Not Fit for Purpose

I am hoping Mother will be home from hospital early next week.

The hospital social worker is convinced she needs to go into a nursing home. She may be right, but she’s not coming up with the evidence.

Once again Mother has been assessed as being unable to perform simple tasks; to walk; to understand instructions.

I asked to be at the assessment. It was carried out without me. I pointed out that I had stayed East especially to attend. Another assessment was arranged.

In conversation on the ‘phone I had already underlined the importance of giving short clear instructions; making tasks ‘real’; not asking questions; giving Mother space.

“Do you want to go home?” asked the OT, “You need to show us you can stand up if you do.”

Obviously there was a great deal wrong with this approach, but I limited myself to saying, “That won’t work”.

I pointed out that Mother was lying down and they were asking her to swing her legs off the bed. It was not something she’d do at home. The bed was extremely high. She didn’t know why she was being asked to sit up. She was cold and tired and for the want of a good reason, it seemed perfectly sensible to refuse and go back to sleep.

The aim was to see if she would transfer from the too high bed to a wheelchair placed out of her sight in a space I knew she would find claustrophobic.

Not good.

The professionals wanted to stick with their plan, so I suggested moving the wheelchair to where she could see it so at least the nature of the task would become clear to her.

We had lift off. Mother struggled into a sitting position and swung her legs over the side of the bed. Then took fright at the distance to the floor which looked slippery and shiny.

The professionals crowded round her. Mother recoiled in fear, her eyes huge behind her glasses.

I’d told staff the previous day that this approach scared her and they had visibly bristled, telling me that was the way to help. I told these professionals the same thing. They exchanged glances but backed as far away as the curtain would allow. Mother advanced once more to the edge of the bed.

I shan’t bore you with all the details, but the assessment of her capabilities was a sham. She was asked to stand up from a chair where the arms were almost at chin height so she could not get leverage. She was repeatedly asked questions.

One of the professionals at least had the grace to say that it had been interesting to see how Mother responded when tasks were clear and they dropped the questions.

Not so the social worker. She reported to me that Mother had not been able to perform the tasks. I pointed out that the tasks had not been appropriate, and in my view, were unhelpful. She said it was difficult; there was always room for improvement, but in her view Mother needed to go to a care home.

And that’s what it was – her view. She had nothing to back it up with. No evidence other than the sham assessment.

Three times the hospital’s assessments have pointed Mother in the direction of a care home, and each time the results of those assessments have been proved wrong as soon as she has reached home.

Surely, by now, someone should be working out that as the assessments are consistently giving a false picture, it is they that need to be adapted, rather than asking a ninety-one-year-old living with dementia to adapt to them.

8 thoughts on “Not Fit for Purpose

  1. Excuse me while I scream loudly on your behalf. What about a home visit assessment in her own environment?

    It’s not rocket science, but these home visits used to be common place, often with carers who know the person in their own environment, present, and maybe the DN if involved.

    Now time is short and money is less they seem to have melted out of existence and the baby has been thrown out with the bath water.

    Oh Isobel.

    • That’s very interesting Pseu, because I asked exactly the same thing and was told, in that very patient tone professionals sometimes use which invariably comes over as smug and patronising, that it was not possible. Had I known it used to be common practice I’d have pushed a bit harder.
      I’d like to know more about care homes, especially how the funding works, and about NHS continuing care which I understand can be given in a person’s home, but I no longer trust the social services. The cuts have been absolutely savage in Mother’s county, and it feels like money is at the bottom of everything.
      I keep asking why she hasn’t had anymore physio this week, but no one so far has been able to tell me. I feel she is being discriminated against and written off.

      • I do hope you can come to a suitable arrangement. All this back and forth is so very exhausting. For her and for you.

  2. I think I had an NHS doublethink experience today. The social worker is still keen for Mother to go to a nursing home. I asked about NHS continuing care. She reckons Mother would not qualify as dementia is not an illness, and Mother doesn’t need qualified nurses to look after her, but the social worker is still talking about a nursing home.
    Dementia is apparently a social condition rather than a medical one.
    Do you understand this?

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