Dementia / LPA / consent to operation

[Spanglylycra]

Hi there

Posting for traffic hoping someone else may have similar experience - also posted on dementia boards but they are quite quiet.

Pls help if you can....

My nan has dementia and breast cancer.

My mum has an old style EPA but not a new LPA (I think that's the right way around).

My nan urgently needs a breast removed she has had a slow growing cancer which all of a sudden has broken through and is weeping.

The surgeon says he cannot operate without my Nan's consent or an LPA. An LPA could take 3 months which to be honest I don't imagine she will have.

I have read that doctors can make a decision in the best interest of the patient if patient lacks capacity. Does anyone have any knowledge of this?

Parents are seeing a solicitor and I have also advised them email PALs and members of the trust board for urgent official stance.

Has anyone had similar situation where urgent medical attention needed and no LPA? Please only be constructive no bashing for lack of LPA as that's not helpful

Thanks

Oh dear, your poor nan. The old EPA only covers finances. As far as I know no one can consent to another person's surgery, I have known doctors consent on the patients behalf in emergency situations, if I remember it's called a Consent Form 4. I will look at the poa website and Google who can consent to medical treatment.

It sounds as if your nan would not have the capacity to consent to a LPA, I doubt a solicitor would allow it to be done. You can apply to a court for authority but this is a lengthy & expensive process.
Could you go back to the surgeon & ask them to proceed in your Nan's best interest?

I am not legally trained in anyway so please do double check the above

I've googled consent form 4 which is a Consent Form for doctors to act in best interests and they have to follow strict guidelines. If you look up the gov.uk power of attorney website there is info on their about gaining consent for someone who lacks capacity.

If you go on the NHS website 'Consent to medical treatment', it says that medical staff can go ahead with treatment where there the patient has no capacity to consent and no LPA in place.

www.nhs.uk/conditions/consent-to-treatment/

Thanks re consent form 4.

I have seen the NHS consent page it does contradict itself slightly re mental conditions though.

Has your nan been assessed for mental capacity by the doctor, that's the first thing to confirm.

She is certainly not competent. She is diagnosed dementia. I don't know every in and out but I don't think anyone would think she was competent. I understand you can make emergency applications to court of protection but that it can cost ££££s and can be thrown out if you don't meet stringent criteria. Basically am trying to establish if the doctor is being unhelpful or correct.

They have been saying for months she doesn't need any treatment re the breast and now this!

Think the doctor is being correct, however he or you could approach the hospitals legal dept and ask for treatment to go ahead in her best interest.

Does sound a very difficult situation, which no one is picking up and running with. Time to start standing up and shouting OP.

It sounds very frustrating but whatever decision is taken or whoever you talk to she will need to have had a formal capacity assessment carried out first, you can find a lot of information about this under the mental capacity act. You can download the Consent Form 4 to read, it goes through each stage of the process, this gives a doctor the ability to sign on behalf of the patient if it's in their best interest to have the treatment.

Recommend asking the dr for a copy of her mental capacity assessment for consent to treatment.
If you feel that there is a possibility that she doesn’t understand the decision around treatment well enough the hospital need to apply to the court of protection for a ruling around capacity for treatment
That’s my understanding of it.