Abraham has a diagnosis of dementia and had been admitted to hospital due to experiencing hallucinations and repeated falls. He had been found wandering in the neighbourhood on a number of occasions and returned home. He was in an assessment bed at a residential home and was deemed to lack capacity to make a decision about where he should live on his discharge.

As well as discussions with the Decision Maker and home manager, POhWER’s Independent Mental Capacity Advocate, Diane met with Abraham, who remained articulate despite his cognitive impairment.  By building rapport with Abraham by discussing his interests and past life Diane established that despite his short-term memory loss, he is still able to give a good account of himself and express his wishes and feelings appropriately.

It became clear that Abraham retains enough information about his circumstances to know that he is not at home and that this causes him great anguish. He also seemed able to appreciate the need for a robust care package at home. Abraham talked about missing his dog and felt all control over his life has been removed since he was placed in a residential home.

Whilst consideration was given to Abraham remaining in residential care, it was felt this would adversely impact his mental health. Diane therefore recommended that he trial a home care package and which would be regularly reviewed in case it was not working. This would allow him to continue to live with an element of control over his life. 

The decision maker agreed this was the least restrictive option and commented:

“Your feedback has been most helpful. Plans are currently being made for Abraham to return home with a package of homecare and for an assistive technology re-assessment to take place”.