the BFN

These questions of mental capacity – they’re always fraught.
Which is why I’m relieved to have caught Richard on the phone. Richard works for the city Mental Health team. He’s great at untangling these things. Vigorous, avuncular, thorough, clear, with a reassuring volume to him, like I’m floundering about in the boat, panicking, and he’s striding along the shore with a megaphone.
‘Helga? Not one I’ve dealt with personally, but I’m pretty sure she was triaged a couple of months ago,’ he says. ‘Just reading the notes, Jim… ah yes. Here we are. Initial referral from GP. Ninety year old female, query more confused than normal. Carers reported bizarre behaviour, putting faeces on the table and so forth. When the GP went in she wouldn’t let him do anything, no bloods, dips or anything. So we went in to assess capacity.’
‘What was the result?’
‘It doesn’t appear we got very far, I’m afraid. She was marked as having moderate cognitive impairment, but wouldn’t engage in any further tests. Wasn’t bad enough to section, not sufficiently a danger to herself or others. We ended up referring her back to the GP. What’s your involvement?’
‘Helga’s private carer has gone away for a few weeks. The family wanted her to go into a home for respite, but she declined at the last minute. The GP’s sent us in to bridge the care gap, and to try our luck assessing her medically again.’
‘Oh? And how did that go?’
‘Not that great, Richard. She was aggressive, abusive. And now she’s insisting on white females only.’
‘Oh dear!’
‘Yep. She dropped the C-word on me.’
‘The C-word? What d’you mean?’
‘Well not cat. Although she has got one. One of those big furry nightmares, with a squashed up expression, like it’s planning something.’
‘I bet it is,’ says Richard. ‘I bet it is.’

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