Who has final say in this situation?

No it wouldn't, if she has capacity to understand the risks and make the decision, she is perfectly entitled to choose to be unsafe in her own home and the PoA would not be activated.

Equally the sons do have a choice whether they continue bearing the burden of care that they do - they also have capacity and can balance their own needs and risks accordingly.

It's much better for everyone that these conversations happen calmly with all parties behaving constructively and investigating options together collaboratively. A good social worker can be a great facilitator of this more positive discussion.

FIL was self funding. MIL took him to a day centre at the care home and one day just didn't take him home.

Totally different world if you don't need funding.

I've been the family carer for my DMiL, she had dementia and would tell all medical visitors, or staff in hospital, that she did all the cooking and cleaning but they always checked for confirmation. We were very lucky that DD and DSiL were both in the care industry so they did that side of caring.

My sister lived opposite her MiL who was in a wheelchair but managed otherwise. Then she started forgetting things, nearly setting her kitchen on fire . At that point she was told she needed to go into a home. They spent a few weeks looking for one and arranged a two week tester session. After all this I don't want to go into a home changed to an I'm staying here attitude. Could you find a home that would do this and tell her she's going on holiday.

Those are excellent points @EdithStourton really interesting to look at things that way. And does explain the total lack of ability to see how their behaviour is affecting everyone else too.

Unfortunately 'capacity' often seems to be 'the capacity to delude myself that I can manage on my own'.

It is VERY difficult. Nobody wants to make the elderly person miserable, but when the cost of them being at home is miserable adult DC and marital barneys... what then?

It's just intractable.

No, not everyone.
One of my elderly cousins was offered a home by a couple of her DC, but said no, it wouldn't be fair on you, your spouses, the DGC - and she went into a care home.

Another part of the issue seems to be that a lot of the people who are very elderly now never had very elderly parents to worry about themselves, not for more than a few years anyway, because average life expectancy was so much lower. A lot of the increase in life expectancy since about 1950 seems to be due to the elderly living longer due to medical intervention, rather than young children surviving because of vaccination and better hygiene. See https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/articles/howhaslifeexpectancychangedovertime/2015-09-09

So - to get back to my point - not having had to deal with a parent in a state of dependency for more than a year or two, and not having had many friends who had to either, they have very little idea of the amount of stress and hassle they're causing. Only ever having worked part-time after having children (or never having been much involved in childcare), they forget that their DD, retired herself, has her grandchildren two days a week to save her own DC nursery fees. It doesn't occur to them that that for the 18 months that they 'kept an eye on Mum' (who just needed someone to drive her home from the supermarket once a week, change the landing lightbulb and hoover the stairs), they were a ten minute walk down the road, not 30 mins (or 3 hours) drive away, and had no childcare responsibilities (because their kids were already into their 20s and didn't have children yet).

So I honestly think a lot of the very elderly just have no idea. Others would if they thought about it but close their eyes to it. And others 'have capacity' but are no longer 100% rational.

@abovetheweather At what stage do you prioritise yourselves though? Why carry on in a situation that's making two families unhappy? You could stay with the status quo but at what cost?

Privately funded care here is £5,500 a month and they decide if they can manage the needs of the potential resident. If not then it's going to be a very expensive nursing home. I think you need to start looking near you and DBil to see what's available given the circumstances. Here LA would not pay if DM is managing at home and has above £23,000. (I think!) So you do need some hard facts before you meet. Your DH is facilitating DM "managing" and gives a false impression.

We all recognise this is a very sad situation but I think you need certainty for the future and holidays! What do your dc think? They must be affected by this. My DH would never have done so much for his DM. Nor our 3 elderly unmarried aunts. It's impossible. So there had to be give and take and ensure the majority of people involved are happy. Not just one, who, being honest, has had a lot of effort and love given by family members. Time for change.

Ah, the mice. We discovered mum's residents when she was making tea and just tipped the poos out of the mug and carried on! Was very annoyed when chucked out the poster because the mice had been shitting in it a lot while eating the crumbs.

You are right in terms of the right or moral choice and in terms of what makes sense for the older person but none of those are reasons to force a person with capacity out of their home.

I hear you , but if these people can only stay in their home, at great personal cost ti their adult children, being run ragged , doing it all behind the scenes, and causing themselves ill health and stress ( and arguments ) in their marriages and relationships with their own children.
then yes it is the best option.
they are not independent and their adult children are not there ti wait on them hand and foot

one of my best friends had a nervous breakdown - her mothers demands and constant criticism.
my friend was destroyed
my friend had to step back
her mother is still at home with carers - who she is leading a merry dance - but at some point she will be in a home.
(she Also had mice because she can’t clear food debris away properly) - has a Cleaner once a week.

They need a lpos and poa asap while she still has capacity. If she becmes unsafe in her home she would have no option and lpoa would enable her sons to determine it. Ideally she would agree before that point.

And no, there isn't a "risk" of death as you put it, death will definitely occur. And being in a care home won't change that.

So the risk of falling downstairs and dying alone in agony shouldn't be addressed because they'll die anyway at some point.

Sorry but I don't share this view and find it quite horrible.

It sounds like she has a terrible quality of life but she also has capacity to choose that quality of life. If social services say she can access more care paid for by the council then that's what needs to happen to take over some of the tasks the sons are doing every weekend. Then the sons need to reduce their visits and see if she manages or if the wheels come off. She's not going to get sectioned or made subject to DOLS if she's got capacity and not at risk of immediate harm which honestly it doesn't sound like she is. She's stuck in bed waiting for carers to help her 4 times a day which sounds shit but that's her choice.

DM was not moved in hospital for 7 weeks. After a few days in a home she was helped to be with other residents in a special chair and talking to people. The DM here might be helped to get out of bed! Carers 4 times a day won't do this. People pop in all the time. Not 4 times a day. It's definitely better for everyone. DM was noticeably brighter and happier. Yes, she missed her home but she accepted we had no choice. With dementia parents do not think of others. That often disappears.

A care home means family worry less. That's worth a lot and in many ways it's the last thing a parent does for dc. They should recognise when dc need help to get through the situation too. The DSs here have given a lot of time and their own families matter too.

Moving into a care home doesn't solve all the issues (and can bring up new ones) but it does solve:
How to cope with elderly parent when carers can't get there (lots are off sick, snow etc).
Adult children no longer having to worry about the buggered boiler (which the parent refuses to have serviced until Darren can do it, but Darren is currently off sick and unlikely to be back at work any time soon if ever), cranky washing machine, etc. And then deal with the fallout when, inevitably, the boiler breaks down on 23 December, or the washing machine floods the kitchen.
Elderly person being less lonely as not stuck indoors solo 23 hours a day, bar Barry next door popping in to change a light bulb ('I don't know what I'd do without Barry!'), the other neighbour calling in dutifully once a fortnight, and the under-appreciated adult children, who come every few days but spend their time running endless errands.
And so on.

@EdithStourton you raise a point I've been musing about - do we all morph into selfish, demanding people as we age, leading to the difficult situations we're reading about here? I've seen grown adults saying they'll never make demands on their offspring like their own parents did to them... and then going on to do just that, makes me worried that I might do the same, despite my determination now, not to!

I think the problem is that people think moving to a care home will magically solve any issues. Someone cared for in bed in a care home doesn't have a much different experience that someone cared for in bed at home. There isn't someone sat by their bed keeping them company... They are on their own, in a room, with carers popping in and out to provide necessary care. The same as at home. Just at home it is likely to be more peaceful (no one in the next room crying out, no carers chatting outside their door at 3am, no alarms going off etc), they may be more likely to feel safe and happy. I am not saying this is in all scenarios, some people want to go into a care home and that's fine. What I'm saying is it should be a choice made by the person themselves so long as they have the mental capacity to do so.

I don't think my view is "disgusting". It also happens to correlate to the law! I happen to have visited people in care homes for my job who literally sit there all day crying. It is heartbreaking. (I have visited people in their own homes who do this too and who I think would be happier in care homes, but if I can't persuade them to go then I still support their choice. I have to.)

And no, there isn't a "risk" of death as you put it, death will definitely occur. And being in a care home won't change that.

Well, precisely. MIL's last years took a significant toll on DH and his siblings, and also caused a lot of friction between them.

Many people reach a state of mind where they lack clarity and manage to delude themselves into believing that 'I can still look after myself' when they can no longer cook a meal (can just about shake out a bag of salad and warm a slice of supermarket flan), change their bedding, arrange for someone to come and mend the fence, or do the shopping. They refuse to recognise that many things are being done by their adult children, while complaining about how the adult children do them ('Well, she weeded the flowerbed, but she didn't make a terribly good job of it, she was out there for two hours and I used to do it much less than that, it wasn't in that bad a state, she said there was terrible bindweed but I've never noticed it, when I looked out she was having a chat over the fence to Barry next door.' 'I think they were talking about finding a fencer.' 'Were they? She didnt say.')

I KNOW that I will mature into a bolshy old crone, and have told my DC not to stand for it. I don't want to put them through what I saw DH deal with and what I'm now seeing friends and relations deal with.

How is it selfish to not want to be put in a care home when care can be provided at home with no issue?

Disgusting to say that the very real risk of death or serious harm by the mother is "no issue". People have kindly explained the situation and you're pretending the issues aren't there.

This is such a naive and selfish perspective. The reality is that lots of families will move heaven and earth to help and support those that they love. It is extremely difficult to withdraw this support if you know that the consequences of this decision could lead to a much loved family member suffering terribly and potentially dying a horrible death.

This is why lots of us feel almost blackmailed into supporting situations and setups that we fundamentally think are completely inadequate, harmful and take a terrible toll on us because we fear the alternative of withdrawing care and highlighting the seriousness of the situation to the elderly person and outside services could lead to a terrible outcome for our loved ones.

I know you think SS are standing up for people's rights but sadly they also will allow people to deteriorate and suffer to an unbelievable and dangerous extent all in the name of autonomy and consent. This conveniently reduces costs and obligations for them and forces families to fill the gaps.

The sons are doing 2.5 / 5 he round trips once a fortnight- while working full time
imagine the impact on your life.
most tiring and unsustainable.
the mum cannot look after herself.
I would not impose myself on my adult children in this way
elderly parents can become stubborn and unrealistic (and very selfish) in their expectations of their adult children.
And in my experience these people weren’t particularly kind when they were younger either.

Unfortunately there are people dealing with elderly relatives who are at their wits end because they demand care from the family and not strangers.

Yes, you are right, it is not what many of us want for our children, but there are so many others who see it as their children's duty to look after them, without making proper legal arrangement (probably because they think it keeps them in control).

The whole business of elder care is a mess and successive governments have fobbed off dealing with it properly. As a society, we need adult conversations about how we deal with it and as individual families, we need to have the difficult conversations sooner rather than later.

If the family don't want to provide the support any more then they shouldn't.
It's not as easy at that.
Would that it was.

That's brilliant
My friends mum resisted for ages
Eventually had to go in and told the family off , for not moving her sooner (she made Loads of friends)