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can social services simply wipe their hands of a person - Carers UK Forum

can social services simply wipe their hands of a person

Share your ideas about the practical side of caring.
Hope you don't mind I am asking this question/request for advice for a close friend.

Just before Christmas her MIL was found by a family member on the floor of her house (MIL lives in a house on her own suggestions of moving to a bungalow have been turned down in no uncertain manner) She was in hospital for approx 3 weeks, she had, apparently, despite family doing shopping etc for her and asking if they could cook a meal for her she had only been eating meals when being invited to my friends house or to another member of family home she had been surviving on yoghurts and binning any fresh food or ready meals. She had also not been taking meds but she was found to be mentally sound.

My friend got hospital SS involved and they put in place a care package before she went back to her home the care package was for 3 visits a day to include meds, meals, dresing etc. , The MIL in her cunning way knew this was the only way she would be discharged, the care lasted for 2 weeks after which the MIL refused to let them into the house and having been found mentally OK SS said it was out of their hands.

The family put in a stairlift for her (she refused to use it and dragged herself upstairs using the banister) likewise all other things bought to aid her including rise and sit chairs were ignored.

It had been noted by family members that MIL was having more and more difficulty walking but all offers of getting GP were thrown out by her she is, to put it mildly, a very matriarchal women. She is visited most days by a family member but non are available to take her into their own homes or live close enough to care for her.

On Monday she was once again found on the floor of the kitchen and refused offers of medical help, a family member got her back upstairs after which she told them to leave on tuesday she was found collapsed on the bedroom floor and after much argueing an ambulance was called, she at 1st refused to let them touch her but eventually gave in, in hospital she was found to have dislocated 1 of her artificial hips and this has now been put back in place and she is now in a hospital bed.

Hospital has said she no longer needs the hospital bed, social services have once again assessed her as mentally sound but as obviously needing some care in the home once again this has been refused by her.

My question is therefore quite simple what happens now if the family distance themselves from doing anything at all for her can SS become obliged to set up another care package? What is the position if she refuses to let carers into home again, can SS just ignore her wishes?

Please do not misunderstand my friend and other family members they have tried everything and are actually kind and loving people and yes I have met the MIL and yes I would guess she is another MIL from hell and the way she speaks to her sons/daughters has me cowering despite it not being aimed at me.

Any advice would be great I downloaded the document on hospital discharge last time which is how SS became involved at Christmas.

Now here is hoping for a few non rain days here in the NE
hugs to you all
I can't give you an 'authoratiative' or informed answer, but I know there are those on this forum who have the knowledge and experience to do so, and I'm sure they'll answer you soon.

It's an invidious situation. In a way, 'obviously' she is NOT in her right mind, as she is refusing to take basic care of herself, so is 'in need of care'.....yet until and unless she is 'sectioned' (or equivalent) presumably is legally free to refuse all help on offer.

Being (slightly!) cynical, it could possibly be that SS don't actually WANT to find her 'non-responsible' for herself, as that would incur costs for them, ie, to rehouse her in a home etc etc, but hopefully that is not so.

Is there something the MIL is actually after? ie, is all this simply to try and force the hands of her family so they take her into their own homes, or come and live with her to look after her? Elderly people can be utterly ruthless and self-focussed (because they have to be!), and it's a possibility that she is deliberately (even if unconsciously) behaving in this way in order to get what she wants (ie, her family too move in or have her move in with them.) If that is so, then I would strongly advise her family 'holding firm' and NOT giving in (especially since you say she is the MIL from hell!)

Of course, it could be that she is simply being doggedly 'independent' as she sees it, and doesn't want any one fussing over her.....

At some point, I would assume (??), SS/the NHS simply HAVE to 'take her into care' for her own safety???? But, as I say, I don't know where the law stands on this, and others here will know a lot more than me.

One other warning - SS may well try and 'solve' the problem (for them!) by seeking to persuade her family to take her in, or move in with her......it is, after all, the 'easiest' solution for the state, ie, dump elder care on family......

If the legal situation is, though,that no one can 'force' the MIL to accept external care or go into a home, then I guess if she IS deemed to be 'compos mentes' then if she wants to pursue this course of self-neglect maybe she is legally free to do so???? (I find it hard to believe so.....)

All the best with a very intractable situation!
Social Services are responsible for "Adult Protection" - a duty they cannot avoid if someone is classed as a vulnerable adult. Hospitals should routinely assess patients for free Continuing Healthcare but frequently don't do this, for a varity of reasons. Hospitals have a duty to ensure any dischaege is safe, there are penalties for unsafe discharges, when someone is readmitted in less than a month. I would say to the family to be as damned difficult and bloody minded as it takes to make sure discharge does not happen until they are sure it's suitable. After discharge it's much morecdifficult to get things arranged. That's the bitter voice of experience I'm afraid!!!.
Your friend is going to have to simply put their foot down and point blank to refuse to accept their MIL being sent home. Get them to point out that there is no one to care for her, that she is refusing care and that she needs a place in residential care. MIL may well change her tune when faced with losing her home and being forced into residential care. She WILL, as bowlingbun and jenny have suggested, try to force her family to either move in or to move in with them. They'll have to be prepared for that and decide together as a family, WITHOUT MIL involvement, whether they're prepared to take that on; they mustn't be bullied into it or find themselves drifting into it. I suspect a lot of us carers make that mistake. Please wish them all the best, it's a horrible situation to face and EVERYONE will try to use guilt and bullying to make the family take on the responsibility.
So true! The day after a meeting at which I was told mum was ready for discharge, pain free, they were injecting her with morphine as she was in so much pain. Trust your own judgement.
So, you see, BB, she WAS painfree, wasn't she....... (!!!!!)
This moral and legal conundrum has been going round and round in circles since the Middle Ages. The problem is: there is a genuine conflict between the autonomy of the individual, the sanctity of the family, and the statutory responsibility of the State to protect vulnerable individuals, and there are no right answers. 'Each case on its merits'. But if someone wants to live in a very 'untidy' way, or self-discharge from hospital, you can't actually stop them unless they are a public health nuisance or insane.
I think Scally sums it up succinctly.

When it comes to the carer/caree relationship it can be very hard for the carer - especially when the caree is the parental generation - NOT to try and 'intervene' in ways they think is appropriate, but which the caree may reject.

I think, psychologically, once the 'child generation' takes over the care of someone in the parent generation, whether their own parent, or inlaw, or grandparent, they can do so so completely that the roles are completely reversed, and maybe we (because that's me, too!) feel sort of 'Look, if I'm going to do this caring stuff then it has to be done MY way, because I'm the one with the short straw!', which means that we find it hard, if not impossible, to remember that the older person does still retain the identity they always had - ie, as 'autonomous' adults.

So, if your friend's MIL does actually want to live in that chaotic, self-neglecting way, she IS still entitled to!

What, of course, she is NOT then entitled to is to have her DIL/children disrupt their own lives excessively in order to look after her the way she wants to be looked after!

In other words, the whole thing boils down to this - if the caree wants to live the way they want to live, that's fine, BUT they can't then expect their 'carers' to adapt to that. If they want to be looked after, then they have to figt in with their carer's needs and life, not the other way round. That's the 'deal' of getting another human being to look after you. You get looked after, yes, but only in the way the person looking after you is prepared to do so, not the way you want them to (hopefully, sometimes both those are the same!)

The alternative is NOT having another human being looking after you, but you are then free to live your life the way you want to, even if others think it's a dreadful way!!!

Personally, I would say that your friend should simply let her MIL live the way she wants to, and take the consequences thereof. Until, that is, the MIL's behaviour hits the level at which the state HAS to intervene, as Scally delineates, at which point the game changes.

Till then, it's her MIL's own life, and if she doesn't want to be fussed over then she doesn't want to be fussed over! (And if all her behaviour is to try and get her children to move in with her, or move in with them, then they must ignore her manipulations - if they take on any caring role it has to be on their terms, not hers - that's the deal!)
My mil is the same.because she can say no she has mental capacity,denies all we say to the professionals.IE she doesn't wet herself ,she can walk ,she is not deaf,she can wash herself etc,etc.
She lives with us but wants things her way,leave me alone I'm happy doing what I want ,doesn't matter what you want.
What can you do?
Lincan, I think, with respect, that yours is a different situation from that of Rea's friend. The MIL there lives in her own house, on her own, and refuses help as described. And in those circumstances it is difficult to see what can be for her 'without her consent'.

But if your MIL lives with you, there is loads and loads you can do about the situation! For a start, you can simply NOT have her live with you. You can insist she goes into a home - unless the house is hers not yours, YOU get to say who lives in it!

Because you are looking after her, you can simply withdraw that care from her. Simply not do it.

I know it's hard, but SHE is making choices that affect YOU, and they are all 'one way' decisions - ie, in her favour, for her benefit, not for yours.

Rea's friend's MIL takes the consequences of her decisions on herself - she is prepared to crawl up the stairs not take the stair lift she does not want, etc etc.

In that sense, if she wants to live that way, it's her choice (again, subject to being sectionable!). But it is NOT your MIL's choice to live her life the way she is currently doing. You are letting her do so.

I'm afraid, in your circumstances, if the house is yours not hers, and you are not using her money, ie, your affairs are legally and financially separate, then I would simply NOT house her any longer, or look after her, while she is being so 'unreasonable' (even if she isn't capable of being 'reasonable').

Currently, she not only wants things her way, she's getting them!!!

And she isn't going to change voluntarily, is she? Why should she? She is, as you say, getting what she wants.

She won't change unless you do!

All the best, and of course it is up to you what you choose to do for her, but don't be pressured into feeling 'guilty' at moving her out, and into some kind of accommodation that will take on the caring role you are doing.

Kind regards, Jenny

PS - and if it's your husband pressuring you to put up withthe situation and have his mum live in your house, and you to look after her while she refuses to admit that she is as infirm as she is (or can't mentally admit it), then YOU are free to walk out completely!