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Elderly parents
Original poster

Tricky situation POA

32 replies

Pianokicker · 26/05/2020 15:59

Don't quite know how to handle this situation regarding my mum.

I have POA for health and welfare for my mum. She has some dementia but I would say she still has capacity (in my opinion). She is currently living at home with my elderly dad. Dad (90) can no longer cope with her needs, even with two carers 4 times a day, she basically has no mobility. The OT has been in to assess her and they have ordered a return 7500, sliding sheets, commode, foot protector and a hospital bed etc...for their tiny flat (this is all according to my dad of course, I haven't seen them since lockdown began).

So we are having ongoing discussions regarding a nursing home, my mum hasn't agreed to go, and I can't see her agreeing to it, the upshot is that my dad has to continue to care for her.

What I am trying to get at is that because she has capacity can she make a decision that negatively affects someone else? My dad is really suffering.

Lockdown has made this horrible situation about 100 times worse of course.

Sorry if it's all a bit waffaly above, thanks for reading.

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FinallyHere · 29/05/2020 20:09

Oh I so feel for you.

An initial two week respite stay is a really good way forward.

As for the lovely house and grounds, the lovely manager of the nursing home my mother spent the last few months of her life told us that even if the people staying can't really appreciate the lovely house and gardens, most of the families and visitors find it a great comfort.

All the best.

HappyHammy · 29/05/2020 10:35

It sounds like you might get the support you all need. Once mum is in the respite home the staff can carry out ap capacity assessment. I would also ask that her gp and Parkinsons nurse visit to assess her needs.

Original poster
Pianokicker · 29/05/2020 09:20

Thanks all

@ukgift2016 I raised the possibility of involving a social worker at a family meeting but my sister was not keen, it wasn't the time to ask just then, but I can't work out if she thought it wasn't going to help or if she was worried about getting social services involved. She's very knowledgeable about all of this so I'd have to talk privately with her.

However we are making small steps forward, dad has reserved a bed for 2 weeks at a nursing home that we had previously seen in Feb. It's actually very nice and I got a good feel from it from visiting, beautiful gardens, lovely old house (although quite frankly I'm not sure mum can appreciate any of this now). It's close to us so dad can visit (eventually). However I'm not clear as to whether mum has consented to all this. My sister has been doing most of the organisation and persuading in all of this, she may have another face to face with them this weekend to see what is what. Thank God she's much more persuasive than me and she has my parents ear, dad sort of brushes me off a bit.

The hospital bed and hoist are due today, the hoist is a 2 man job, again I'm rather hoping given the dimensions in the flat that it may not be safe/practical for either my mum or the carers and that it's a no go.

It's really hard to judge my mum's mental state over the phone, she just can't get to grips with tech (zoom etc) as she can't really hold anything or use a screen to communicate. On the phone it's difficult to hear her (parkinsons and lack of muscle control and strength) and after a few moments I think her arm sort of drops down from her ear. She is having lots of hallucinations now 😦.

Sorry for the ramble, it feels somewhat cathartic to write it all down.

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ukgift2016 · 29/05/2020 07:19

OP, does your mum have a social worker? They can do an career assesment for your dad and provide him with respite.

They can also assess the situation and decide if it is sustainable. As POA you do have that power and responsibility, don't think your opinion does not matter.

I would contact the OT and ask for a social care assesment/review as your concerned of carer break down. Tell them you have POA. Having a 'middle man' can help in these circumstances.

RedRosie · 28/05/2020 19:08

All of this is just around the corner for me @Pianokicker

I'm so sorry for my dad too ... he's trying so hard, and caring doesn't come naturally to him.

And they are 200 miles away.

No advice, just sympathy. Flowers

strawberry2017 · 28/05/2020 18:48

Could they move in to assisted living together instead?

Original poster
Pianokicker · 28/05/2020 18:37

@HRHPP

I'm rather hoping that all this equipment won't fit (and/or the carers can't use it safely due to lack of space), it may force the issue, whilst that may sound unkind it really would be better for them if mum was in care.

I appreciate that that is my opinion though and their wishes at this time override my thoughts.

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Original poster
Pianokicker · 28/05/2020 18:31

Thanks Hammy, SS is an option I was considering (for dad)

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HRHPP · 28/05/2020 18:28

You can get a tracking hoist if a mobile won’t fit

HappyHammy · 28/05/2020 13:38

The gp can assess mum capacity. With the hoist there is a real risk to them both if dad uses it. You can contact Age UK or adult social services safeguarding team if you feel dad is at risk by helping with her care.

Original poster
Pianokicker · 27/05/2020 21:47

Thank you Jules

Things didn't exactly go as I would have wished today. Dad is back pedalling somewhat on the care home issue. He is still clinging to the idea that the equipment will magically solve all the problems. My mum failed the test for use of the return 7500 so they are now ordering a hoist! I'm secretly hoping it won't fit in the flat, the one in the hospital I saw was pretty big. Also realistically it isn't safe for my dad to use it so mum would still have to wait for the carers to toilet her etc...
At this point it's still mum and dad's decision I guess, I'm just disappointed as they are both suffering for it.

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AnnaMagnani · 27/05/2020 21:37

I would say she probably doesn't have capacity if she is unable to take on board the information that her husband, your Dad, can no longer continue with the status quo.

For a LPA for Health and Welfare you don't have to 'activate' it in the same way you do for LPA for Finance. It is decision specific - so she might have capacity for one decision in which case she gets to make that herself, and not for another - in which case you can make it as the LPA.

As her LPA you can only make decisions in her best interests, thinking how she would have made them if she still had capacity - you can't just go off and make the decisions you want.

However in this case it sounds like the decision is making itself and she would really want to look after your Dad and be mortified she was paranoid about him, if she didn't have dementia.

JulesLo · 27/05/2020 17:31

I really do hope it all works out for you, your Mum and your Dad. Hopefully being able to talk it through here has helped too - it's so common that families end up in a crisis situation with elderly parents because nobody really likes to plan in advance for their infirmity. And crises develop very quickly as you've found out.

Here's a quote that brings it home for me:

"There are only four kinds of people in the world:
those who have been caregivers,
those who are currently caregivers,
those who will be caregivers,
and those who will need caregivers."

  • Rosalynn Carter
Original poster
Pianokicker · 27/05/2020 12:04

Thanks all, GP is visiting later.

Dad is 90, he's basically been a full time carer for my mum for 2 years, he has no quality of life at the moment, and he is emotionally and physically exhausted, he knows mum could be better cared for in a home. My mum has paranoia and believes she is being persecuted and that we are scheming against her, she attacks dad (verbally), this is all part of the parkinsons dementia. But actually mum would be much more comfortable in a nursing home where they can properly look after her, at the moment the carers get her up and put her to bed but in the meantime she is sitting in a collapsible wheelchair all day (sort of slumped over). At the moment I'm focusing on the practical side of things because I can't dwell too long on how much pain and discomfort she is in. It's really since her last fall 2 weeks ago that it's got to this crisis level.

The LPA is all registered, I'm hoping we can all reach a consensus. Maybe I'm just catastrophising. My mum with her full faculties would be horrified at all this and would probably be booking herself off to dignitas.

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MereDintofPandiculation · 27/05/2020 09:51

Also, depending on the wording in the LPA, you may be able to use it before she loses capacity. That applies only to the financial LPA, not to the Health and Welfare one.

cptartapp · 27/05/2020 08:46

Your dad doesn't have to continue to care for her. As a last resort, force social services to act and bring your dad to live (until your mum is relocated into care) to live with you. Make very clear to him that his move I still temporary. Give social services 48 hours notice of your plan.

drayco · 27/05/2020 08:34

She needs a mental capacity assessment around understanding her own needs and where she wants to live.

The GP can do it as can a social worker. GP might be best bet at the moment as SW may not be doing visits at the moment. This will help activate the POA though best interest decision still needs to be made.

It's very common that this happens and the other spouse is left to cope. If it continues she may find herself in emergency respite anyway when it's carer breakdown.

purpletrees3 · 26/05/2020 20:22

Sorry to hear about your family's situation. In this scenario I'd be very clear with the OT/SW on what your Dad isn't coping with. Is it physically or mentally etc. Please consider what your Dads wishes are in all this too, yes he may find it tough but maybe he's happy with things that way as he gets to have his wife at home with him. In the first instance I'd check what carer support services are in place locally to support your Dad. I'd also look into respite services to give your Dad a rest & to potential ease the transition into full time are if that is what is everyone's best interests. Best of luck

HRHPP · 26/05/2020 20:10

Even with no or fluctuating capacity her wishes and feelings will be considered. You can’t just remove people from their home . A best interest decision will have to be taken and a Dols applied for .

Speak to the OT and social worker about how to support your dad . He will be entitled to a carers assessment which will give him his chance to ask for help.

FinallyHere · 26/05/2020 19:58

Hope it goes well with you tomorrow

In our case, we found the home instead people really very good but there came a time when two carers were need that a nursing Holme was the safer option.

At that point we contacted homes who offered an initial trial period which we called respite care. As it happened, my mother only once or twice asked when she was going home and then her condition deteriorated really quite quickly.

Hope you find a good solution All the best.

Original poster
Pianokicker · 26/05/2020 17:44

Thanks all
I have LPA, the GP is going there tomorrow so we will see what comes of that.

It all kicked off just before lockdown with a fall and hospital admission for mum, she was frail but they were doing OK; however the deterioration since has been swift (mental and physical).

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GinghamStyle · 26/05/2020 17:26

It depends on whether it’s an EPA (if not signed by you will not be valid) or LPA which just needs registering. Registration can take 8-12 weeks and so you’re best starting the process ASAP.

As an attorney, you have a duty to act in your mum’s best interests. It might be worthwhile having a chat with her GP re capacity. In this situation, the POA is beneficial as if Social Services do become involved, you’re a spokesperson for your mum to make sure that what happens is as she would want ie staying at home as long as possible rather than going straight into a home etc. Also, depending on the wording in the LPA, you may be able to use it before she loses capacity. If she drew it up at a solicitors, it may be worth speaking with them about whether your mum mentioned any specific wishes re homes etc when she made it. The solicitor will also be able to advise you about the care options available and the next steps to take. If you were someone I knew in RL, I’d advise you to phone a lady in my office who deals with LPAs.

Aurorie11 · 26/05/2020 17:15

Does your Mum have a social worker? My mum was similar 4 care visits a day and my Dad couldn't cope. The social worker and members of family, it was agreed that care home was best solution and there was a conversation with Mum and questions were put in a way to get agreement to go into care

RandomMess · 26/05/2020 17:06

See to me it sounds like she doesn't have capacity anymore due to her dementia although she has the appearance that she still does.

I hope you can get it sorted, must be so upsetting and stressful for your Dad as well as you Thanks