Want to scream!!!! Capacity and Power of Attorney(21 Posts)
FIL is nearly 79 and has vascular dementia. He does not understand this, thinks he is ok and does not need help. He would rather 'give up' than go into a care home. He complains he is lonely and cries most the time. We are his only family and live an hour away in a different county. He has been told he cant drive and has hidden his car keys and nobody can find them. He lives in a rural village with no means of shopping except carers. He lives in a rented semi and we pay all the bills. The ndn are getting fed up with him chopping wood at all hours inside his house (sometimes 3am etc). He has storage heaters on the wall but wont use them and needs an open fire to heat the water in the back boiler anyway. He rarely washes himself or clothes! Its freezing. We think he has lost the will to feed or get himself a drink so the carers make sure he does this. He has overdosed on meds before so he now has a locked dosset tray but sometimes needs pain relief more than the once a day the carers come. Despite all of this social care say he' has capacity'.This means the Power of Attorney can not be 'activated'.
We have got him the lower rate of attendance allowance and this covers most of the care costs of carers coming in once a day for an hour. He does not realise they come in every day. Everyone (except FIL) now thinks the visits should be twice a day. However this is going to add £500 to the costs a month and obviously deplete his savings much more quickly. He would not have the carers if he knew they would cost him money. He has given us some money 'to help with the bills'. As far as I am aware we can use his money (the financial p of a) but not overide his wishes for no carers (the health p of a). The social workers and health professionals wont give us a straight answer when we try and explain the following:
Can we use his money for his care even if he is unaware/ may refuse if he knew the truth, when they still say he technically 'has capacity'?
I’m in the middle of this just now so you have my sympathy. Do you have POA Aformwelfare set up? It has to have been set up when your father has been lucid enough to understand what he’s doing.
Carers are not the ones to decide whether a person has capacity -this can only be done by a psychiatrist, amd agreed with another doctor, so 2 doctors.
Can I suggest you ask his GP for a referral to a suitable psychiatrist? In my are it’s just called “old age psychiatry”. We have an appointment for assessment next week
Thanks for the reply. Yes we have both P of As but the Health and Welfare, I believe, has to be activated once 'capacity' is lost. The mental health team seem to be of the same view as us that he has lost capacity. He has a mental health nurse that is very concerned about him and has kept her team leader updated. It is interesting what you say about it being signed off by the doctor and the psychiatrist. I think it may be the GP then that we need to be speaking to again.
Yes that’s what we’ve been told re the Health&Welfare, just last week. Sorry you’re going through this, it isn’t easy x
Why are carers only coming once a day and being paid for by him? We were told they can come up to 4 times a day paid for by SS and its not means tested?
If the mental health care worker thinks he has lost capacity that should carry a lot of weight.
I would speak to the GP. You may not need to see psychiatry.
Does he have or had a link worker or CPN?
Push social work re extra supports, have you contacted the Alzheimer's society for more local advice?
Providing you are acting in his best interests then although not within the spirit of the mental capacity act to the letter of the law no one is actually going to kick up a fuss if you spend money he is giving you 'to help with the bills' on additional care for him.
I suspect that's why you aren't getting a straight answer from social care, they can't actually tell you to go ahead and do it but they aren't going to object if you do
Has a mental capacity assessment actually been completed by a qualified social worker? Recently? I'm surprised that if he isn't aware the visits are coming daily and isn't recognising he has social care needs that the isn't more of a query over his capacity.
Halcyon that sounds like it might be for a temporary package of support e.g to get someone out of hospital or a reablement package. Those do tend to be up to 4 visits a day and non means tested but usually only for 4-6 weeks until a more permanent plan is put in place.
It also depends who told you that... unless you heard it directly from the social worker dealing with your case I would double check. I've known GPs / paramedics etc tell families all sorts of stuff like that in the belief it's true.
You don't "have capacity" in a general way. It's decision by decision based, so he may not have capacity say, to decide to drive but would have capacity to buy a mobile phone or decide which shoes to wear. Make sure that they have assessed his capacity specifically regarding the decisions in hand. It can also vary during the day. Sorry this has been stressful.
You can use the financial poa as soon as it's registered so long as the correct box has been ticked, you will find it but I can't remember what page it is on. His GP can do a capacity assessment, some nurses and social workers do them too, health and welfare cannot be activated until loss of capacity has been determined. Has he has a needs assessment at home from the social services, this would include how he is managing, what help he needs, any equipment he might need and a financial assessment to see what he would have to pay for himself. Poa is a big responsibility, you must always act in the person's best interests. Do you pay his bills from his money. Could you organise online shopping, would he have hot meal delivery, I would be worried about the fire, I sympathise with the neighbours, this you could discuss with his GP and mental health team.
Interestingly we have asking why he hasn't got a social worker and finally one went round today. I then had a phone call from FIL crying, saying she'd taken his stuff away so that's how I found out one had visited (of course he had no idea who she was so that was another hour wasted)!
I think that was off the back of the psychiatrist report we got 2 weeks ago that they said they got today.
What sort of things does he say they have taken.
You can ring Age UK for sensible advice on this, they often are a lot clearer than social services
We have had various 'teams' in to assess him. The main problem is that he is very convincing at telling them he is doing well. For instance, adult social care asked if they could put in a 'canary' system which would assess his movements and wandering particularly between 11pm-7am. However he said he didn't want it, so they won't put it in. They said because he says he has a bath every night and washes himself, he is doing well. We have told them he is lying or delusional because we know he has had 2 baths in 4 months (we put toilet paper in the bath as a marker as we were worried). We have had community nurses, mental health nurses, energy efficiency officers, fire officers, adult social care, gps and befrienders. He hid from the befrienders. He won't say yes to any help unless it's free so we got some free loft insulation and a - wait for it- washing up stool. Apologies for the sarcasm but it is unbelievable sometimes. He eats off scraps of paper towel when he can be bothered to eat so he never uses plates. If the carers weren't there once a day to make sure he ate, drank and got food he wouldn't be here now.
Thank you for all the replies!
Apologies I am on my phone so am slow typing.
retirednow he said they had taken 'his stuff' and when I enquirer what he said 'a hammer'. He reckoned he was shooting rats in the garden at 3am a couple of weeks ago. He'd lost the keys to the gun cabinet so my husband broke in and brought them over to ours. The shotguns are deactivated but of course we can't find the certificates he's lost. A policeman threatened to arrest my husband because he had transported them without the paperwork. We got to try and find the axe he's chopping wood with at the weekend.....
...lovely policewoman managed to find the gun codes on the computer system so we are still here!
Ring social services tomorrow and ask for his hammer back.
Explain he is insistent that they took it.
See what they have to say then about his understanding of what's going on around him
(That's assuming they didn't actually take his hammer)
I'm a social worker and deadly serious
Someone may have done similar to a colleague
me very early on in their my career.
It was extremely effective.
It's a good job we kind of know his GP. FIL said a new young doctor grabbed his wrists and stabbed him with a needle, saying he needs to go into a home. In real life, the GP did a home visit and took some blood. We thought we'd better mention it to the GP because FIL was so convincing to other people (tears, shaking etc). GP has known FIL for years. We joked that at least FIL thought the GP was young! The problem is I don't think people realise how quickly FIL is deteriorating and it's a real struggle to get anyone to help. And it takes sooo much time. DH missed parents evening for our Dd for the first time as he was sorting another drama out the other day. He working at weekends trying to catch up with business too. Whilst FIL is obilivious to it all....
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