At home, no capacity and no deputyship - access to money

If the hospital let her go home it’s an unsafe discharge, she may end up back in hospital and it’s then called a failed discharge. This sort of thing happens a lot. You will need to step back, let the shit hit the fan (this is the hardest bit to do for you) and let SS take over. Safeguarding will be enforced and she will have to go into care because she cannot run her own house herself. Mental care acts come into play if she refuses a care home. It’s tough, really tough for all involved. But she is refusing help. She needs food and bills to be paid. A charge will be put on the house.
one last chance is to say to her plainly, when she is more lucid, you need more help than I can give, do you want SS to make all your decisions or do you want me to?? Her answer cannot be ‘nobody’, and if it is then report it back to SS. Please remember SS want you to take over as its one less person on their books! But from how you are explaining things, it may be the best option. Good luck

Thanks

We’re close to this stage with DM. I do empathise and am following with interest. I suspect things will have to fail catastrophically and an altogether ‘less than good’ set up will occur.

All of which could be avoided if DM was less obstreperous.

She’s setting herself up for a random from the LA to make decisions for her, rather than a family member.

Yep same here. Social worker has to step in. But again, if the relative refuses and is deemed as having capacity, then they will need to grant the GP permission.

This doesn't stop the carers, reporting their concerns directly with the GP, however. They just can't be involved in discussions with the GP. The GP can then pick this up with you or the social care team. Encourage the care team to email the GP and Social worker. The carers are unlikely to do this themselves so try and get hold of their manager.

Another problem I discovered yesterday: the GP surgery have me down as having permission to discuss my relative’s medical matters and make appts etc, because they (relative) signed a letter granting this two years ago.

The new carers tried to make an appt (to discuss the fact that he’s not consistently taking his medication, not allowing carers to monitor it) and we’re told they couldn’t, no permission.

I rang, I can’t grant permission as don’t have POA. Relative has to give permission, but will not unless we catch him on an extremely “good”/ confused day!

Have emailed social worker handing that problem to her.

Again, other patients must be in this kind of situation: what happens?

Indeed OP! But that's great news, I'm glad for you. Yeah I was surprised when my visitor told me this morning that the LA had appointees too - they expressly didn't tell me that!

Oh and have found out there is a charge for appointeeship, about £70-80 a month.

I was just coming here to post that provision of meals via shopping and preparing food can absolutely be part of the care package and that it will be added to the care bill. The adult social care team will do a financial assessment and likely recoup the costs.

Im sorry it took you so long to get that answer from your relative's social services. I hope all goes well for you and them and you get a solution that works for you all.

I "hearted" that post not for the huge difficulties described but for your dedication!

Main update which I felt I had to post here asap after meeting Age UK guy - his role / office (Appointeeship Coordinator) only exists in Northants, Coventry and Warks, sadly. However all local authorities have staff who can perform the appointeeship role, so ask social services about it if your relative is in another county.

Most Age UK charities do offer money management services though - eg taking someone to a cash point if they can't otherwise access cash, assisting with paying bills etc. But they can only help ie the individual has to clearly have capacity.

Sympathies.

I at least have PoA. And one that lets me act if I believe EPICF (elderly person i care for) to have lost capacity. Which I do for lots of things especially deciding whether or not they can still safely live at home.

However, they are fronting really well and confabulate amazingly. Other PoA and I had a big sit down chat about "the future" with them and it was most illuminating. Apparently I've done nothing over the last year as EPICF has done everything.

Especially the tasks I've struggled with eg. getting their falls alarm reconnected after digital voice knocked it out. The were able to describe in great detail how they had managed this. If I didn't know better I would completely have believed them. Except it was me who did it including complaining to the ombudsman!

It does partially explain why the professionals involved keep making what seem like mad decisions to us. And of course the other attorney (my Bro) thinks it's hilarious that I'm getting zero credit ... and if EPICF wasn't taking the credit themselves they were giving it to him.

When actually he will openly admit he has done fuck all except agree some big expenditures with me and give me the odd glass of whisky after a particularly fraught day.

I have arranged to meet with the Age UK Appointeeship Coordinator tomorrow (at my house, very accommodating guy!)

I will update here.

I need to ask things like, "How do we pay for essential repairs to my relative's roof, there won't be enough in the appointee account for that, but there will be in the other (presumably dormant) account, into which his workplace pensions will continue to be paid?"

And may be this is all the old woman wants, to live a bit her life

You are in that no man's land then until she is so ill they can't not step in, I am afraid. DM was exactly the same. There isn't a sensible shortcut.

Also, Social Services stepping in where you are now, is very different to when there is a crisis and an admission to a residential setting. Up until that point the person is free to choose. At the point of real crisis, social services can legally assess them as needing to be deprived of their liberties and to not return home. How long it takes to reach that point with your relative is anyone's guess.

Good luck.

Can you keep using the term SOVA - Safeguarding Of Vulnerable Adults - this is a SOVA situation? This means you or professionals can act without her consent, as I understand it. As a PP said, self neglect is a safeguarding issue.

But I understand these sort of situations are very nuanced and difficult, and professionals have to act within a) their rules and b) their budgets….

You can print off and attach any additional information you think the DWP needs, in addition to any hospital letters, prescription list etc. Not sure how effective it will be in your particular circumstances, but it's definitely worth a try!

DWP won't do anything in the circumstances you describe. But they may make a referral back to adult social care on your relative's behalf. It will send you round the houses again, but it all adds to the evidence based that they can't cope - meaning that eventually social services will have to step in.

If they are functional but with MH issues, has there been a formal diagnosis and is there a MH liaison nurse/crisis team in place? If so, I would be pushing there rather than GP. If not, then you need to keep badgering the GP for a referral and keep stating safeguarding concerns (neglect is a safeguarding issue by the way, as is self-neglect).

Early stage dementia and MH issues are often very similar, and pushing to go one route over another complicates getting the right help at the right time. We had that issue with DM. But they do exist as co-morbid conditions and a switched on GP or social care team should know this so don't lose sight of the pre-exusting conditions too.

Sounds like you have to let her fail. Let her go hungry. Until such time as she consents for someone else to help her??

Hopefully the specialist team will be of use for you tmrw.
We have a dx thank goodness.

Well that’s what I’ve just done, but not with the DWP yet. The Age UK Officer must be confident that the DWP won’t raise any objections. Am not sure whether they’ll even directly speak to my relative as there’s been a MCA for finances

(He doesn’t know why he has two carers, mind you!)

Report safeguarding concerns (for her or by her) to social services.

My relative has ended up with two carers for every visit because of his occasional aggression. I thought that would make him more liable to get angry but he seems to have accepted it at the moment.

Ring your local (or any?) Age UK Appointeeship Officer and ask them OP. They have a national helpline (and online advice too). They know about this stuff, in detail.
I think the DWP may be more canny about this than you’re imagining.