# Father being mentally assessed in a nursing home - Implications.



## Grizzly (23 Aug 2012)

I have been told by a sibling(rather suddenly) that our elderly father is to be mentally assessed in the nursing home where he resides. The sibling who told me this normally deals with all of his matters to the extent that everyone has been excluded from helping out. Unfortunately or conveniently this sibling will be away when the assessment takes place and has asked me to step in. I have never been asked before to help out.
I am wondering if I am being handed some sort of poison chalice here? My father is not aware that this assessment will be taking place. I am not even sure who instigated the assessment in the first place. As I have to sit in on the assessment I know that my father will blame me for the whole thing.
Can my father refuse to have anything to do with this assessment or is it normal to assess the elderly in a nursing home? Is it legal for the nursing home to do this?


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## alexandra123 (23 Aug 2012)

Grizzly - I don't think you are being fair on the sibling being away for the assessment. You as a sibling should be aware of your fathers deterioration or change in state of health. If your not - then maybe it is because you don't see him that often. You should not have to be asked to help out. You should be just doing it !

The assessment could have been instigated by the nursing home. Maybe your father is in a wing that does not fully cater for his needs and he might need to reside in another wing or maybe even in another nursing home that can cope with his needs. I dont think you should refuse the assessment. You need to do what is in the best interests of your father. You need to be their to fully understand what is going on and what the potential outcomes of the assessment will be. It is legal for the nursing home to do this. At the end of the day - he is in their care and not in your families care, so they are solely responsible for him. Any new patient that looks to get into a nursing home - needs to be assessed, so it is quite common. 

I suggest you ring the nursing home before the assessment and ask them why is he being assessed - or go back to your family and ask them why. Having this information in hand will better prepare you for the assessment and might relieve some pent up worry that your feeling.

It could be as simple as the fact that he needs more one to one care or it could be more severe in the fact that maybe his mind is going a little bit. You dont know until the assessment is done.


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## Grizzly (23 Aug 2012)

alexandra123 said:


> Grizzly - I don't think you are being fair on the sibling being away for the assessment. You as a sibling should be aware of your fathers deterioration or change in state of health. If your not - then maybe it is because you don't see him that often. You should not have to be asked to help out. ..
> 
> .


 
There has been no deterioration in his state of health. I see him as often as my other siblings.  I have also tried to help out but I was prevented.

I thought it strange that my sibling who deals with these matters has not told him that he is to be assessed.


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## alexandra123 (23 Aug 2012)

The sibling is probably just trying to avoid your father any unnecessary stress. I don't think he will know he is being assessed as it will just be a chat or they might ask him to do 1 or 2 things. I think your best bet is to just find out why he is being assessed. You can ask the nursing home for the findings before your father hears them or you could ask them that your wishes is that he is not aware of the assessment results. 


You never know - things may well stay the same as they already are, so no point in worrying your father until the results come through or at least until you find out why he is being assessed.

Good luck with the assessment.


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## Grizzly (24 Aug 2012)

alexandra123 said:


> I don't think he will know he is being assessed as it will just be a chat or they might ask him to do 1 or 2 things. .......or you could ask them that your wishes is that he is not aware of the assessment results.


 
I cannot believe that in this day and age that a person can be mentally assessed without their permission or knowledge. Even a criminal has rights?


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## huskerdu (24 Aug 2012)

Grizzly said:


> I cannot believe that in this day and age that a person can be mentally assessed without their permission or knowledge. Even a criminal has rights?



I know nothing about the process in nursing homes, but if i was in your shoes, i would contact the nursing home and state that  you will present at the assessment and you need to given details in writing of the reasons for the assessment, who has requested it, what rules and regulations are used for these assessment and when you will be given the esults afterwards, who else will be given the results and how these results can be used. 

I am not suggesting that you do this agressively, but the information you have been given by your sibling is murky and you and your father are entitled to  clear answers on the questions above. 

One explanation that I can think of is that the nursing home think he is too high maintenance and need to prove that he falls outside their remit (if they only take residents that do not have high dependency needs) in order to insist that he be moved. This is only a guess on my part, but if it was my father, i would want to make sure that mo-one was being underhand. 

if the explanation is simple and above board, it will be made clear to you, if it is not, you will be able to fight for your fathers rights


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## inseventeen (24 Aug 2012)

If it was my father and I was asked to do this by any of my siblings, I would let my father know everything.


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## aob117 (25 Aug 2012)

This proposal might be just to establish a baseline for the future.  Mental capacity would have an implication as to the standard of care required. For example the regulations would differ for a simple care home, a nursing home or one set up for dementia residents. It may be to do with obtaining power of attorney over his affairs, again perhaps for some time in the future.


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## paddi22 (26 Aug 2012)

Nursing homes run constant assessments so they can chart a patients status. I'm sure if till be done subtly and gently, and your father will probably not even know. With my mother, it was basic questions to check her clarity and memory recall. You don't mention what kind of condition your father is in, does he have full mobility, does he has dementia?

It is in his benefit to be assessed often, as the people dealing with him daily will pick up on stuff that visitors won't. My mother was the same. I did fulltime care and she was in a bad state, but she would perk up when visitors came, so they didn't see the extent of how bad she was for ages. 

Hopefully getting involved with this assessment will bring you back into the loop with your father and his condition.


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## Laughahalla (25 Jun 2013)

Somebody may be in the process of making your dad a ward of court.


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## WizardDr (25 Jun 2013)

I think what is at issue here is the capacity of the individual patient to make decisions.
Essentially any adult can refuse treatment and check themselves out and also refuse to allow family to participate. 

The slight problem for the medics on the matter of 'informed consent' is that this might exclude discussing any or all matters with family.

What I would do is insist on meting the medical team - and if they refuse to discuss the case I would then warn them that their duty of care extends to the family - and if anything happens to our Dad then I will be drawing the attention of any reviewers to this conversation and would it be a 'generally accepted practice' to exclude the family from decisions affecting the welfare of your Dad.


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## SoylentGreen (26 Jun 2013)

In my case the nursing home will only deal with one family member. Our Dad is in a home and although all three children have given our contact details to the home they will only ever make contact and discuss our father with one of us, the same person all of the time. I can understand the nursing home doing this for convenience but things have happened concerning our father and the other two of us have not been informed by either the nursing home or our sister.
The latest thing that we have heard is that our sister has asked the nursing home doctor to increase his medication in order to "calm" him down. She gets embarrassed by his antics and it seems that they are happy to oblige. We were wondering why every time we call to the home he is asleep.
I would be interested to know if we can insist that the home contact all of us or can they appoint one person to deal with?


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## twofor1 (26 Jun 2013)

SoylentGreen said:


> I would be interested to know if we can insist that the home contact all of us or can they appoint one person to deal with?


Seems unreasonable to expect the nursing home to contact all three of you, whatever communication issues there are between siblings should be sorted out between siblings.

If you have any issues regarding medication then you should speak to the clinical nurse manager who will put your concerns to the doctor. You or your siblings can give an opinion but only the doctor can decide what medication is given and the dosage.


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## Kimmagegirl (26 Jun 2013)

Is there a department or body perhaps in the HSE that deals with Nursing/Retirement homes if a person had concerns about the treatment an elderly person was receiving?


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## twofor1 (26 Jun 2013)

Kimmagegirl said:


> Is there a department or body perhaps in the HSE that deals with Nursing/Retirement homes if a person had concerns about the treatment an elderly person was receiving?


 

http://www.hiqa.ie/about-us/what-we-do-and-why


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