You are a Mental Health Occupational Therapist, treating an elderly male who has been diagnosed with mild dementia and has had life long difficulties due to a diagnosis of Asperger's. Both parents passed away, leaving him a considerable inheritance including a 4 bedroom house with two bathrooms on a large property. He has difficulty with complex activities of daily living, but able to do all his personal cares independently. A few years ago a well meaning lady found him living in squalor with cockroaches infesting his house. She kindly offered to move in and did a great job of cleaning the house and has managed to maintain it over the years. She has provided care to your client and he is now physically in a much healthier state. He is very stubborn and constantly playing pranks on his friend and is certainly not easy to live with. It would be very difficult to find a carer with the patience to support him and the lady who provides 3 hours a week support has told you she is ready to resign.
Two years ago the well meaning live-in friend convinced him to sign over half of the property to her name which he did. Your team sought professional and legal advice and because he was deemed to have capacity to set up a will, the solicitors ruled that he had the right to give away half his property. They recommended that he appoints an independent Enduring Power of Attorney, but he refuses to do this. You and your team have been advised to apply to appoint a welfare guardian and have asked the social worker to assist in this. however you do not have explicit consent for this either.
It is clear that the client/serivce user cares a great deal for this woman and you feel that she may have manipulated him by threatening to leave. She is keen for you to provide him therapy to enable greater independence and is seems to be supporting his best interest. Yet you feel uneasy about her intentions and have noticed that he frequently changes his answers when she is not present. He says that finds her moods difficult to manage, but that he will do anything to keep her in the house. Attempts to teach him to be more assertive have not worked. Your initial assessment revealed that your client could not live independently and you wonder if he would be better living in care. He already enjoys attending a day program at a rest home 3 times a week, but is clear that he would not want to leave his family home. Due to his Aperger's he finds it difficult to adjust to change. You also know that he would be devastated to be separated from his friend.
what would you do in this situation ? Would a welfare guardian be able to protect this mans best interests, if the friend stays in the house full time ?
Should he be allowed to live where he wants, despite evidence of manipulative behaviour from the friend ?
Would it be justified to recommend he moves to residential care ?
It is proposed that the client is supported to live in the family home with his friend but be appointed a welfare guardian