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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

Power of attorney and weight issues

31 replies

Hellostrawberries · 24/09/2023 18:29

I just got involved in a big heated debate. I'm pretty certain I'm right but no one agreed with me which drove me mad as a person's bodily autonomy was at stake. Sorry it's a long one.

My parents live in a retirement block. All residents have their own flat and there are carers for people who need it. There's a restaurant on site. One woman who lives there, will call her Sally, is 75 and great fun. She's sociable and chatty and has a great sense of humour. She has dementia and tends to hold onto information for around 10 minutes. So if you make a reference to an earlier conversation she'll have forgotten it. She has a daughter who lives abroad and visits a couple of times a year. The daughter has power of attorney.

Now Sally, like lots of us, likes her food. She's overweight but not excessively so and has no weight related health problems. From looking at her I'd say she was a size 16 or 18. Apparently her daughter came to visit last week and was shocked at how much weight her mother had put on. So she spoke to all the staff and literally demanded that she be put on an enforced diet, so she mustn't be served any desserts, biscuits or cake.

To clarify, this is not a care home. Sally has her own money and a bank account. A carer takes her shopping and Sally eats her meals either from the food in her flat, which a carer helps her to prepare. Or she orders and pays for a meal in the on site restaurant. Biscuits are offered free of charge twice a week at a coffee morning. Sally's daughter has said that her mother must be told she's not allowed to take one! She's also spoken to the restaurant staff and said that her mum can't order desserts.

It's irritated the hell out of me seeing someone treated like this. Because she has dementia and her daughter has LPA, everyone's acting like there's no choice but to comply with the demands. But being a bit fat isn't a situation where power of attorney kicks in. This is literally one adult, having a preference for another adult losing weight. And so instructing everyone around them to withhold food. And that isn't a thing.

OP posts:

LockdownLisa · 24/09/2023 18:32

I'm no legal expert but I find it hard to believe that somebody with LPA can request this and it has to be enforced! If I was the home manager, I'd refuse the request unless it was court ordered.

Frozenone · 24/09/2023 18:33

LockdownLisa · 24/09/2023 18:32

I'm no legal expert but I find it hard to believe that somebody with LPA can request this and it has to be enforced! If I was the home manager, I'd refuse the request unless it was court ordered.

This

Doggymummar · 24/09/2023 18:33

It's a tough one, do you know Sally's medical history? She might have diabetes or other illnesses that would benefit from reduced sugar. I have heard that dementia reacts to sugar in the diet too. Or her daughter might just want her to live a long time and be safeguarding her weight.

User183642 · 24/09/2023 18:33

If she can still retain information for 10 minutes or so I wouldn’t have thought she would have reached the stage where power of attorney could be invoked for such minor issues. Whilst it wouldn’t be unreasonable to ask the staff to remind her that she had already eaten if she requested multiple meals or snacks in a short time period a complete ban on desserts and snacks is both taking too things and also likely to be unhelpful in the long run.

helpfulperson · 24/09/2023 18:35

Not 100% sure about elsewhere but in Scotland capacity is decision specific so someone might not have capacity to decide where to live but still have capacity to decide if they want another biscuit. I suspected that staff may well have made polite noises when told this and will continue to allow this lady to eat what she wants.

AngryAndAnxious · 24/09/2023 18:35

I can’t believe nobody told the daughter that Sally has the right to choose to eat whatever the hell she likes.

GOODCAT · 24/09/2023 18:37

You can only use a health and welfare power of attorney when someone is incapable of making the particular decision at the particular time. From what you have said, she may have dementia, but she can still decide whether or not to eat something, so the power of attorney doesn't kick in.

slobro · 24/09/2023 18:37

She's 75! If you can't enjoy a few biscuits then when bloody can you?

User183642 · 24/09/2023 18:38

Doggymummar · 24/09/2023 18:33

Edited

Let’s face it for a majority of people living with dementia living for a long time is not in their best interests. Whilst it is entirely possible to live a fulfilling life in the early and mid stages nobody wants to spend a prolonged period living with no idea who anybody is and being incapable of doing the most basic of everyday tasks.

Hellocatshome · 24/09/2023 18:42

I doubt any of the staff will actually stick to these rules once the daughter has left.

starrynight21 · 24/09/2023 18:42

I'm on Sally's side ! You can only invoke LPA to make decisions about such things as giving permission for the person to have necessary surgery or other medical procedures. You can't use it to put the person on a diet !

nc14 · 24/09/2023 18:45

A relative I have an LPA for (who also has dementia) has put on a lot of weight in her nursing home. She was very thin before, and always loved her food (biscuits, chocolates, etc) but deprived herself as she was so self conscious about her weight. I’m really happy she’s now able to enjoy those things without worry… so YANBU.

MatildaTheCat · 24/09/2023 18:52

Completely unreasonable to ask this of the staff in a retirement block.

If Sally was in a care home and deemed unfit to make her own decisions then the staff would have to apply for a Deprivation of Liberty order to make decisions for her and stop her wandering off. The LPOA would also be invoked so the appointee could make medical and financial decisions. That might include food restrictions if she was very overweight or diabetic etc.

In this situation Sally is safe and can continue to have her treats. Actually in early dementia a very sweet tooth is quite common and can wear off.

Original poster

Hellostrawberries · 24/09/2023 18:53

Doggymummar · 24/09/2023 18:33

Edited

I know for a fact that she doesn't have diabetes. Of course the daughter is thinking about her mother's health to a certain extent. And of course everyone would benefit from eating less cake and having a normal bmi. But this isn't a situation in which LPA is relevant and so Sally has the same rights as anyone else. If my husband told me I wasn't allowed to eat biscuits my family would tell me to leave him. Sally deserves the same advocacy.

OP posts:

AngelinaFibres · 24/09/2023 18:58

I think once you have dementia it's a downhill run.There is no point enforcing a 'healthy ' diet. She's 75 for goodness sake.Quality of life far outweighs quantity.
I read somewhere that dementia is like a big glass bowl of fairy lights where the lights gradually go out one at a time. Denying her treats won't change this.

Syndulla · 24/09/2023 19:01

In England capacity is also decision specific. So just because someone has dementia does not mean that they are incapable of choosing their own snacks.

I'm amazed the carers are agreeing to this. It says to me that there is either information you are not privy to, or there is a training need, quite a significant one!

Either way, I would recommend you contact your local adult safeguarding board (council adult social services) and report your concerns.

AnnaMagnani · 24/09/2023 19:01

I'd be surprised if Sally doesn't have capacity to decide what she likes to eat.

Her daughter might also like to consider that weight loss isn't recommended in the frail elderly, and as Sally's dementia deteriorates she will need more and more support with eating so having gained weight and preferring high calorie foods is in her best interests.

Princessdebthe1st · 24/09/2023 19:45

I have an LPA for my mum and in my professional role I need quite in depth knowledge of this. Under capacity law (mental capacity act) in England each assessment about capacity is decision specific (I.e not being able to decide where to live does not mean you can't decide what to eat), decisions made on behalf of those unable to make a decision themselves should be made in their best interest (this is NOT the same as what you think they should do) and should be the least restrictive decision possible. Based on what you have posted it doesn't sound as if those principles are being adhered to. As a PP stated I would refer to the adult safeguarding team so they can look into it. If all those principles are being adhered to then all well and good. If not the daughter and staff may need some support to better understand best interest decision making.

Andylippy1 · 24/09/2023 19:49

I used to work with the legislation in this area. Sounds like Sally probably does have capacity on her diet and what foods she likes to eat. This is Sally's decision and not her daughter's unless Sally is assessed as not having capacity to decide on her diet and health.

I would advise contacting adult social care and asking for an allocated social worker to undertake a capacity assessment on Sally with the decision being regarding her diet (health). Sally is being deprived of her human rights to choose what she wants to eat and this is unlawful if she has the capacity to decide on her diet. The LPA would only apply if Sally doesn't have capacity to decide on her diet.

Andylippy1 · 24/09/2023 19:52

Just to also mention this matter of diet and capacity does come up with older adults quite often. Even if someone has dementia they may still have the capacity to decide on a decision.

Original poster

Hellostrawberries · 24/09/2023 19:54

Some really good advice here from people with experience in this area, thank you. I really hope that as soon as the daughter goes back, the staff will forget all about it and not impose any restrictions. If not I definitely will raise these points and escalate it if needed.

OP posts:

LakeTiticaca · 24/09/2023 20:07

It's an outrageous assault on personal freedoms IMHO. The poor women's got dementia ffs. She should be able to enjoy the time she has left.
When I did home care I looked after a lady in her 80s, no dementia but poor eyesight. He daughter decreed that she couldn't have pasties and cream cakes. The lady used to send me out to the bakery once a week and I used to take the empty bags away in case the daughter rummaged through the bins 😉😉

Branleuse · 24/09/2023 20:15

They can't. Even if a person has deputyship or LPA, it's an abuse of power to not allow someone to make decisions that they have capacity to make. If that woman can clearly say what she wants to eat, then she has capacity to make that decision

user1471453601 · 24/09/2023 20:23

I'm very pleased to hear, from those with specific knowledge, that capacity is decision dependant.

Eating food is/can be one of the few pleasures of old age. I'm 72 and was diet conscious most of my life. At age 68 or so, I decided "fuck it, I'm going to eat exactly what I want". And I do. I still try to get my five a day (Though usually fail) so I take a multi vitamin.

But honestly, what does it matter? I'm old, I'm frail my body has taken so very many traumas, and that lady's body and mind is taking more. Buy her cream cakes and tell her sanctimonious daughter to bugger off.

I spent too many years with my Mum who was refusing to eat in her last years, to have any patience with those who think they can/should restrict someone's diet because they are old. A size 10 75 year old with dementia is only different from the same, but size 16 in that the size 16 one has the pleasure o good they want.

2jacqi · 24/09/2023 20:34

is the lady in question actually a big lady? can she carry the extra weight? Daughter does not appear to have poa over finance so lady can buy what she wants, also to remember that layer of fat will keep her warmer in winter

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