Is it worth having a carer's assessment?

I'm not sure whether or not to have a carer's assessment.  My adult son's needs remain unchanged.  He's extremely withdrawn, reverse sleeps, lives in one room, no friends, no connection with the outside world other than to do a little grocery shopping and will not engage with services.  To be fair, it's gone really badly in the past.  The "help" from mental health services was quite damaging and also, since we pushed for this "help" (cos all of the advice is, of course, to "seek help"), eroded any trust he had in us as parents.  Moreover these services appeared to have no knowledge of autism - if they had, I'm sure my son would have been diagnosed and we'd have thought about our own neurodivergence and the implications at a much earlier stage.  Plus the mental health assessment we endured was, quite frankly, frightening, with the threat of hospitalisation and very basic, one-size -fits all meds/therapy.  

Against this background we are left on our own to cope with issues like managing benefits and finances generally, very poor hygiene (don't know how to get a very withdrawn adult to bathe or clean their teeth)  and the impact on us psychologically.  I am constantly anxious and worried but, in a similar pattern to my son, have given up on NHS services.  They have little to no autism awareness and no non pathologising model of neurodivergence embedded in their approaches.  I don't trust them.

At the same time, I feel desperate and need some support, advice and guidance.  Would it be worth having a carer's assessment?  What might be provided?  Would I have to be very careful about what I said to services to avoid triggering another damaging mental health assessment for my son?  Can I proceed without involving him at all, instead relying on paperwork from our past engagement with services?  

Anyone out there who's experienced this and got anything helpful to their caring for a young adult in an extreme "hikikomori" state? 

Parents
  • are u saying your son has not been seen by a professional psychologists and doesn't have a diagnosis ? i could be picking this up wrong.

    if this is true then u're son may be more than autistic.

    i think you should ring the helplines  to discuss things in more  detail because it just appear to be sliding to out-of-control.

    I could be so wrong her  but I think u need help. i think ur son needs help.

    I'll add the helpline link..... before u ring, check their working hours 

    www.autism.org.uk/.../help-and-support

  • He was seen by the crisis team, then by several psychiatrists, psychologists and CPNs linked to the Early Intervention in Psychosis team for around 3 1/2 years before eventually being discharged by the last psychiatrist who said that there was no evidence of mental illness, only of autism (Asperger's).  This was then reviewed a year later by another mental health team, triggered when I sought help for myself, and suggestions around psychosis and hebephrenia were made, in addition to autism.  They agreed, however, that our previous engagement with services hadn't helped (it basically pushed our son deeper into himself and away from us as he no longer trusted us not to get the "men in white coats" round) and that pursuing things for him would be tantamount to harrassment.  One CPN with over 30 years experience said that he'd never known anyone engage so little. 

    However, since our son now refuses to engage with services at all (including for a full autism assessment) and he is deemed to have capacity, I need support for myself and advice or guidance for us as a whole family in order to help us to help him.  In the meantime (it's over 3 years later already!) both myself and my older son have been diagnosed with autism and, given that it runs in our family (my dad, cousins, aunts etc) we think that autism is the main diagnosis.  Other issues, we believe, have crept in due to very late identification of our autism, problems at school and college with bullying, isolation and lack of acceptance or accommodations.  

    I tried the helpline a couple of years ago but, given our son's age (now 26), it was felt that we needed to accept his autonomous decisions (which include lack of engagement with menatl health services and the DWP).

    I am actually at my wit's end with all of this.  What I need to know (I think) is how to help someone to come out of a state of deep autistic burnout or, failing that, how to get help with basic things such as cleaning, personal hygiene and help with personal finances for a person who basically won't participate with this process.  Plus, after all of our experiences with MH services, I want to do this without triggering a MH assessment (which would only lead to more useless meds, psychologists who have no specialism in neurodivergence and possibly even coercion, which experience has shown will set our son back).  

    So, yes, a quagmire basically.              

  • And you'll have to forgive me for being leery of seeking help.  We did this from around age 15, when CAMHS wouldn't help us because our son wouldn't engage, then various GPs before things got so bad the crisis team became involved, although they didn't have much to offer at all.   I was left feeling very shocked at how little when, after I asked for information on psychosis they basically printed out a factsheet from MIND, as if I just hadn't thought to look this up myself. 

    What I was looking for was a thorough formulation of our son's issues and a very patient and steady approach to encouraging engagement instead of the rather circular pattern of us seeking help, them stating it's hindered by lack of engagement, us expecting them to know how to handle that, them just reiterating there was nothing they could do like a broken record.  :(  :(  :(     

  • He qualifies for ESA and, from a family perspective, that'll do for the forseeable future.  PIP was looked at by one of his CPNs but it was hard to put enough in any of the criteria and the MH team wasn't sure we'd get it.  Plus ideally we'd like to minimise contact with the DWP because of the regular need for updated information - always an issue when someone won't engage and there's nothing to substantiate a claim (well, unless they came to our house but apparently you need the requirement for a home visit to be confirmed by your GP to get that and, of course, he won't engage with the GP).    

    He does talk to other gamers so that's something at least.  However, it's mostly about gaming strategies plus a lot of swearing.  Maybe that's how he's venting his emotions.  Plus he'll say enough to bus drivers and checkout staff to be polite and get by, but no more.  He tends to be in a hurry to get away from people, ourselves included, and clips his words or answers monosyllabically, in spite of having quite a good vocabulary (which we know from earlier in life and his school reports and exam results).  I think he's very afraid and wary of others.  

    And yes, I think we could revisit the house rules.  I don't understand why he doesn't want to be clean.  My dad was like that all his life and I never understood that either, especially since he knew his daughters' feelings about it.  It might also have something to do with fear (fear of dentists, fear of anything associated with dentists) or the discomfort or inconvenience of bathing.  But it feels like a blind spot to me - it seems as though his attention and priorities are elsewhere and there's just no space left for hygiene matters.  Negotitations don't seem to alter anything in the longer run either - it lapses as soon as we lapse and it feels odd to have to reward hygiene (the reward is feeling clean!)  The good habits installed in childhood have fallen away and I don't know why (all those dentists' and hygienists' appointments, disclosing tablets, encouragement with flossing etc over the years - I don't know where all of that has gone)

    It all puzzles me and really I'd like to work with a very experienced neurodivergent coach and try to improve our family dynamics.  I had been hoping to simply love him through it but we're actually not getting through.  Things are staying the same.    

  • i would check the benefits situations with the CAB ( citizens advice bureau ) and PIP for him as well. I am no expert but think u should be getting something. As an adult he qualifies for some benefits surely?  then u can charge him a small rent.

    he sounds way more independent than i imagined.  it could be depression / or he doesnt want to talk as thats when problems occur for him? 

    yea maybe selective mutism.

    does he talk on headset with other gamers ?

    and sound like he is having fun for example ?

    does he use Discord (gamers site ) ?

    does he talk to check out staff, bus driver  ?

    would it possible to get him on this website ? --

    -- on this website forum a person  is having  hygiene issues with his autistic flatmate here.  so many autistic people (me included ) dont see hygiene as an issue to be concerned about. u have to learn hygiene rules eg wash yourself once a week teeth everyday, look in the mirror before walking out the door. 

    if he uses your router threaten to turn it off if he doesn't shower, tell him there are new house rules because you are getting older and he has to do more. 

    if he doent play online games then offer the reverse

    you will get him online games and a membership if he starts , make a deal

    1. shower once a week, brushes teeth each day

    2. improves his laundry

    3 talks to psychologist and joins this NAS community website 

    I'm clutching at straws but i rather say than not say

  • He speaks to us occasionally regarding food and money.  More stable than he was a few years ago and slightly better for not seeing any professionals (I use the term "professionals" loosely after our experiences with them).  But I'm not sure about separate accommodation.  We're all he has and he might feel rejected by the only people he has in the world. 

    He mostly plays computer games, he's OK with making his own food, basic grocery shopping, travelling on public transport etc.  Just very very withdrawn and extremely poor personal hygiene.  I am wondering whether he is selectively mute too.  

    Our preferred option is for more support to keep him here.  No DLA and no carer's allowance (investigated but we don't fit the elegibility criteria, esp. for carer's as this seems to be disallowed if there's any other income/benefits at all).  

  • Path 2 

    I suggest to write to your MP now to get him into sheltered accommodation ---- how can someone with autism be expected to look after another autistic adult with such a stance.

    please write to your MP asking for professional help to get him into his own accommodation. 

    stating this is what u want.

    What I was looking for was a thorough formulation of our son's issues and a very patient and steady approach to encouraging engagement instead of the rather circular pattern of us seeking help, them stating it's hindered by lack of engagement, us expecting them to know how to handle that, them just reiterating there was nothing they could do like a broken record.  :(  :(  :(     
  • that sounds so stupid  i mean he wont engage ----- of course not he has gone into a non cooperation state  and boy it works--- it really shows how alone we really are.

    what does he do all day ? sit comatose , read, play computer games ?

    does he talk to u ?

    FINANCE oh  u are getting  DLA  and a carers allowance payment to look after him right ?  and your other son

    i have Plan B below it maybe worth while i dont know. 

Reply
  • that sounds so stupid  i mean he wont engage ----- of course not he has gone into a non cooperation state  and boy it works--- it really shows how alone we really are.

    what does he do all day ? sit comatose , read, play computer games ?

    does he talk to u ?

    FINANCE oh  u are getting  DLA  and a carers allowance payment to look after him right ?  and your other son

    i have Plan B below it maybe worth while i dont know. 

Children
  • He qualifies for ESA and, from a family perspective, that'll do for the forseeable future.  PIP was looked at by one of his CPNs but it was hard to put enough in any of the criteria and the MH team wasn't sure we'd get it.  Plus ideally we'd like to minimise contact with the DWP because of the regular need for updated information - always an issue when someone won't engage and there's nothing to substantiate a claim (well, unless they came to our house but apparently you need the requirement for a home visit to be confirmed by your GP to get that and, of course, he won't engage with the GP).    

    He does talk to other gamers so that's something at least.  However, it's mostly about gaming strategies plus a lot of swearing.  Maybe that's how he's venting his emotions.  Plus he'll say enough to bus drivers and checkout staff to be polite and get by, but no more.  He tends to be in a hurry to get away from people, ourselves included, and clips his words or answers monosyllabically, in spite of having quite a good vocabulary (which we know from earlier in life and his school reports and exam results).  I think he's very afraid and wary of others.  

    And yes, I think we could revisit the house rules.  I don't understand why he doesn't want to be clean.  My dad was like that all his life and I never understood that either, especially since he knew his daughters' feelings about it.  It might also have something to do with fear (fear of dentists, fear of anything associated with dentists) or the discomfort or inconvenience of bathing.  But it feels like a blind spot to me - it seems as though his attention and priorities are elsewhere and there's just no space left for hygiene matters.  Negotitations don't seem to alter anything in the longer run either - it lapses as soon as we lapse and it feels odd to have to reward hygiene (the reward is feeling clean!)  The good habits installed in childhood have fallen away and I don't know why (all those dentists' and hygienists' appointments, disclosing tablets, encouragement with flossing etc over the years - I don't know where all of that has gone)

    It all puzzles me and really I'd like to work with a very experienced neurodivergent coach and try to improve our family dynamics.  I had been hoping to simply love him through it but we're actually not getting through.  Things are staying the same.    

  • i would check the benefits situations with the CAB ( citizens advice bureau ) and PIP for him as well. I am no expert but think u should be getting something. As an adult he qualifies for some benefits surely?  then u can charge him a small rent.

    he sounds way more independent than i imagined.  it could be depression / or he doesnt want to talk as thats when problems occur for him? 

    yea maybe selective mutism.

    does he talk on headset with other gamers ?

    and sound like he is having fun for example ?

    does he use Discord (gamers site ) ?

    does he talk to check out staff, bus driver  ?

    would it possible to get him on this website ? --

    -- on this website forum a person  is having  hygiene issues with his autistic flatmate here.  so many autistic people (me included ) dont see hygiene as an issue to be concerned about. u have to learn hygiene rules eg wash yourself once a week teeth everyday, look in the mirror before walking out the door. 

    if he uses your router threaten to turn it off if he doesn't shower, tell him there are new house rules because you are getting older and he has to do more. 

    if he doent play online games then offer the reverse

    you will get him online games and a membership if he starts , make a deal

    1. shower once a week, brushes teeth each day

    2. improves his laundry

    3 talks to psychologist and joins this NAS community website 

    I'm clutching at straws but i rather say than not say

  • He speaks to us occasionally regarding food and money.  More stable than he was a few years ago and slightly better for not seeing any professionals (I use the term "professionals" loosely after our experiences with them).  But I'm not sure about separate accommodation.  We're all he has and he might feel rejected by the only people he has in the world. 

    He mostly plays computer games, he's OK with making his own food, basic grocery shopping, travelling on public transport etc.  Just very very withdrawn and extremely poor personal hygiene.  I am wondering whether he is selectively mute too.  

    Our preferred option is for more support to keep him here.  No DLA and no carer's allowance (investigated but we don't fit the elegibility criteria, esp. for carer's as this seems to be disallowed if there's any other income/benefits at all).  

  • Path 2 

    I suggest to write to your MP now to get him into sheltered accommodation ---- how can someone with autism be expected to look after another autistic adult with such a stance.

    please write to your MP asking for professional help to get him into his own accommodation. 

    stating this is what u want.

    What I was looking for was a thorough formulation of our son's issues and a very patient and steady approach to encouraging engagement instead of the rather circular pattern of us seeking help, them stating it's hindered by lack of engagement, us expecting them to know how to handle that, them just reiterating there was nothing they could do like a broken record.  :(  :(  :(