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Doing The Right Thing?

(13 Posts)
HollyDaze Thu 12-Jun-14 09:55:26

Bedford Borough Council and South Essex Partnership University NHS Foundation Trust have been criticised for letting a severely mentally ill patient live in "squalor" leading him to suffer malnutrition.

It has been stated that health and social care professionals were so fixated on the man's wishes to live independently, that they failed to carry out a capacity assessment of his ability to look after himself, which would have revealed that he was unable to cope with everyday tasks like feeding himself and cleaning.

"As a result, he was two-and-a-half-stone underweight, his teeth were rotten and his bedclothes hadn't been washed in months."

After a number of years of inadequate care, the man was finally moved into supported accommodation in December 2011 and his general condition has "improved".

Whilst I can understand that some people would prefer to live independently and I know of some people for whom this works very well, does the time come when, no matter what an individual may feel, that their 'right' to live independently cannot be endorsed? Did the health care professionals worry more about his rights than what was right for him?

rosesarered Thu 12-Jun-14 10:02:59

It's a difficult one isn't it?A lot of people with mental health problems hate outside interference in their lives, and can be difficult to deal with.What we would deem squalor, is what health care pro's see around them on a daily basis, just how a lot of people live their lives.It has to get to a certain point sometimes, before they can step in.If the man had been appealing for help [and they had not given it] that would be another matter.

NfkDumpling Thu 12-Jun-14 10:11:10

This can be so difficult. Even if they ignored his human rights, it could have been very hard if not impossible to winkle him out of his shell without a section order or using force. It can take a lot of time and patient persuasion - which may have been in short supply.

HollyDaze Thu 12-Jun-14 10:15:24

If the man had been appealing for help [and they had not given it] that would be another matter.

That is a good point and one that I hadn't considered. I wonder if he was offered home-help? Would it be better to make home-help compulsory for those who may not be able to look after themselves?

It is a difficult one.

HollyDaze Thu 12-Jun-14 10:17:52

^ It can take a lot of time and patient persuasion - which may have been in short supply.^

I do wonder if that is the crux of the problem. Everything has been cut back to the bone and there just aren't enough resources.

I was reading up on Care in the Community (it said it is a British thing - does it not exist anywhere else?) and after several paragraphs of reasons for its being introduced, towards the end of the reasons came the inevitable 'cost' factor: it is cheaper than residential care.

Mishap Thu 12-Jun-14 11:26:54

Good community care is not cheaper than residential care. Poor community care is cheap. This was the battle we fought as social workers when all this was first introduced. No-one was listening. A good package of community care that truly meets a person's needs is not a cheap option at all; and now that LA funding is dwindling people will suffer (and indeed die) because this is not being done properly.

janerowena Thu 12-Jun-14 11:45:12

A friend of mine had such trouble to get help for her mother, even when nurses told the social worker how bad she was the woman seemed disinclined to believe them. She just didn't want another patient I think.

Good residential care now costs her £1000 A WEEK and she had been thinking it would be that per month. Six months on and she is still trying to find somewhere that will take her mother and has spent all of her own and her mother's savings on a nursing home that can't really cope but has taken her mother on the understanding that she will go in every day for a few hours to help out.

She tried to cope by herself for some time at her mother's home but she has health problems and needs lots of sleep. She had carers too for a while but even 95 year olds escape at times. I can't begin to think what the answer is.

Two friends of mine have younger male family members who have always had mental problems and live in the community, it means a constant rota of visiting relatives visiting at least once a year to check up on bill-paying, carers and house maintenance. They are lucky to have that. One friend lives in Australia and the cost to her and her family is great, in time, money and stress.

Maybe the answer for the government is, to let them/us die. We now all live so far from our immediate families that I can't see how else it can be for most of us.

rosesarered Thu 12-Jun-14 15:09:07

Yes jane for a lot it will be 'sink or swim', it's very sad.

HollyDaze Thu 12-Jun-14 15:51:37

£1000 A WEEK - I am truly shocked that it costs that much - how on earth are people supposed to be able to afford that? If you are of sound mind (and not incontinent), it would be cheaper to stay in a hotel or just keep sailing around the Med on a cheap cruise (they even have a doctor onboard so I'm told).

Maybe the answer for the government is, to let them/us die. We now all live so far from our immediate families that I can't see how else it can be for most of us.

It does make you think that way doesn't it. What is the point of living to a ripe old age if you are not 100% and can't afford fees such as those? What are people supposed to do?

I know that my daughter wouldn't want me living with her and neither would my daughter-n-law (my son would be very happy about it) and, if I'm honest, I wouldn't want to live with either of them (but would jump at the chance if it was just my son - he's a lot of fun and very caring).

janerowena Thu 12-Jun-14 16:33:38

I watched a programme years ago about good carehomes closing because of who they could employ, health and safety, food wastage, no chance whatsoever to cut corners, replacing perfectly good doors with fire doors, all sorts of things that we wouldn't do in our own homes yet they were expected to provide and pay for them. The list was endless. It really was a very long time ago and at the time it was £300 a week. The best carehomes charge around £1000 a week plus, but the social services refuse to pay it so that there are not enough spaces left for everyone, the waiting lists are huge in many areas. My friend says that even the expensive homes have waiting lists in many cases. She can't find a home near where she lives at all, so is staying in her mother's house until she can sell it. After that, she doesn't know what will happen as she won't be able to live nearby, so the home won't let her mother stay anyway!

Her mother had left her the house in her will, but the reality is, she won't see a penny of it. None of us will.

FlicketyB Thu 12-Jun-14 16:36:22

The health professionals would have wanted him to succeed as it is much cheaper to have someone living under the 'assisted living' scheme than in a community situation.

A member of my family is autistic and his parents were under considerable pressure to 'encourage' him to opt for assisted living. He would have been in a flat on his own with five other flats similarly occupied, there was no community space and a care worker would look in only weekly. He said he didn't want to live like that. His parents supported him and he is now living in a therapeutic community where he leads an active life, loves helping with the cooking and growing vegetables.

But it took the threat of legal action and an independent assessment to get him to where he now livesvery happily. Among the things the Social workers said was, that by having 5 other similarly disabled people in these flats they could socialise and get to know each other. Leaving all of us wondering whether the Social worker had any idea what autism is and how it affects people.

durhamjen Thu 12-Jun-14 16:47:47

My mother in law is in a nursing home costing £500 per week. Her sons are in the middle of selling her house to pay for it, which will be interesting as she keeps asking people to help her to go home.

She was in hospital, then went home and realised she could not cope if she fell. She was supposedly given care assistants to help four times a day for ten weeks, but by the third week there was only one coming to make sure she had got out of bed every morning, because she did not want them in her house. However much you try to help someone, they still have the right to refuse that help.

FlicketyB Thu 12-Jun-14 17:02:45

But that must assume that the person concerned is still capable of making that decision. Once it is clear that they are not decisions must be made for them.

I had an aunt and uncle, both with dementia, both physically disabled. When my aunt returned home after a spell in hospital Social Services assumed they would be able to function at home with carers three times a day. Within days it became absolutely clear that they were not safe to be left alone. We had six emergency visits by different medical professionals in three days and on one evening the wonderful carer extended her evening half hour visit to over four hours and was there till after midnight trying to get my aunt ready for bed and into it.

The next day the decision was made by others that they needed to move into care immediately.