:help:

I am an extremely worried daughter and grandaughter.

My grandma is 83 years old and lives on her own, she is extremely confused ie; doesn't always know where she is, the month, the time of day etc. She goes out not knowing where she is or where she's going. She has carers who visit her (now 4 times per day to give medication, prepare meals) but she won't always let them help her. My parents have had to have police out twice looking for her at 9-10pm at night yet she doesn't understand the worry and can't understand why marks and spencers is closed! Her last wander out at night resulted in her being found just off london road (luckily be a kind lady) she had fallen and broken her wrist.

After a ten week stay in hospital, where consultants and doctors assessed her and said she was safe to live on her own and make her own decisions she came home.

She has been home over 2 weeks now and seems to be worse than ever, she has been missing til 9pm at night once again, her personal hygiene is nil, my mum is visiting and finding soiled pants all over the house, she takes food out of the freezer and then re-freezes it, she is losing money (or hiding it, we don't know) and if I was to go on I'd be sat here typing for days.

My parents are constantly on edge with worry. They both work and cannot be at my grandmas house all the time, they go as often as they can and ring her everyday. Its my dads mum and he has tried to discuss with her about going in a home but she refuses. He has today taken her to see a consultant who asked her questions for example: what season is it, where are you now, what month is it? all of which she got wrong. She did answer some questions correctly but having had all the info from my parents about the concern for her safety, health, hygiene and diet he says she is still in a position to make her own decisions.

I am extremely worried about my grandmother (for her safety and health) and my parents (for there own lives and health, they won't plan holidays, worry about going out for a drink etc).

I understand about peoples human rights and its against my grandmas rights to make her do something she doesn't want to do (and it isn't a case of shoving her in a home it is genuine worry and my parents cannot go on like it) but what about her human rights of someone saying shes safe to live on her own but then her wandering out again at night and something worse happening than before. Does someone hold their hand up and say she shouldn't have been living on her own?!

Sorry if this is a long message, I'm just trying to put you in the picture and this is just brief, I wonder if anyone has been in a similar situation - have you any advice, it would be much appreciated?

Thankyou

Sorry to hear about your grandma, it must a worry for all the family. Which service was she assessed at? For example, was it the Memory Clinic or another specialist dementia service? Does your Grandma's GP know about her problems?
They should be able to access specialist services to offer support for your family as well as your Grandma. Additionally you could ask for a social services assessment to see what practical help could be arranged.

Get her GP in to assess her with another family member there so you can discuss your concerns.I work for a GP and we have to do these visits from time to time.Good luck and love to your Gran x

Thanks for your reply's Daisy and Dawn.

Her GP and social services know the situation, the social worker even says 'she needs looking after doesn't she?'. Everyone knows that she needs caring for, but its just how and its so annoying when the consultant says she can make her own decisions, they don't see her on a daily basis. Even the carers who go in aren't brilliant, they have to give medication and on some occasions have given the wrong dosage or not it all!

It doesn't help because my grandma refuses help as she thinks she's okay, she gets really cross and says she's not daft - which we know she's not daft but shes just not safe and very disorientated - eg - I visited her last week and she said she wanted to go home - she was sat in her own living room!

Shes just a constant worry.

it's very difficult to deal with when you are seeing a loved one in that sort of condition.

Contact the Alzheimers Society in Sheffield, they can give you shedloads of advice, on all aspects of dealing with Alzheimers.

They were a great listening ear when my Gran was going through dementia, (she had a combination of Alzheimers, and something called "Multi-Infarct" dementia:- that is, she'd had strokes aka infarctions in her brain - an interruption to the blood supply. and each one took a bit more of her faculties. it was hellish)

it's very difficult to deal with when you are seeing a loved one in that sort of condition.

Contact the Alzheimers Society in Sheffield, they can give you shedloads of advice, on all aspects of dealing with Alzheimers.

They were a great listening ear when my Gran was going through dementia, (she had a combination of Alzheimers, and something called "Multi-Infarct" dementia:- that is, she'd had strokes aka infarctions in her brain - an interruption to the blood supply. and each one took a bit more of her faculties. it was hellish)


They can also give you advice and help for all dementias, not just Alzheimers, and it sounds your gran may be suffering some kind of dementia.

My husband works for an older people's charity, and his advice is to contact them, so *snap*, PT, lol.

Follow this link: http://www.alzheimers.org.uk/BranchWebsites/Sheffield/index.htm

They are here:

Contact us

In person/by post:

Venture House

105 Arundel Street

Sheffield

S1 2NT

Our office is open between 9.00am and 4.30pm, Monday to Friday

By phone: 0114 276 8414

By e-mail: enquiries@alzshef.org.uk

By fax: 0114 276 9240

My nan suffered like this and my dad was constantly on edge.She did eventually go into a retirement home as she was so confused.There she had company and care 24 7.It must have been hard for my dad but it was the right thing to do.She was a very independent lady and to see this happen to them is hard.

Hi I think I know where your coming from as my father was in a similar state before he passed away. You might find something in the legalities if what is happening here http://www.dh.gov.uk/en/PublicationsAndStatistics/Bulletins/ChiefExecutiveBulletin/DH_4108436
Unfortunately the law is much tighter now than it used to be which don't help much in your situation.

Move to Scotland. You'll get everything she needs for free. And you can sit round drinking buckfast all day and not work while the mugs in England pay for it.

Sorry about your gran though, hope you manage to find the help you need.

It seems you are all doing what you can to help. Would it be worthwhile to ask your GP for a second opinion? Have you thought about respite care so your parents can have a break and recharge their batteries?
In addition to the Alzheimers Disease society there is also a carers group where you can get support. I think it is still on Charles St.

It seems you are all doing what you can to help. Would it be worthwhile to ask your GP for a second opinion? Have you thought about respite care so your parents can have a break and recharge their batteries?
In addition to the Alzheimers Disease society there is also a carers group where you can get support. I think it is still on Charles St.

I believe the sheffield Carers soc (princess Royal trust for carers?) is off trippett lane these days, in a place called "bells Square"

ah, here we are. found the link
google was my friend!:D

http://www.sheffieldcarers.org.uk/

Hi there,

Im in a similar position at the moment with my dad. He has dementia and getting very forgetful, despite receiving care 3 times a day all the family are always worried as he gets terribly scared at night and Im not sure if he has or hasnt took his medication.

Ask Social Services for specifically a Community Care Assesment, this will be a formal assessment and family can be there. They will assess your grandmothers needs and see what options as in support, poss short term respite help or longer help in a home, they would also talk to you about savings etc for funding.

Ive been to see a few homes, the thought was quite scary but some homes have specialist beds for EMI people, basically people who suffer from dementia or mental health. Some of the homes are lovely and the staff seem fantastic.

Good luck in whatever you decide but asking social services for a formal community care assesment may be a good idea.

Agencies who may be able to give additional help and support are:-
- Age Concern - they are fab in Sheffield, have good resources to send out
- Sheffield Law Centre - most law centres are very good with community care legislation
- CLS direct - 0845 345 43 45, they can give specialist advice on community care and possibly casework for those people who are eligable for legal aid.

Phew .. good luck! Keep us posted

Loops

Hi
If you can get a report from a OT (Occupational Therapist) this should help the ball rolling if your nan need to go into accomodation or not. It also sounds like telecare could be another good idea you can set this up for wandering alarms, fall alerts, bed wetting etc.

Instead of waiting for a social services visit which possibly could take up to 6mths you would be better off contacting your gp or try ringing Sheffield Stayput they have an ot who is very nice.
Pls pm me for further details if required.

Paul :-)))

Hi
If you can get a report from a OT (Occupational Therapist) this should help the ball rolling if your nan need to go into accomodation or not. It also sounds like telecare could be another good idea you can set this up for wandering alarms, fall alerts, bed wetting etc.

Instead of waiting for a social services visit which possibly could take up to 6mths you would be better off contacting your gp or try ringing Sheffield Stayput they have an ot who is very nice.
Pls pm me for further details if required.

Paul :-)))
There is a good chance she will have been seen by an OT at the hospital with the consultant and also it seems that social services are in involved with the daily calls by carer's unless it is a private arrangement funded by the family. It is difficult to get someone into care when they don't want to go, even when others can see that it's better for them.

this lady is already in the social service system , her social worker should be earning their money and getting something done. city wide alarms are a good thing to have as they have an alarm that tells you if the client gets out of the door at night or day to wonder. there are a few things you can do but get that social worker to get her/his finger out thats what she/he gets paid for . your nan has an advantage on other people at least she is known to ss and she has a social worker , see about some respite ask the sw about sheltered accommodation or extra care housing she will still be independent but there will be someone there to keep an eye on her, good luck with it keep us informed

My heart goes out to you, been in a similar situation myself with both my disabled brother and my Dad.

It will all work out OK in the end, I'll seem daunting having had all that info thrown at you.

I would not hold out much hope with the SW and my experiences haven't been good with Social Services but what I would say is find out who their manager is and go straight to them instead, you are able to ask for a different SW but this is a lengthy process and allocations take forever.

The GP should be more supportive and I know that Alzheimers are fantastic so I'd make them my first call tomorrow as they're great with advice where to start (I spoke with Debbie there). It does help if you've had a definate diagnosis with Alzheiners but I know it takes so frustratingly long.

My best wishes to you and your parents, they are lucky to have your support.

Myself & my father went through this with my nan back in 2000. She had lived alone since my grandad passed away in '94 and my Dad visited everyday for tea after work and I went a few days a week after school. We started noticing that she wasn't cooking the food properly (almost raw oven chips etc), and there was sugar in the salt pot, things in the fridge that shouldn't have been in there - but worst of all she was leaving the oven & hobs on - or blowing the flames out and leaving the gas running. Luckily she had a fantastic neighbour, who if my nan knocked on the wall, would come round to help. We started having to lock all the windows before we left, and check the oven. I'm not sure how, but my dad had arranged for somebody to come and check her mental state - think it was classed as a mental health assessor.
A few days before the assessor was due, she was ill in the night (she'd been ill a few times before that, sickness & runs etc so dad had spent days there on the sofa having to take time off work) and dad had to rush round, he found her collapsed at top of the stairs. Took her to hospital and doctor pretty much said there was nothing wrong with her and she was ok to to go home - after Dad had given him what for about what a state she'd been in at home (very messy) she made a point of "showing" the doctor how bad she'd been - and he kept her in. It turned out she kept passing out because her heart rate was too slow and ended up having a pacemaker fitted.

She never came home after that as was kept in hospital as they realised that she was not safe to be home alone - she had to get to bed upstairs and they deemed her not well enough to climb the stairs - she said they'd move the bed downstairs for her - and she's got a commode so she'd be ok for toilet (and said she'd be ok to clean it herself.. hmmm). When the caring staff suggested to her that she may be better in residential care (not a nursing home) she was almost in tears - and the reason? She said they were horrid places and she'd be made to scrub the floors and be ordered about. I kid you not - those were her words, they were horrible to hear but when you tried to explain that this is not the case she just would not listen!

She was in hospital from August 2000 until December 2000, as from when she had the operation and was well enough from that - they couldn't send her home and had nowhere else for her to go. She visited several residential homes but she wanted to be in the one on our estate and wouldn't go anywhere else. We were lucky that a place came up, and she has lived there ever since. Unfortunately her memory and state of mind has deteriorated every since - now as soon as we walk out of the door she's forgotten that we've been to visit. She had a two or three day stint in hospital a couple of years ago when she had a chest infection - on the first day she was there she was in a like an intermediate ward - where you go after A&E for them to assess you to be admitted onto a ward. Nan was trying to tell me that they had stolen all her clothes and her wardrobe from behind her bed. I tried explaining to her that she had only come to hospital that morning but she sat there and shouted at me that I was a liar and I was trying to pull wool over her eyes. I had to talk to the nurse on duty and explain everything to them about her health state (I was pretty narked off to be honest that a member of staff from the home hadn't stayed with her). I went home to fetch her some things and came back within an hour - and she couldn't remember I'd been originally.

I know that seems like a long story - but what I'm trying to say is you have to persevere. I'm confident that from what you have said that your gran is in no fit state to be at home on her own. Have you looked at the option of sheltered housing? That way she would still have her own flat but there is always a warden on duty to keep an eye. You should contact an Alzheimers Charity to get some more information and I'm confident they can point you in the right direction. I lost my step-nan to Alzheimers and it is pretty frightening watching someone you love deteriorate in such a way.

Good luck with whatever you decide to do, but please, contact the charity (or an advisor) for some help - keep a diary of events if you have to and present these to the GP/social worker so they know how bad events are. Good luck xx

As she has been clearly assessed and she is not getting the care she needs, have you considered taking legal advice as the social services are obviously negligent. They do have a legal duty of care.

This was taken from the NSF
Hope this is some use so that you no what should be happening.
Has any body given your Nan a diagnosis of dementia? and has she been reassessed in the last six months

Whenever older people attend primary care, seek help from social services or attend
hospital, either as an elective admission or in an emergency, health and social care
professionals should be aware that they may have needs, beyond their immediate
problem. Front-line professionals should explore whether these further problems
exist through questions which may be asked at first contact. Further investigation of
particular problems such as eyesight or mobility may be needed. Alternatively, the
problems may appear to be of such complexity that a fuller assessment is needed.
Older people who have complex needs may have multi-factorial problems, such as
dementia, or incontinence, or exhibit challenging behaviour.
2.33 A fuller assessment will consist of the exploration of a set of standardised domains
of need, as outlined in the box below. This can be carried out by front-line health
and social care staff such as community nurses, social workers, occupational
therapists or physiotherapists 112 (C1) 113 (B1) 114 (C1). Further investigation of
National Service Framework – for Older People
Page 31
domains will need to be carried out by appropriately qualified professionals; for
example, measuring blood pressure needs to be carried out by a nurse or doctor.
What is important in the fuller assessment is that all of the domains are considered
and that no presumptions are made about whether exploration of a particular area
is important.
2.34 Older people should be invited to play as full a part in this overview, including
elements of self-assessment.
National Service Framework – for Older People
Page 32
User’s perspective
• Problems and issues in the user’s own words
• User’s expectations and motivation
Clinical background
• History of medical problems
• History of falls
• Medication use
Disease prevention
• History of blood pressure monitoring
• Nutrition
• Vaccination history
• Drinking and smoking history
• Exercise pattern
• History of cervical and breast screening
Personal care and physical well-being
• Personal hygiene, including washing, bathing, toiletting and grooming
• Dressing
• Pain
• Oral health
• Foot-care
• Tissue viability
• Mobility
• Continence
• Sleeping patterns
2.35 While undertaking an assessment it will be important for users and professionals to
confirm and record current levels of help from carers, health services, social services,
housing services, and other services. Assessment information will need to be
updated or revised over time as needs change or as older people move through the
care system.
2.36 Assessment may identify the need for more specialist assessments; for example, a
specialist medical need such as cognitive impairment, for a mobility or dexterity
problem, or a need for pensions or benefits advice. If admission to long-term care is
a possibility, full multi-disciplinary assessment should take place to identify
opportunities for rehabilitation and to reduce inappropriate admissions. This will
involve assessment by the most appropriate team - such as the specialist stroke team,
old age multi-disciplinary team, or the old age mental health team.
2.37 Finding out about the help that older people already receive should reveal whether
family members or friends are acting as carers. Carers should be identified and
offered either the opportunity to be involved in the older person’s assessment, or
where it appears appropriate, informed of their right as part of a holistic assessment
to an assessment in their own right under the Carers and Disabled Children Act 2000.
Guidance on carers’ assessments is to be found in the practice guidance on the Carers
and Disabled Children Act 2000, and the Practitioner’s Guide to A Carer’s Assessment.
National Service Framework – for Older People
Page 33
Senses
• Sight
• Hearing
• Communication
Mental health
• Cognition including dementia
• Mental health including depression
Relationships
• Social contacts, relationships and involvement
• Caring arrangements
Safety
• Abuse or neglect
• Other aspects of personal safety
• Public safety
Immediate environment and resources
• Care of the home
• Accommodation
• Finances
• Access to local facilities and services
2.38 Suitably trained registered nurses will be involved in any assessment process which
has identified registered nursing needs, including the decision on the appropriate
setting for the delivery of that nursing care. These determinations will be submitted
to the manager in the PCG/T who is responsible for the implementation of ‘free
nursing care in nursing homes’ and is the budget manager for this expenditure.
This manager will be responsible for agreement that the free nursing care budget
will pay for the determined level of registered nursing care.
2.39 Consideration of what help to provide and how care should be managed follows
assessment. While the care of all older people should be managed appropriately
and effectively, the most vulnerable older people will often require fuller
assessment and more intensive forms of care management. For this reason
dedicated care managers should work with the most vulnerable older people over
time. 115 (A2/B3) 116 (B3) 117 (A2) 118 (B3) 119 (B3). The care managers should be
the most appropriate professional, given the individual older person’s needs.
2.40 Following assessment, older people will receive an individual care plan that clearly
describes the objectives and outcomes of providing help as well the detail of that
help and who to contact in emergencies or if needs change. Care plans should be
agreed with the older person, who should hold their own copy of the care plan.
2.41 There will be national work to support the implementation of the single assessment
process. An Assessment Working Group is being established by the Department of
Health and will provide national guidance, based on the best current evidence,
which will advise on:
• identifying the circumstances which would lead to an exploration of all the
domains (as described in the box) or a more focused assessment
• a tool and, as part of that, scales to support assessment practice.
2.42 Guidance based on the work of the Assessment Working Group will be published in
summer 2001. The aim is to move towards a more standardised approach on
assessment, so that organisational boundaries become less important; for example,
where PCG/Ts deal with more than one social services department, the similar
arrangements in place will facilitate the sharing of information collected in a
systematic way by all agencies.


Paul :-)))

There is a good chance she will have been seen by an OT at the hospital with the consultant and also it seems that social services are in involved with the daily calls by carer's unless it is a private arrangement funded by the family. It is difficult to get someone into care when they don't want to go, even when others can see that it's better for them.

As she has been clearly assessed and she is not getting the care she needs, have you considered taking legal advice as the social services are obviously negligent. They do have a legal duty of care.

True but the Social worker alone cannot get the lady committed against her will. The legalities are you cannot take someone against their will and do as you want with them. Now if they were Certified as unable to look after themselves by (racking my brain here so might be wrong)
a: Approved Social Worker (ASW) which is different from a social worker,
b: The persons own GP
c: A Psychiatric Consultant

They all have to get together and agree to Section the client as unfit to live alone. No one person can do this it is the law for the protection of the client.
As i said earlier I went through this with my father and it's tough.

The basics about power of attorney and descion making.
Hopefully people have given you lots of info for you to get the right outcome for your family.

The Mental capacity act could help you with this

Thanx Paul :-)))))))

Mental Capacity Act 2005
Overview of act
The Mental Capacity Act was implemented in 2007. It aims to protect people with learning disabilities and mental health conditions, for example, Alzheimer's disease. It will provide clear guidelines for carers and professionals about who can take decisions in which situations.

Assessment of capacity
Person is unable to make decisions for himself if he is unable:
understand information relevant to decisions
retain that information
to use that information to make decisions
to communicate his decision by any means

Impact on client
Protection
Empowerment (Power of Attorney)
Clients best interests

If Sectioned this act does not apply
Will the Power of attorney work in your best interests?
Will this act in practice be applied to everyone?


References
DirectGov (2007) Mental Capacity Act. Accessed on 9th May 2007 [online] at: http://www.direct.gov.uk/en/DisabledPeople/HealthAndSupport/YourRightsInHealth/DG_10016888

Sounds to me like you should get power of attorney, your doing a great job, keep fighting for her hon...Shes a lucky lady to have a family that cares so much about her.

Sounds to me like you should get power of attorney, your doing a great job, keep fighting for her hon...Shes a lucky lady to have a family that cares so much about her.
From the Direct Gov website
Quote
"When someone is no longer able to decide

The Act intends to protect people who lose the capacity to make their own decisions. It will:

* allow the person, while they are still able, to appoint someone (for example a trusted relative or friend) to make decisions on their behalf once they lose the ability to do so. This will mean they can make decisions on the person's health and personal welfare. Previously, the law only covered financial matters" unquote

Which is your catch 22 you have to be mentally able to fill in and understand the Power of attorney forms first and get your G.P to agree that you are of sound mind, it’s too late when dementia has set in. It’s part of the protection to stop someone who the Elderly/Ill person being abused by someone who is not trustworthy or even known to the person. On a personal note when we found out this we did the power of attorney forms immediately naming those who we trust to act on our behalf should we become unfit later in life.