September is World Alzheimer's month. Below is a case study which shows how a POhWER IMCA supported a man with Alzheimer's disease.

Tan’s Story

Tan had been repatriated from Thailand to the London Borough of Hounslow as he was no longer able to be cared for by his family in Thailand. He has Alzheimer's disease and requires 24 hour care in a residential nursing home. At the time of the IMCA referral, Tan was in hospital and medically fit for discharge. However, due to challenging behaviours it had been difficult to find an appropriate placement for him.

Tan was born in Manchester and has children living there who he has not had contact with for many years as their relationship had broken down. The Council were able to contact his family and following a visit to Tan it was established that there would be no objection to his moving to a nursing home closer to them. This was in line with Tan’s wishes to return home to Manchester. However, a residential nursing home had been found for him in London by the Clinical Commissioning Group (CCG) who had not considered the option of a move up North.

POhWER IMCA, Kim, read through relevant documents and looked at Tan’s relevant past history, social and nursing care needs as well as how he was best able to communicate. Prior to visiting him, Kim also tried to ascertain any wishes or views he may have expressed about a change of accommodation. Kim ensured that she visited Tan when he was most likely to be awake and alert, and not receiving personal care or eating.

Kim introduced herself to Tan and in clear and simple terms explained the reason for her visit. Tan was able to communicate well but was very confused and unable to identify his care needs or why he was in hospital. However, he was able to understand that a residential nursing home was being considered for him and did not object to this.

Kim chatted with Tan and encouraged him to talk about his wishes and beliefs. Tan talked about his life in Manchester, his friends and his children although he became quite confused at times. He said that he wanted to help people although he was unclear in what way, but was keen to include this in his future plans.

Kim asked Tan what he thought about staying in London to which he smiled and replied yes I would like that, but when Kim then said that there was also the possibility that he may be able to move back to Manchester he became much more animated and gave a big smile saying that he would really like that.

Both Kim and the allocated social worker considered that it would be the less restrictive option in Tan’s best interests for a residential nursing home to be found near to his family in Manchester where he had knowledge of the local area.  However, the CCG providers still wanted to move Tan to a nursing home in London.

Kim pointed out the reasons why she was not in agreement with this decision and discussed the best interest decision making process with the decision maker and what her findings were. The decision maker was concerned that the CCG panel would not agree but Kim reiterated that the Mental Capacity Act had to be followed and take Tan’s views and wishes into account as well as her own findings.

The Decision Maker went back to the panel and it was agreed that Tan could move to a nursing home in Manchester. He has since moved and is settling in well.