Who has final say in this situation?

This. It relies on it being reported which very few people want to do. I begged my dad not to drive anymore as I didn't think he was safe. He agreed but also said to another family member he thought I had "been a bit over the top about it" and so I took the keys away. No regrets, would do it again.

I also knew someone whose GP wrote to the DVLA saying his eyesight wasn't good enough to keep driving. DVLA wrote to him saying they'd awarded him a three year only licence. 🙄 Don't imagine the DVLA are on top of this. As with many other things, the dirty work comes down to you.

Huge numbers of people drive with dementia! No one tells DVLA.

The problem is that capacity isn't a black and white thing and there are lots of people that operate very much on the margins
. It's easier to manage some things (e.g. Driving which the DVLA simply won't allow) than other things that technically are possible but are a terrible idea.

Such excellent points . Capacity ... capacity for what?
It's supposed to be decision dependent , but in reality I think it's only assessed for major decisions like moving into care.
And of course capacity fluctuates and will depend on factors like health, stress, tiredness etc.

This option would make perfect sense if the MIL had perfect capacity and was able to appropriately weigh up the options available to her and make a sensible decision accordingly. It doesn't necessarily have to be the decision that the family want, but it is a decision that has a chance of working, won't lead to the MIL incurring harm or potentially death and gives the sons a real option of withdrawing any care that they are offering without worrying that they have effectively hurt or killed their mother by doing so.

The problem is that capacity isn't a black and white thing and there are lots of people that operate very much on the margins. This often disproportionately includes the old and the disabled. I have a relative who has very strong opinions about where they live and what they do but these desires are often completely unrealistic and often dangerous for them and others. It's easier to manage some things (e.g. Driving which the DVLA simply won't allow) than other things that technically are possible but are a terrible idea. The reality is that SS like to facilitate some of this stuff and they then simply don't have the resources or expertise to help when someone inevitably goes wrong. The family is then stuck solving yet another completely avoidable problem.

It's unusual but not unheard of, presumably the donor had their reasons at the time for choosing them. Although it might have been helpful (hindsight is a lovely thing) if they had also left them with clear instructions of their wishes that would have covered the situation.

The donor having to agree - like anything with capacity, if they have the capacity to agree then yes they would (and are within their rights to request one), if they don't one could be appointed in their best interests. The LPA might need to agree but it wouldn't be a good look if it later went to COP and they'd refused. A social worker could also request an IMCA without needing the LPA to agree.

Start a new thread, there are a lot of people on here with deep knowledge of the legal protections for vulnerable adults. A professional attorney is not such an uncommon situation that it's going to be outing, many people choose it for all sorts of reasons - not wanting to burden family/friends, having no family to take on the PoA, having complex needs.

Well I would have done, but see that function is still disabled.
I thought it had been reinstated .
I'll have a think about advocates.I imagine the donor would need to agree to an advocate .?
I'm tempted to start a new thread but it might be outing, though that's not really a concern.
But also it seems so rare to have a solicitor as poa for H&W.

Thank you so much @VerityUnreasonble ,I will PM you if you don't mind .

I don't mind PMs (although probably not going to click on links!). It depends a bit what the issues are really but fundamentally any issues with a POA, if you feel they are acting improperly or against the best interests of the person would be the domain of the Office of the Public Guardian and then possibly need to go to Court of Protection. I've always found the OPG quite helpful to ask about things.

Another possibly less nuclear option would be to see if an advocate could be appointed for the person who lacks capacity, they might have more luck negotiating with the POA about any issues. How you request an advocate can vary slightly from place to place (depends on how local services are set up) but you can usually Google your local area and advocate. Depending on the issues an IMCA (independent mental capacity advocate) might be appropriate but they tend to need a professional referral.

Apologies for high jacking , was going to PM but not everyone happy to open PMs.

Thank you @VerityUnreasonble for that clear and helpful post .
I don't suppose you could signpost me to advice on what to do with a situation where an professional attorney holding a H& W poa is causing real difficulties for friends of the donor?

The main criteria for sectioning someone is that they have a mental "disturbance" that requires assessing or treating in hospital, they also need to be presenting a risk because of this to themselves or others (and be refusing an informal admission). You can't section someone because their physical health makes them vulnerable. Even with dementia you'd mostly need someone to be experiencing BPSD not just some memory loss.

DOLS can only be used for people who lack capacity and only applies in care homes / hospitals (so once a person is in a care home the care home can apply for a DOLS to prevent them from leaving, or to keep them on a 1:1 etc.). You can't apply for a DOLS order for someone who is in their own home.

Social care do have some powers to insist someone is cared for in a care home if their needs cannot be met at home (but would be likely to go to court of protection to request an order if there was a lack of capacity and any concerns about what the person might want).

Courts can also look at Protection of Vulnerable Adults as an option.

Generally though, if a person has capacity and wants to stay at home social care will support that. Even if someone loses capacity, if they have expressed or it is clear that their preference is to be cared for at home - and their needs can be met, this will be done at home (which both social services and the courts would support).

It can be a nightmare for families who just want the person they care for to be safe and looked after but even if you are old / frail / disabled / forgetful you still usually get to make your own choices until you lose capacity. Even if other people disagree. If you lose capacity other people make those choices for you but best interests (mental capacity act) says those choices still need to consider what you would want if you could choose and what is least restrictive.

I can only speak from our family's experience re DOL and sectioning.

FIL had dementia, refused any care and was seen peeing into an electric fire / heater. Totally unable to prepare his own meals and refusing meals on wheels yet complaining he was hungry. He was just about mobile but physically and mentally frail. He was seen by a psychiatrist at home and deemed to lack capacity and therefore a danger to himself as he was refusing assistance. Was sectioned and taken to hospital. From there he went into a care home, were he lived for another 3 or so years.

The OP's MIL can't contact anyone outside of the 4 times a day visits from carers. She has short term memory loss, is doubly incontinent, bed bound, unable to get herself a drink, let alone a meal. I'd say that was dangerous.

I'm not familiar with a DOL but isn't b that directed at keeping someone in place somewhere?
What grounds would she be sectioned on - she's neither a danger to herself or anyone else.

That is great advice! Thank you

Just telling a person that they have to live their life according to the wishes of their family doesn't work, it just creates conflict and anger.....

'The person' here could easily be the sons, though, as well as the mum.

What her life looks like! Not much without her sons. A life she's not experienced. What she wants is the status quo. If she didn't, her sons, Dils and GC would have been considered. They haven't been. Yes, a two way conversation but continuing to expect this level of support should not be in the table. Maybe working out what her life looks like without constant attention from her sons would be a start, but many old people cannot imagine this. Sons feel guilty and carry on. You get absolutely nowhere if the elderly person decides with no reality check. The OP's family need to have a united front and think of their lives.

My DM thrived in her care home. Got a new lease of life. Op needs to see what homes are possible. SS won't do anything. It's down to family. Where dm was, lots of people were self referrals. They were not pushed into anything but realised relatives needed to get on with their lives and be sure about safety. They need to be able to stop worrying.

But ultimately her choices are at the heart of this because she has the capacity to choose what her life looks like. If she tells Social Services she wants to continue at home and she is found to have the capacity to make that decision, then that is what will happen. The family will either have to go along or leave her to cope without their support.

By centering the older person, by listening to their needs, wishes, etc, it is much easier for everyone to have a constructive conversation about what the future looks like, and that horrible but much used statement "what good looks like" and to steer the conversation to the goals that work best for everyone. Just telling a person that they have to live their life according to the wishes of their family doesn't work, it just creates conflict and anger.....

@TizerorFizz
Agree.
Mil wants her sons to keep picking up the slack....so unless you're prepared to step back, and let the cards fall, nothing will change - except the health and wellbeing of the sons gets worse.

@roundaboutthehillsareshining Unfortunately that type of conversation centred on what the older person wants gets most of us nowhere! We know what they want. No change. Everyone has to be the centre of the discussion because others are making huge sacrifices in this situation to facilitate what one person wants. What about what dc might need? The dc of the carers?

It's also not the case the MIL hasn't had a huge amount of input and consideration from her family. Maybe now it's her time to give something back. Their time and work/life balance. Maybe they need to be kind to themselves and do need to be clear about their needs. It cannot be one sided with agreement to everything mil wants. She could of course fund everything herself. Or a home much nearer op. Just because you are old you should not stop being considerate.

I got Mum assessed by the mental health team when I felt she had dementia but at this point I'd already got POA for her.

Shes in a home following a fall and a spell in hospital. She's had a subsequent fall at the care home and is now bed bound which is sad as she was wheelchair dependent to get around and to do activities with her friends at the home.

Unfortunately she is way over the threshold for the LA to pay for part of it So she's funding it herself out of her savings.

I'm sure you can speak to her GP to get her assessed and hopefully put in a home. They have to take into account the wishes of family members and their mental health as well.

I would strongly advise you (based on personal experience) to set the scene carefully for this conversation. Even if your MIL is the calmest, most rational person in the world, this conversation is about matters fundamental to her life, and it will be distressing and may make her angry if the conversation is presented as a "united front against me", which will happen if you've discussed it between yourselves in advance, but the conversation is "sprung" upon her. This is not intended to be a criticism of you, the kindest person in the world can trigger this reaction if the conversation has no foreshadowing.

You've said this can't happen for a couple of weeks, so that gives you a couple of weeks to do the groundwork. If you're able to visit her, if not write a letter (and if you are visiting, write a letter or make a recording anyway so she can revisit it as she needs to), organising a date for the conversation, and explaining your point of view and outlining the options as you see them and have described above. Explain that you are doing this so she has time to think about what she wants. Don't get drawn into having the conversation in advance, but do explain to her what and why you need to have the discussion. Ask her to think about what she wants her life to look like going forwards, and to think about how she can be supported to achieve that.

When you have the conversation, make sure you are centering her wishes for her life. Of course this can be tempered with what you can provide, but ultimately you need her to lead on this decision, and the best way to do that is by listening and concentrating on her needs and wishes and how she can be supported to achieve them while meeting your needs.

Make sure you have also done some research to know what is possible with what she has. While noone should ask her to choose a care home as part of this conversation, knowing what kind of home she might be able to access given her condition and financial status means those questions can be answered confidently and honestly.

Remember whatever her physical state, her life has meaning to her. She will have needs, wishes, things that bring her joy and sadness. She's not "just a burden", though I completely understand it feels that way sometimes.

Finally a practical recommendation. Have a safe word agreed between you all, especially those who she is a blood relative of. If they need to, they use this word and the non-relatives need to faciliate a break in the conversation. It's just to give people a safe way to release tension, so the conversation can be kept calm.

It sounds like the MIL owes a home outright which the 2 sons will inherit?

Can't you frame it in your mind that your DH is 'working' for that inheritance?

I personally think it's something that families do to look after their elders (yes I am English!) but if they don't want that there is the option of paying for more care or a housekeeper visit at the weekend.

And yes I have cared for both of my parents (together with my siblings - we shared the load) I also lived 2.5 hours away.
It was hard at times, but also a privilege to spend time with them and return the care they gave me when I was a child.

One parent died at home the one did go into a care home for the last 12 months of life and we kept the house until their death so we could use it when visiting them.
I found once they went into a home they declined so much that it felt we lost him then.
Especially as although the home & staff were nice it always felt awkward living in public like that.
You could tell my parent didn't like it, but they accepted their fate (also dementia but still kept their reasoning and never forgot who we were) and just gave up.
That was ok to be at peace with because they'd stayed home for as long as possible.

But I'm glad we didn't put them into a home a second sooner than we did.

If you'd asked him if he wanted to go home, he'd have said yes, but he meant home with my then dead mum in it, and no one could provide that. That was heartbreaking.

I think that's the crux of it quite often. Everyone wants things to be different but it's not possible. It's so sad but ultimately the best decision is going to be hard whatever it is.

There can be a world of difference. At home, my dad was on his own with the TV, and had 4 x 15 minutes visits from carers. They'd make him food but his sheets didn't get changed, his clothes didn't get washed, and the toilet didn't get cleaned. In the care home, all those things happened, plus he was encouraged to eat, had a choice of food, and had company down the corridor if he wanted it. He was safe and if he fell, he'd be seen and picked up; if he soiled himself he'd be cleaned up; he was showered, shaved and helped to dress every morning, help his lovely carers at home had never been able to get him to accept. So I'd disagree that there is 'not much difference'. My dad wasn't happy in the care home but due to the dementia, by then he wasn't happy anywhere. If you'd asked him if he wanted to go home, he'd have said yes, but he meant home with my then dead mum in it, and no one could provide that. That was heartbreaking.