Susie is an 82-year-old woman with dementia who was living in her own home. Concerns were raised that she was self-neglecting and could unintentionally be placing herself at risk. Following a safeguarding alert being raised, it was found that Susie's home had become cluttered and severely neglected. Susie had boxed up items which she was not using, and the boxes were piled up precariously. She was unable to shop, clean and cook meals for herself. Susie smoked and would regularly leave cigarettes on windowsills, the carpet and her sofa (which she was sleeping on) creating a fire hazard. Susie was also at risk of falls because of poor mobility and although she was supposed to use a walking stick she would often forget to do so due to dementia. She was also at risk of abuse as she invited strangers in to her home on a regular basis – Susie said she did this because she felt lonely and didn’t see any risk in doing so.

Susie’s Social Worker completed a capacity assessment which found that Susie lacked the capacity to make decisions about her care and place of residence. A POhWER Independent Mental Capacity Advocate (IMCA), Jennie, was instructed to obtain Susie's views about moving in to a residential care home.

Jennie met with Susie and found that she was able to explain her wishes and so she provided instructed advocacy to Susie. Jennie adapted her communication to suit Susie's needs by speaking slowly and allowing time for Susie to digest the information and respond to ensure her views were taken into account.

Jennie explained to Susie that because of the safeguarding issues around her staying in her own home, there were concerns about her welfare. Susie stated that she wanted to remain in her property and did not want to move to a care home, but that she would be happy to have carers come into her home to support her. Jennie explained that social services did not deliver a care package that would suit her needs, as she had been assessed as needing more than the maximum of four care calls per day to ensure her safety and wellbeing.

Susie explained that she did not want to move in to a care home as she had previously spent time institutionalised as a young person and it was not a good experience.

Jennie listened to Susie and reassured her that care providers had improved since then. Susie was open to the idea of improving her care and her health. Jennie explained that in a care home, Susie would have access to social support, which appeared to be something that Susie craved. Susie considered the idea of moving into a care home and in discussions about the support that could be provided to her she was willing to listen and think about her options.

Susie decided that although she would rather stay in her home with support, she would consider viewing care homes to see what they were like. Jennie showed Susie pictures and videos of the care homes that could be an option for her. Susie enjoyed this and started to come around to the idea. Susie was particularly interested in the activities that she could engage in at care homes.

A care home placement was found that suited Susie’s needs and Susie agreed to move in.

When Jennie met with Susie after the move, she found that Susie had flourished in the care home. Susie told her it was the best decision to be made. Susie said she felt supported, happy and was enjoying the activities in the care home. She was also making friends with the other residents and no longer felt lonely.