to himself. He was a very accomplished artist and threatened suicide as he felt his mind unraveling - his words.
We have noticed a change in the care staff in the short time he has been there - getting on for 5 months. He was with the same company before at his previous home (and yes, they would have been happy to have him remain at that home) and the ratio of auxiliary to qualified care has changed markedly. A lot are agency care now.
There was a complaint from the family of the woman who he was found in the room with. No complaint from her, although she too has advanced dementia. I've had no answer as to why her family were told and we were not.
I am taking the psychiatric report with me, cannot get the community team to attend, the days of them having enough staff for that are long gone.
I intend to get them to do most of the talking and ask what the contingency plans are having had the money up front.
I've a fair bit of knowledge of dealing with sectioning and the mental health system, which is why I'm going along as he does not need sectioning, he needs the level of care that was agreed at the start, and that his estate is funding. When he first became unwell he was sectioned as he was a risk to himself. He was a very accomplished artist and threatened suicide as he felt his mind unraveling - his words.
We have noticed a change in the care staff in the short time he has been there - getting on for 5 months. He was with the same company before at his previous home (and yes, they would have been happy to have him remain at that home) and the ratio of auxiliary to qualified care has changed markedly. A lot are agency care now.
There was a complaint from the family of the woman who he was found in the room with. No complaint from her, although she too has advanced dementia. I've had no answer as to why her family were told and we were not.
I am taking the psychiatric report with me, cannot get the community team to attend, the days of them having enough staff for that are long gone.
I intend to get them to do most of the talking and ask what the contingency plans are having had the money up front.
A difficult one this.
If the care home admitted him knowing the fact's then they "should" be able to cope with his care needs.
But saying this from the side of the care home, if Social services and the NHS had been involved prior to his admission don't expect them to give all the important information the care home needs to make a informed decision if they can cope with his care needs and risks involved which is care. They are only interested in getting the cheapest place for him. As it will always come down to money.
As with him being naked with another residents and both being consenting. The other party may have consented but if they don't have capacity when it comes to daily living and choices then they will just be going along with what was happening on the day. Possibly.
If your family found the home, pay privately and informed the home fully about his condition and the home accepted him on these ground then they should have understood what was needed with looking after him in their environment. But saying that everyone is different and their manner and care needs can change depending on the place they are staying. IE: he can be different at his own home, this can change in a care home or hospital. So possibly his care needs are greater in a care home than where he was before. Even if he was in another care home
It's really difficult and I hope you get it sorted
If the care home admitted him knowing the fact's then they "should" be able to cope with his care needs.
But saying this from the side of the care home, if Social services and the NHS had been involved prior to his admission don't expect them to give all the important information the care home needs to make a informed decision if they can cope with his care needs and risks involved which is care. They are only interested in getting the cheapest place for him. As it will always come down to money.
As with him being naked with another residents and both being consenting. The other party may have consented but if they don't have capacity when it comes to daily living and choices then they will just be going along with what was happening on the day. Possibly.
If your family found the home, pay privately and informed the home fully about his condition and the home accepted him on these ground then they should have understood what was needed with looking after him in their environment. But saying that everyone is different and their manner and care needs can change depending on the place they are staying. IE: he can be different at his own home, this can change in a care home or hospital. So possibly his care needs are greater in a care home than where he was before. Even if he was in another care home
It's really difficult and I hope you get it sorted
It's not that difficult to be honest. You had a situation where two seniors, both of doubtful capacity, were trying to play hide the sausage. They got discovered by carers, who's reaction seems to indicate that they don't think the elderly should be allowed to play such games and who have taken the view that it's the blokes fault. If they both consented nobody is at fault, because it's not wrong for two adults to play hide the sausage if they so desire, no matter how icky we might think that sausage is.
The care home want to get shot of him because they are worried about being liable should something happen involving another resident or possibly the same resident again. They've categorised him as a potential trouble source and just want rid. That is why they are pushing for sectioning, even though from what you have said it would not be in any way appropriate.
As to their points, constant care does not infringe on his human rights. I can't see how it would, not meeting his care needs would infringe on his human rights and if his care needs are such that constant care is required then that is what his rights would demand.
In regard to risk, I think the risk they are anticipating is that he might try to rape or sexually assault another resident or worker and that they would be liable. This strikes me as being completely unfounded, largely because their own account was that both adults consented to what they were doing.
It seems that the staff and management at this home are far too immature to deal with the concept that old people might still be sexually active.
The care home want to get shot of him because they are worried about being liable should something happen involving another resident or possibly the same resident again. They've categorised him as a potential trouble source and just want rid. That is why they are pushing for sectioning, even though from what you have said it would not be in any way appropriate.
As to their points, constant care does not infringe on his human rights. I can't see how it would, not meeting his care needs would infringe on his human rights and if his care needs are such that constant care is required then that is what his rights would demand.
In regard to risk, I think the risk they are anticipating is that he might try to rape or sexually assault another resident or worker and that they would be liable. This strikes me as being completely unfounded, largely because their own account was that both adults consented to what they were doing.
It seems that the staff and management at this home are far too immature to deal with the concept that old people might still be sexually active.
OP - Firstly my sympathies. I have not had to experience this fully myself as yet but know a number of people who are and have gone through this and it is very distressing, even if you happen to have all the facts and information.
IMO you and obviously the person with POA need to speak to a Solicitor who is a member of Solicitors for the Elderly: - http://www.sfe.legal/
Many of these people have first hand, as well as Client based, experience of the sort of issues you are going through in one form or another, I know our 2 ladies have!
IMO you and obviously the person with POA need to speak to a Solicitor who is a member of Solicitors for the Elderly: - http://www.sfe.legal/
Many of these people have first hand, as well as Client based, experience of the sort of issues you are going through in one form or another, I know our 2 ladies have!
Some great stuff there.
And many thanks to those who PM'd me with further ideas.
Turns out the home have dropped a clanger and forgot to inform social services he was there. (He moved from a care home in the same company and this was part of the relocation fleecing)
Many thanks for the link to the specialist solicitor group. That will get explored.
Meeting with the home once they have sorted the social worker aspect.....
I have been given some good ideas regarding different tacks and am grateful to this community yet again.
And many thanks to those who PM'd me with further ideas.
Turns out the home have dropped a clanger and forgot to inform social services he was there. (He moved from a care home in the same company and this was part of the relocation fleecing)
Many thanks for the link to the specialist solicitor group. That will get explored.
Meeting with the home once they have sorted the social worker aspect.....
I have been given some good ideas regarding different tacks and am grateful to this community yet again.
just an additional point which may be raised at the review meeting (forewarned and all that).
the care home may argue the human rights angle based on the duty to protect the rights of other residents. from the history it could be that they would make reference to the duty to preserve the rights and dignity of other residents and to keep them free from exploitation.
they are "duty holders" and also "rights bearers" - they may feel able to support the case that the right to "evict" supersedes the individual's rights to reside and would be compatible with their duty of care to, and the protection of, others.
how successfully they could argue this will be contingent upon many factors including the attendees at the review and the desire to seek a solution rather than shifting the "problem".
some years ago i was treating an elderly male resident placed by the NHS in a private sector nursing home. he had a degenerative disorder and syndromal frontal lobe features - his disinhibitions were very similar to what you have described but were pervasive rather than isolated. the solution was increased funding for the 1:1 care, usually but not exclusively male staff, actually provided from within the care home establishment. essentially, his fees were increased by the cost of one care team member, per shift. win-win on this as when he was sleeping or settled (quite often) the home benefited from an extra pair of hands on duty but, when awake, he received the required support.
the suggestion that 1:1 erodes his own rights demonstrates a poor understanding of the relevant legislation
paul
the care home may argue the human rights angle based on the duty to protect the rights of other residents. from the history it could be that they would make reference to the duty to preserve the rights and dignity of other residents and to keep them free from exploitation.
they are "duty holders" and also "rights bearers" - they may feel able to support the case that the right to "evict" supersedes the individual's rights to reside and would be compatible with their duty of care to, and the protection of, others.
how successfully they could argue this will be contingent upon many factors including the attendees at the review and the desire to seek a solution rather than shifting the "problem".
some years ago i was treating an elderly male resident placed by the NHS in a private sector nursing home. he had a degenerative disorder and syndromal frontal lobe features - his disinhibitions were very similar to what you have described but were pervasive rather than isolated. the solution was increased funding for the 1:1 care, usually but not exclusively male staff, actually provided from within the care home establishment. essentially, his fees were increased by the cost of one care team member, per shift. win-win on this as when he was sleeping or settled (quite often) the home benefited from an extra pair of hands on duty but, when awake, he received the required support.
the suggestion that 1:1 erodes his own rights demonstrates a poor understanding of the relevant legislation
paul
Edited by paulmakin on Friday 2nd October 20:07
Nudity is a fairly common occurrence in the home my father is in, they're all final stage dementia 
It's important that your relative is in a home that specialises in the stage of dementia he's currently at. Final stage management is a specialised undertaking IMO, not all homes are up to the job.
It's important that your relative is in a home that specialises in the stage of dementia he's currently at. Final stage management is a specialised undertaking IMO, not all homes are up to the job.
Gassing Station | Speed, Plod & the Law | Top of Page | What's New | My Stuff