Hi, I used to be a psychiatric nurse so have some background. Firstly "capacity" is not a fixed thing. A person may have capacity to make some decisions but not others. For example, your relative may have the capacity to decide what to eat for lunch but may not have the capacity to recognise that there is a health risk because a food item is out of date, or kitchen utensils aren't properly washed or there are flies buzzing around an un-emptied bin. Unfortunately a person with Alzheimer's may truly believe they are cleaning their house adequately, yet they are not. I think the SW is more concerned about any risks to the health and safety of the person, not that a cleaner will refuse to go into a dirty house. It is difficult to persuade people with Alzheimer's to do something they don't want to do, because they just don't understand that it is necessary, so sometimes it is necessary to take the initiative and intervene because it's in their best interest to do so. The SW can call a "Best Interest Meeting" for this very reason where SW, health workers, doctors and family can all jointly decide what course of action to take to enable the person to remain safely in their own home. Unfortunately, the nature of the illness means that eventually, if assistance in the home is unsuccessful or refused, they may recommend a nursing home.